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All Journal Jurnal Anestesiologi Indonesia Bali Journal of Anesthesiology Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Majalah Anestesia & Critical Care (MACC)
Auerkari, Aino Nindya
Departemen Anestesiologi Dan Terapi Intensif, Fakultas Kedokteran Universitas Indonesia-RS Cipto Mangunkusumo
Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Public Health Other

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Estimation of surgical blood loss and transfusion requirements in orthopaedic soft tissue tumor surgery: associated factors Auerkari, Aino Nindya; Tantri, Aida Rosita; Alatas, Anas
Bali Journal of Anesthesiology Vol 3, No 2 (2019)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (306.902 KB) | DOI: 10.15562/bjoa.v3i2.156

Abstract

Over half of soft tissue tumor surgeries require intraoperative Packed Red Cell (PRC) transfusion. Transfusion should be sufficient, as inadequacy will increase risk of tissue ischemia, morbidity and mortality. On the other hand, liberal transfusion is related to infection, tumor recurrence, and immunosuppression. Therefore, good PRC planning measures in preoperative period are essential. Several factors that can be identified in the preoperative period, have been associated with surgical bleeding and transfusion in soft tissue tumor surgery. These factors are ASA score, preoperative hemoglobin (Hb) value, malignancy, size, and location of tumor. By acknowledging influencing factors, a system for predicting blood requirement can be established to promote patient safety and avoid waste. This study aimed to determine factors associated with surgical blood loss and intraoperative PRC transfusion.A retrospective cohort was analyzed on 84 records of orthopaedic soft tissue tumor surgery during 2014-2018. In all subjects, the aforementioned factors, amount of intraoperative bleeding and intraoperative PRC transfusion was recorded. Data was analyzed by linear regression to see the relationship of factors to the amount of bleeding and by logistic regression to assess the probability of receiving intraoperative PRC transfusions. A multivariate analysis identified tumor size as an independent determining factor of bleeding. In further analysis, it was found that tumor size and preoperative Hb value were predictors of the probability of requiring intraoperative PRC transfusion. 
MANAJEMEN ANESTESIA PADA SINDROM HUNTER Aino Nindya Auerkari; Andi Ade Wijaya Ramlan
Majalah Kedokteran Indonesia Vol 69 No 10 (2019): Journal of the Indonesian Medical Association Majalah Kedokteran Indonesia Volu
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.1234/jinma.v69i10.182

Abstract

Pendahuluan: Sindrom Hunter adalah kumpulan kelainan metabolik bawaan akibat defisiensi enzim lisosom. Pada kelainan ini, terjadi gangguan pemecahan glikosaminoglikans, suatu jenis mukopolisakarida. Karena tidak dipecah secara sempurna, terdapat penumpukan glikosaminoglikans di jaringan, yang mengganggu fungsi organ dan menimbulkan gejala. Penumpukan glikosaminoglikans progresif di jaringan menyebabkan pengidap sindrom Hunter akan dihadapkan pada operasi berkali-kali dalam hidupnya. Anestesiologis diharapkan dapat mempersiapkan pemeriksaan praoperasi, mengelola intraoperasi, dan merawat pascaoperasi pasien ini dengan baik. Deposit substrat, terutama di jalan napas, dapat menjadi penyulit anestesia. Kami menjabarkan pengalaman manajemen jalan napas sulit pada pasien Sindrom Hunter yang telah menjalani terapi sulih enzim. Kesulitan utama pada pasien adalah leher pendek dan keterbatasan gerak sendi. Selain jalan napas, tumpukan glikosaminoglikans di berbagai organ seperti sendi, tulang belakang, dan jantung juga menjadi perhatian khusus dalam manajemen anestesia. Metabolisme obat-obat anestesia juga dapat berbeda jika dibandingkan populasi normal. Karena merupakan penyakit jarang, penyandang sindrom Hunter sebaiknya menjalani pembiusan oleh anestesiologis yang sudah berpengalaman, di pusat kesehatan yang berpengalaman menangani sindrom Hunter.
Faktor Prediktor Nyeri Pascabedah Sedang dan Berat di RSUPN Dr. Cipto Mangunkusumo Mahdi Nugroho, Alfan; Auerkari, Aino Nindya; Roza, Rizky Loviana
Majalah Anestesia & Critical Care Vol 44 No 1 (2026): Februari
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif (PERDATIN) / The Indonesian Society of Anesthesiology and Intensive Care (INSAIC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55497/majanestcricar.v44i1.494

