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All Journal Jurnal Anestesiologi Indonesia Sumatera Medical Journal Majalah Anestesia & Critical Care (MACC) The Journal of Society Medicine (JSOCMED)

Wijaya, Dadik Wahyu

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Author-ID : 1324609

Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Perioperative Nutritional Status of Digestive Surgery Laparotomy Surgery Iqbal, Aulia; Wijaya, Dadik Wahyu; Lubis, Bastian
Journal of Society Medicine Vol. 1 No. 3 (2022): December
Publisher : CoinReads Media Prima

Introduction: Laparotomy is one of the most frequently performed surgical procedures. Surgery causes a stress response that increases the risk of experiencing malnutrition, especially in patients undergoing laparotomy. Malnutrition can increase the risk of adverse outcomes in postoperative patients. This study aims to evaluate perioperative nutritional status in patients who will undergo laparotomy surgery at Haji Adam Malik General Hospital Method:This research is an observational study with a prospective design. This study involved 65 research subjects withthe sampling technique was carried out by non-probability sampling, namely consecutive sampling. Results:The majority of study subjects had BMI ≥18.5, without weight loss >3.6 kg in the last 6 months, without a history of food intake <50% portion in the last 1 week, and albumin value ≥3.0 pre- and post- operative. Postoperatively. The number of subjects with PONS value ≥1 changed from 33.85% before surgery to 52.31% after surgery. There was a significant change in PONS values before and after laparotomy (p = 0.001). Conclusion:Statuspost-operative nutritional study subjects decreased compared to before surgery. A significant increase in PONS scores also occurred after laparotomy.

Patterns of Antibiotic Use in The One Hour Bundle Treatment of Sepsis Syaputra, Adhika; Wijaya, Dadik Wahyu; Hanafie, Achsanuddin
Journal of Society Medicine Vol. 1 No. 3 (2022): December
Publisher : CoinReads Media Prima

Introduction: Sepsis and septic shock are major health problems, affecting millions of people worldwide and a leading cause of death. Administration of broad-spectrum empiric antibiotics as a one hour sepsis bundle treatment is associated with antimicrobial resistance which has various adverse effects and reduces the quality of health services. The aim of this research was to determine the pattern of empiric antibiotic use in the management of one hour bundle of sepsis at Haji Adam Malik General Hospital Medan. Method: This study used a descriptive method from November 2022 to December 2022 in the Emergency Room (ER), Medical Inpatient Room, Surgical Inpatient Room, and Adult Intensive Care Unit (ICU) of Haji Adam Malik General Hospital Medan. This study used a consecutive sampling technique to recruit 42 sepsis patients who were given a one hour bundle of sepsis according to the inclusion and exclusion criteria. This descriptive analysis was used to determine the characteristics of the sample, namely age, sex, culture results, and antibiotic sensitivity test results. Results: The most common use of antibiotics in the one hour bundle sepsis strategy was ceftriaxone 1 gram in 20 patients (47.6%), Ampicillin-Sulbactam 1.5 grams in 10 patients (23.8%), Levofloxacin 750 mg in 6 patients (14.3%), Meropenem 1 gram in 4 patients (9.5%), and Ciprofloxacin 200 mg in 2 patients (4.8%). Conclusion: Antibiotic administration time is less than 1 hour in the one hour bundle strategy carried out in the ER. Most of the antibiotics given are in accordance with the antibiotic sensitivity test results, but there are still some patients who still experience resistance to the antibiotics.given so it is important to always or immediately carry out culture and sensitivity tests on patients so that the antibiotics given can be more optimal

The Relationship Between The Characteristics of COVID-19 Patients To Predict Mortality in The COVID-19 ICU Special Care Taufik, Maulana; Wijaya, Dadik Wahyu; Lubis, Andriamuri Primaputra
Journal of Society Medicine Vol. 1 No. 1 (2022): October
Publisher : CoinReads Media Prima

Introduction: The SARS-CoV-2 epidemic is sweeping the world with several waves of infections continuing. In some COVID-19 patients, this condition can develop into ARDS (acute respiratory distress syndrome) which requires ICU care with a mortality rate of 50-65 and the need for mechanical ventilation reaches 97%. The aim of this research was to know characteristics of COVID-19 patients to predict mortality in the Negative Pressure Isolation Room COVID 19 ICU at H. Adam Malik General Hospital Method: Retrospective research method with secondary data sources of COVID-19 Negative Pressure Isolation Room ICU (RITN) patients at RSUP H. Adam Malik Medan for the period May 2021 – July 2021.The data collected was in the form of patient data including name, gender, age, medical record number, comorbidities, NLR, D-Dimer, Fibrinogen, PF ratio, use of oxygen supplementation, and length of ICU stay. Chi Square statistical analysis was used for categorical data, while the T-test or Mann Whitney was used for numerical data. Then between the variables an ANOVA test was carried out to assess the comparison of clinical characteristics with mortality. Results: The results of this study indicate a higher mortality rate in women41 people (57.7%), 56-65 years age group 26 people (36.6%), patients using ventilators 51 people (71.8%), comorbid hypertension 33 people (46.5%) ), Moderate PF Ratio were 44 people (62%) and Length of stay <10 days were 55 people (77.5%). The mean fibrinogen value in COVID-19 patients who died was 658.96 ± 674.98, as well as the D-dimer value of 658.96 ± 674.98 and NLR of 11.06 ± 3.23 which showed a significant increase compared to patients Survivors of COVID-19 (p<0.05). Conclusion: A significant relationship was found between gender, age, breathing apparatus, D-dimer, Fibrinogen, NLR and length of stay with mortality of COVID-19 patients treated in the COVID Negative Pressure Room (RITN) ICU

