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All Journal Bali Journal of Anesthesiology Majalah Anestesia & Critical Care (MACC)
Alatas, Anas
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Health Professions Medicine & Pharmacology 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. 
Blok Subarahnoid Dosis Rendah dan Epidural pada Pasien Hamil dengan Gagal Jantung dan Komorbid Lain yang Menjalani Seksio Sesarea: Sebuah Laporan Kasus Soenarto, Ratna Farida; Alexandra, Arky Kurniati; Ramlan, Andi Ade Wijaya; Alatas, Anas
Majalah Anestesia & Critical Care Vol 40 No 1 (2022): 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 | Full PDF (634.716 KB) | DOI: 10.55497/majanestcricar.v40i1.238

Abstract

Latar Belakang: Penyakit kardiovaskuler merupakan penyebab signifikan pada mortalitas ibu di negara-negara berkembang. Komorbid yang mempengaruhi ini mencakupi obesitas, hipertensi dan kehamilan tua yang memperberat kinerja jantung sehingga dapat mengakibatkan gagal jantung. Ini menjadi tantangan untuk tatalaksana anestesi dengan tujuan utama mencegah luaran buruk kepada ibu dan neonatusnya. Ilustrasi Kasus: Pada kasus ini kami melaporkan wanita, 28 tahun, G4P3A1 hamil 28 minggu, ASA 3 dengan gagal jantung kongestif, superimposed pereklampsia, serta obesitas morbid. Pasien direncanakan untuk seksio sesarea dengan kombinasi anestesi menggunakan penggunaan blok subarahnoid dosis rendah dan epidural (Combined Spinal Epidural Anesthesia/CSE), serta pertimbangan tatalaksana anestesi pada ibu hamil dengan gagal jantung atau komorbid lainnya. Simpulan: Anestesi dengan blok subarakhnoid dosis rendah memiliki efek yang minimal terhadap hemodinamik, dan dapat digunakan pada selektif pasien yang mengalami gagal jantung dan komorbid lainnya.
Co-Authors Alexandra, Arky Kurniati Auerkari, Aino Nindya Ramlan, Andi Ade Wijaya Ratna Farida Soenarto Tantri, Aida Rosita