Abstract

Pendahuluan: Prevalensi nyeri pascabedah di RSUPN Dr. Cipto Mangunkusumo tahun 2017 menunjukkan intensitas nyeri sedang (57,4%) dan nyeri berat (20,4%). Penelitian ini bertujuan untuk menentukan faktor prediktor nyeri pascabedah sedang dan berat, menganalisis hubungan, dan mengembangkan model prediksi nyeri pascabedah sedang dan berat. Metode: Penelitian ini menggunakan desain kohort prospektif pada 135 pasien yang menjalani pembedahan di RSUPN Dr. Cipto Mangunkusumo yang memenuhi kriteria inklusi. Setiap faktor prediktor dianalisis menggunakan analisis bivariat dan dilanjutkan dengan analisis multivariat menggunakan regresi logistik. Sistem skor prediksi dirangkum dari hasil analisis multivariat. Hasil: Risiko kejadian (RR) untuk setiap faktor prediktor yang diidentifikasi berdasarkan analisis bivariat yaitu tingkat kecemasan prabedah (RR: 3,32, 95% CI: 1,28 – 8,56), durasi pembedahan lebih dari 90 menit (RR: 7,23, 95% CI: 1,85 – 28,29), jenis pembedahan mayor (RR: 2,69, 95% CI: 1,58 – 4,57), konsumsi opioid intraoperatif (RR: 2,67, 95% CI: 1,68 – 4,25), dan jenis anestesi (RR: 2,37, 95% CI: 1,06 – 5,33). Analisis multivariat menunjukkan bahwa prediktor signifikan untuk nyeri pascabedah sedang hingga berat adalah tingkat kecemasan prabedah (p = 0,085, RR: 2,23, 95% CI: 0,87 – 5,54), durasi pembedahan (p = 0,056, RR: 3,92, 95% CI: 0,96 – 15,96), jenis pembedahan mayor (p = 0,061, RR: 1,63, 95% CI: 0,97 – 2,72), dan konsumsi opioid intraoperatif (p = 0,011, RR: 1,78, 95% CI: 1,14 – 2,78). Simpulan: Faktor prediktor nyeri pascabedah pada penelitian ini adalah tingkat kecemasan prabedah, jenis pembedahan, durasi pembedahan, dan konsumsi opioid intraoperatif. Persamaan regresi disusun berdasarkan empat faktor prediktor tersebut.
Rapid Response Systems as Secondary Responders to In-Hospital Clinical Deterioration: A Four-Year Observational Study Manggala, Sidharta Kusuma; Ramlan, Andi Ade Wijaya; Aditianingsih, Dita; Firdaus, Riyadh; Cahyadi, Arief; Auerkari, Aino Nindya; Hafidz, Noor; Parasian, Luther Holan; Sugiarto, Adhrie; Devina, Yoan; Mujono, Aivi; Cresma, Avisa Cetta
JAI (Jurnal Anestesiologi Indonesia) Vol 18, No 1 (2026): JAI (Jurnal Anestesiologi Indonesia)
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.80762

Abstract

Background: In-hospital cardiac arrest (IHCA) is a major cause of preventable inpatient mortality, especially in low- and middle-income countries (LMICs) where rapid response systems (RRS) are still developing. Evidence regarding RRS performance in Indonesia is limited. This study evaluated the performance and operational challenges of an institutional RRS over four years at a large tertiary referral hospital in Jakarta.Objective: This study aimed to determine the proportion of immediate survival following RRS activation and to investigate secondary outcomes, including the association between activation indications and mortality, and system-level barriers.Methods: This retrospective observational cohort study included all inpatient RRS activations at Cipto Mangunkusumo National General Hospital (RSCM), Jakarta, Indonesia, from January 1, 2021, to December 31, 2024. Data from the hospital’s RRS registry were analyzed for activation triggers, interventions, immediate outcomes, and operational issues.Results: Among 246,367 inpatient admissions, there were 5,900 eligible inpatient RRS activations, yielding an activation rate of 23.9 per 1,000 admissions. Immediate survival occurred in 4,763 (80.7%) events, while 1,137 (19.3%) patients did not survive. Cardiac arrest (8.0%) and respiratory arrest (6.5%) were the strongest predictors of non-survival odds ratio (OR) 48.17 and 27.13 vs. red early warning score (EWS) reference, both p<0.001). Most activations occurred out of hours (63.0%), and mortality was significantly higher (71.3% vs. 61.1%; p < 0.001). The most frequent single-parameter triggers were oxygen saturation ≤90% (38.5%) and sudden deterioration of consciousness (15.8%). Mismatched activations, where the patient’s condition upon team arrival differed from the activation indicationwere strongly associated with higher mortality (OR 17.3, 95% confidence interval (CI) 14.3–20.2, p<0.001).Conclusion: The institutional RRS demonstrated a moderate activation rate and favorable immediate survival compared with similar LMIC settings. However, outcomes were influenced by delayed recognition, out-of-hours activation, and limited critical-care capacity. Strengthening early-escalation culture, monitoring afferent-limb failure (ALF), expanding nighttime coverage, and increasing intensive care unit (ICU) capacity are essential to enhance RRS effectiveness and reduce preventable in-hospital mortality in resource-limited settings.
Co-Authors Alatas, Anas Andi Ade Wijaya Ramlan Arief Cahyadi Cresma, Avisa Cetta Devina, Yoan Dita Aditianingsih Firdaus, Riyadh Hafidz, Noor Manggala, Sidharta Kusuma Mujono, Aivi Nugroho, Alfan Mahdi Parasian, Luther Holan Ramlan, Andi Ade Wijaya Rizky Loviana Roza Sugiarto, Adhrie Tantri, Aida Rosita