Perbandingan Efektivitas Phenylephrine sebagai Pencegahan Spinal Anesthesia-Induced Hypotension pada Pasien Seksio Sesarea Thibri, Muhibbut; Wijaya, Dadik Wahyu; Bisono, Luwih
Majalah Anestesia & Critical Care Vol 43 No 2 (2025): Juni
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.v43i2.407

Latar Belakang: Spinal anesthesia-induced hypotension (SAIH) adalah respons fisiologis selama seksio sesarea dengan anestesi spinal berkontribusi terhadap mual, muntah, pusing, dan bahkan kolaps kardiovaskular pada ibu. Phenylephrine adalah agonis-reseptor-α-adrenergik telah dikaitkan pencegahan hipotensi maternal dan variabilitas tekanan darah. Dengan dosis yang tepat dapat mengurangi resiko hipotensi dan mempertahankan aliran uteroplasenta sehingga mengurangi resiko efek samping hipotensi pada ibu dan neonatal.Metode: Penelitian ini menggunakan desain randomized clinical trial dengan double blind. Sampel dibagi berdasarkan dosis phenylephrine: kelompok 1 (50μg), kelompok 2 (75μg), dan kelompok 3 (100μg). Data akan dianalisis uji Annova atau uji Kruskal Wallis. Kemudian dilakukan uji post hoc untuk melihat perbedaan antar kelompok.Hasil: Terdapat 47 sampel dengan distribusi 16 sampel kelompok 1, 16 sampel kelompok 2, dan 15 sampel kelompok 3. Pada analisis variabel usia, tinggi badan, berat badan, dan IMT diketahui tidak ada perbedaan yang signifikan secara statistik antar kelompok perlakuan (p=0,950, p=0,468, p=0,763, dan p=0,647). Didapati bahwa data tekanan darah sistolik dan diastolik memiliki perbedaan yang signifikan pada pengukuran T1 (p=0,020 dan p=0,004) dan T2 (p=0,018 dan p=0,046). Didapati bahwa data MAP memiliki perbedaan yang signifikan pada pengukuran T1 (p=0,004), T2 (p=0,046), dan T6 (0,035). Didapati bahwa data nadi pada pengukuran T5 (p=0,017) memiliki perbedaan yang signifikan.Simpulan: Dalam penelitian ini ditemukan dosis phenylephrine yang paling efektif dalam mencegah kejadian SAIH secara klinis adalah dosis 75 μg, 50 μg, dan 100 μg.

Comparison of The Efficacy of Intravenous Norepinephrine and Phenylephrine as Vasopressor Agents in The Management of Septic Shock in ICU Patients at Haji Adam Malik General Hospital Using Lactate and Stroke Volume Variation Indicators Attamimi, Fandy Faidhul; Wijaya, Dadik Wahyu; Tanjung, Qadri Fauzi; Amelia, Rina
JAI (Jurnal Anestesiologi Indonesia) Publication In-Press
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.67835

Background: Septic shock is a life-threatening complication of sepsis, characterized by refractory hypotension and tissue hypoperfusion, requiring rapid vasopressor therapy. Norepinephrine is the drug of choice, but phenylephrine is still used in certain conditions, such as tachyarrhythmia or high output. Evidence comparing the effectiveness of the two is still limited, especially in Indonesian ICUs. Therefore, this study assessed the efficacy of norepinephrine and phenylephrine using lactate clearance and stroke volume variation (SVV) as indicators of perfusion and hemodynamic response in the intensive care unit (ICU) of Adam Malik General Hospital, Medan.Methods: This study was a prospective, double-blind, randomized controlled clinical trial conducted in the ICU of Adam Malik General Hospital, Medan, involving 32 adult patients (aged 18–65 years) with septic shock, as defined by the Sepsis-3 criteria. Patients were randomly assigned to two groups receiving norepinephrine infusion (n = 16) or phenylephrine infusion (n = 16) as the primary vasopressor. Lactate levels and SVV were measured at baseline (T0) and 6 hours after therapy (T1). The primary outcome was the change in lactate and SVV, with analysis using paired and independent t-tests at a significance level of p < 0.05.Results: 32 patients were divided into two groups, each with 16 patients receiving norepinephrine or phenylephrine. After 6 hours of therapy, norepinephrine reduced lactate levels from 8.41±1.88 to 5.76±1.99 mmol/L and SVV from 14.25±2.17 to 8.18±1.90 mmHg (p<0.001). Phenylephrine also reduced lactate from 7.40±1.77 to 6.70±1.77 mmol/L and SVV from 15.93±2.56 to 12.50±2.63 mmHg (p<0.001).Conclusions: Intravenous norepinephrine is more effective than phenylephrine in lowering lactate and improving SVV in septic shock patients in the ICU, thus supporting its use as the primary vasopressor. Phenylephrine remains an alternative with close hemodynamic monitoring. Further studies are needed to confirm these findings and understand the mechanism behind the difference in effectiveness between the two.

Co-Authors Attamimi, Fandy Faidhul Bastian Lubis Bisono, Luwih Febrina Isnaini Franz Josef Tarigan Gultom, Andrio Farel Edward Hanafie, Achsanuddin Hanafie, Achsanudin Handayani, Bejo Utomo Hasanul Arifin Hasibuan, Muhammad Ramadhan Indrawan, Jhonsen Iqbal, Aulia Irina, Rr Sinta Karim, T. Abdul Lubis, Andriamuri Primaputra Lubis, Asmin Muhammad Ihsan Muhibbut Thibri Qadri Fauzi Tanjung Ricardo, Dion Rina Amelia Syaputra, Adhika Tambunan, Marco Audrik Silvester Taufik, Maulana Wahyuni, Arlinda Sari Wijaya, Yudhi

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