Claim Missing Document
Check
Articles

Found 3 Documents
Search

Penggunaan Shock Index sebagai Prediktor MODS pada Pasien Multi-trauma di RSUP Prof. Dr. R. D. Kandou Manado Senjaya, Yan; Lahunduitan, Ishak; Tjandra, Djony
Jurnal Biomedik : JBM Vol 10, No 1 (2018): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.10.1.2018.19001

Abstract

Abstract: Multiple organ dysfunction syndrome (MODS) is the leading cause of mortality in patients that still survive in several hours post trauma. Shock index (SI) has been proved to be useful in the early diagnosis of acute hypovolemia in normal blood pressure and pulse condition. It is used to determine the severity of injury and poor outcome in traumatic patient. This study was aimed to obtain the cut-off point ratio of SI which can be used to predict the occurence of MODS and to determine the sensitivity and specificity of SI as a predictor of MODS in multitrauma patients at Prof. Dr. R. D. Kandou Hospital Manado. This was a diagnostic test study with a cross sectional design conducted from Febuary 2016 to May 2017. Population and samples were all multitrauma patients during that period of time that met the inclusion criteria. Data were analyzed by using cut-off point analysis to obtain the area under curve (AUC), as well as the sensitivity and specificity of SI to MODS. There were 150 multitrauma patients in this study, most were males, with the mean age of 33.99 years. The mean ISS was 28.4, SIRS as many as 68.66%, and the mean shock class was 1.4. There were 63 patients with MODS, 37 patients needed PRC transfusion, and 16 patients died. The AUC 80.5% (95% CI 73.0-88.0%; P = 0.000); SI 0.950588 with the sensitivity 74.6% and specificity 78.2% to MODS. The AUC 74.1% (95% CI 61.1-87.2%; P = 0.002); SI 0.97559 with 75.0% sensitivity and 64.2% spesificity to death. Conclusion: Shock index can be used as a predictor of the occurence of MODS and death in multi-trauma patients.Keywords: SI, MODS, multitraumaAbstrak: Multiple organ dysfunction syndrome (MODS) merupakan penyebab utama mortalitas pada pasien yang selamat dalam beberapa jam setelah trauma. Shock index (SI) bermanfaat untuk mendiagnosis awal hipovolemia akut pada keadaan tekanan darah dan nadi yang normal dan digunakan sebagai penanda keparahan suatu cedera dan keluaran yang buruk untuk pasien trauma. Penelitian ini bertujuan untuk mendapatkan cut off point ratio SI yang dapat digunakan sebagai pedoman untuk memrediksi terjadinya MODS dan menentukan sensitivitas dan spesifitas SI sebagai prediktor MODS pada pasien multitrauma di IRDB RSUP Prof. Dr. R. D. Kandou, Manado. Jenis penelitian ialah uji diagnostik dengan desain potong lintang yang dilakukan mulai bulan Febuari 2016 sampai Mei 2017. Populasi dan sampel ialah semua pasien multitrauma yang memenuhi kriteria inklusi. Analisis data menggunakan analisis cut-off point serta mencari area under curve (AUC), sensitivitas, dan spesifitas instrumen SI terhadap MODS. Terdapat 150 pasien multitrauma dalam studi ini, sebagian besar berjenis kelamin laki-laki dengan rerata usia 33,99 tahun. Rerata ISS 28,4, SIRS sebanyak 68,66%, dan rerata syok kelas 1.4. Terdapat 63 pasien multitrauma mengalami MODS, 37 pasien memerlukan transfusi PRC, dan 16 pasien meninggal. Nilai AUC 80,5% (95% interval kepercayaan [IK] 73,0-88,0%; P = 0,000); SI 0,950588 dengan sensitivitas 74,6% dan spesifisitas 78,2% terhadap MODS. Nilai AUC 74,1% (95% interval kepercayaan [IK] 61,1-87,2%; p = 0,002); SI 0,97559 memiliki sensitivitas 75,0% dan spesifisitas 64,2% terhadap terjadinya kematian. Simpulan: Shock index dapat digunakan sebagai prediktor terjadinya MODS dan kematian pada pasien dengan multitrauma.Kata kunci: SI, MODS, multitrauma
Endovascular Fistula Salvage for Preserving Arteriovenous Fistula Failure in Haemodialysis Patient: Tertiary Referral Hospital, a Single-Centre Experience Karundeng, Billy; Sumangkut, Richard; Tjandra, Djony; Khosama, Yuansun; Juliandi, Tomi
e-CliniC Vol. 12 No. 2 (2024): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v12i2.46644

