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All Journal Jurnal Komplikasi Anestesi
Muhammad Imam Mulia
Faculty of Medicine Universitas Indonesia Jakarta
Medicine & Pharmacology

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When “Adequate” MAP Is Not Enough: Underresuscitation as a Driver of Multiple Organ Dysfunction Syndrome in Polytrauma Vizzi Alvi Fitrah Nasution; Muhammad Imam Mulia; Muhammad Azhari Taufik
Jurnal Komplikasi Anestesi Vol 13 No 3 (2026)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v13i3.14669

Abstract

Case: Male, 68 years old, with a history of coronary heart disease and stroke, had shock due to kidney trauma, tension pneumothorax, hemothorax, multiple rib fractures, complete left radius fracture, and right frontal laceration following a traffic accident while driving a car. The patient underwent fluid resuscitation, placed water seal drainage (WSD), and administered dobutamine and norepinephrine via central access in the emergency department. The patient was then transferred to the high care unit (HCU). After 31 hours of treatment, the patient experienced multiple organ dysfunction syndrome (MODS), then treated in the intensive care unit (ICU) on mechanical ventilation. During treatment in the ICU, the patient underwent continuous renal replacement therapy (CRRT) for 48 hours. There were clinical improvements during CRRT, but his condition deteriorated after CRRT terminated. He died on the fifth day. Discussion: Trauma is the main preventable cause of morbidity and mortality in adults. Sepsis can increase the risk of mortality in trauma cases. Insufficient identification of shock etiology and lack of follow-up in this patient led to suboptimal resuscitation up to MODS and death. Mechanical ventilation should be performed during initial resuscitation to reduce oxygen consumption.
Co-Authors Muhammad Azhari Taufik Vizzi Alvi Fitrah Nasution