Abstract

Abstract: Efficacy of endovascular intervention for the preservation of failing accesses is very important in hemodialysis patients. This study aimed to determine the efficacy of endovascular balloon angioplasty in preserving the patency of hemodialysis arteriovenous fistula (AVF) failure. This was a retrospective study of hemodialysis patients who received endovascular intervention due to access difficulties. A single-center study was created between January 2022 and June 2022. Fistulography was conducted on patients suspected of having access stenosis, and balloon angioplasty was performed in the same setting if stenosis of 50% was confirmed. Post-operative complications and access restenosis or failure were monitored. The results obtained 69 patients with hemodialysis access failure due to AVF stenosis, occlusion, and thrombosis that were admitted or referred to our hospital. The majority of patients were 40-60 years (50.7%); 88.4% patients were male and 11.6% were female, with a mean age of 56.3±11.6 (range, 18–77). The sites of AVF failure were brachiocephalic (81.1%) and radiocephalic (18.9%). There was no complication recorded. The procedure succes rate was 81.1%. In conclusion, endovascular balloon angioplasty is effective in restoring hemodialysis access patency. Recurrence is common, and interventions must be repeated. Keeping access open can save lives. Percutaneous transluminal angioplasty (PTA) can be used to achieve safely and successfully repair arteriovenous fistulas failure. Keywords: angioplasty; arteriovenous fistula; arteriovenous graft; hemodialysis
Outcomes of Endovascular Intervention for Salvage of Failing Hemodialysis Access Karundeng, Billy; Tjandra, Djony; Sumangkut, Richard; Winarto, Michael D.
Medical Scope Journal Vol. 7 No. 1 (2025): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v7i1.55971

Abstract

Abstract: Chronic kidney disease (CKD) is a worldwide public health problem. Hemodialysis accesses are prone to failure due to thrombosis and stenosis over the anastomosis or outflow vein. This study aimed to obtain the outcomes of endovascular intervention for salvage of failing hemodialysis access. This was a retrospective and descriptibe study. Data were collected from all patients who underwent endovascular intervention for failing hemodialysis access starting from January 2021 – June 2023 at Prof. Dr. R. D. Kandou Hospital, Manado. The results showed that 136 subjects were included in this study. The highest comorbidities were found in patients with a history of hypertension (52.9%). The most common arteriovenous fistulas (AVF) hemodialysis access was at the brachiocephalic location (75.7%). The most frequent cause of access dysfunction was simple stenosis (64.7%). Pseudoaneurysm was occurred in two subjects (1.4%), and ruptured outflow vein was occurred in one subject (0.7%). The patency rate at three months was 77.6%, but the primary patency rate would decrease to less than 50% over six months. Endovascular intervention in the form of balloon angioplasty is currently the main line of choice in dealing with problematic AVFs in principle what is being done is to intraluminaly dilate the narrowed or blocked lumen of the outflow vein. The complication rate from the procedure performed was 2.2% where in two patients a pseudoaneurysm occurred at the puncture site, namely the brachial artery and the radial artery then another patient had rupture of the AVFs outflow vein, therefore, an additional procedure was performed to close the AVFs with ligation. In conclusion, endovascular intervention for failing hemodialysis access has good results, but the primary patency rate will decrease to less than 50% over six months. Keywords: chronic kidney disease; hemodialysis access; endovascular intervention