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All Journal The New Ropanasuri Journal of Surgery
Putra, Muhammad A
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology

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Cardiac Tamponade and Laceration of Right Ventricle in Blunt Thoracic Injury: A Case Report Simbolon, Prabowo W; Putra, Muhammad A
The New Ropanasuri Journal of Surgery Vol. 5, No. 1
Publisher : UI Scholars Hub

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Introduction. Cardiac tamponade caused by blunt thoracic injuries is a rare case with a high mortality rate. Generally, patients with blunt cardiac injury were not survived before they reach the hospital. We present the case of a 50-year-old man was admitted to our emergency department after a motorcycle hit the cart he was pushing on the street, and then the handle hit the chest. He presented with hemodynamically unstable and a bruised on precordial area, then he went into cardiac arrest. Standard CPR was done for 2 minutes, continued with intubation and ROSC. FAST showed fluid in the pericardial sac. After doing pericardiocentesis, an amount of blood about +/- 40 mL was aspirated. A median sternotomy was performed, and lacerations were found in the right ventricle and right ventricle pulmonary junction. Method. Literature searching was done in Proquest, PubMed and ScienceDirect database. The research papers were selected based on exclusion and inclusion criteria and were critically appraised using the tools from PRISMA. Result. Two articles were found to be relevant to the topic. Experimental research was not found; there were only two case-report articles. A median sternotomy was a preferable surgical approach in blunt chest trauma with the presentation of cardiac tamponade with hemodynamically unstable. Conclusion. Prompt diagnosis and definitive operation can be lifesaving in traumatic acute cardiac tamponade caused by blunt chest trauma based on the level of evidence 4. The FAST examination was beneficial in diagnosing cardiac tamponade and pericardiocentesis can be a temporary measure. A median sternotomy was a safe surgical approach in controlling the cardiac injury. The patient was discharged on the fifth post-operation day.
Survival Rate of Critically Ill Coronavirus Disease 2019 Patients on Tracheostomy in Indonesia Ramdhani, Aris; Aditianingsih, Dita; Zahra, Raihanita; Putra, Muhammad A; Soeharto, Wuryantoro; Kwa, Melvin D.B.
The New Ropanasuri Journal of Surgery Vol. 6, No. 2
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Introduction. During COVID-19 global pandemic, tracheostomy is often performed on critically ill COVID-19 patients. There is no available data on the survival rate of critically ill COVID-19 patients on tracheostomy in Indonesia. This study aimed to find the survival rate of critically ill COVID-19 patients on tracheostomy in Indonesia. Methods. A descriptive survival analysis study enrolled critically ill COVID-19 patients in RSUI who underwent a tracheostomy procedure. Baseline data, including clinical characteristics and laboratory findings before tracheostomy, were recorded. Survival analysis was conducted using the Kaplan-Meier plot. Results. Forty-two subjects were enrolled in the study: 25 males (59.5%) and 17 females (40.5%). The median age was 57 (26 – 72) years. Subjects with diabetes mellitus or hypertension were 78.6% and 78.6% with BMI >25 kg/m2. The mean duration of intubation was 16.24 ±7.62 days, the median duration of tracheostomy before the outcome was 8 (0 – 53) days. There were 9.5% of subjects survived and were discharged. The median survival time was 8 (0 – 53). In the first 15 days after tracheostomy procedures, those who were deceased were 75% of the subjects. Conclusion. In this study, the survival rate of critically ill COVID-19 patients on tracheostomy remains low. Another study to evaluate the cause of the low survival rate of critically ill patients with COVID-19 on tracheostomy is required.
Effect of Ischemia-Reperfusion injury and Preconditioning on Lung Parenchyma after Acute Limb Ischemia Hutagaol, David; Susanti, Dhama S; Soeharto, Wuryantoro; Putra, Muhammad A; Wardoyo, Suprayitno; Makdinata, William; Setiawan, Moira
The New Ropanasuri Journal of Surgery Vol. 7, No. 1
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Introduction. Acute limb ischemia, a sudden decrease of perfusion to the extremities, can compromise the survival of the limbs. Medical intervention and surgery are often needed to return perfusion. However, reperfusion injury can trigger oxidative stress and inflammatory response, leading to local and remote tissue damage, such as the lungs, which increases morbidity and mortality. This research aims to study the effects of hypothermia and remote ischemic preconditioning (RIPC) on the lung parenchyma after being exposed to reperfusion after acute limb ischemia in rabbits. Method. Eighteen New Zealand White rabbits were divided into three groups of 6. The femoral artery was ligated to induce ischemia. The hypothermia group was given cooling pads to maintain a temperature of 28°C for 4 hours, and the RIPC group was assigned RIPC before ligation for 5 minutes in three cycles. Both groups underwent reperfusion for eight hours. Evaluation of histologic characteristics was performed independently by a pathologist. Results. The mean scores for the control group, hypothermia group, and RIPC group were 12.03 + 1.43 (severe injury), 8.03 + 3.03 (moderate injury), and 4.80 + 2.61 (mild injury), respectively. In addition, there was a significant difference between lung parenchymal damage in the control group and hypothermia group (p = 0.015) and between the control group and RIPC group (p = 0.000). Conclusion. Both hypothermia and RIPC have a protective effect on lung parenchyma exposed to remote reperfusion injury after lower limb ischemia, where RIPC protects the lungs to a higher degree.
Surgical Intervention for Endobronchial Tuberculosis with Total Bronchial Occlusion: A Case Report Putra, Muhammad A; Billy, Matthew; Ardaya, Radhyaksa; Ekasiwi, Rut HP; Rahmawati, Sari; Sumarsudi, Karel HS
The New Ropanasuri Journal of Surgery Vol. 7, No. 2
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Introduction. Endobronchial Tuberculosis (EBTB) is a specific TB form affecting the tracheobronchial tree with microbial and histopathological evidence. Early diagnosis is essential to provide timely treatment and prevent complications but also proves difficult due to the low positive rate of acid–fast bacilli (AFB) staining of sputum smears and non–specific clinical and radiological findings. Case Illustration. We reported a 19–year–old man with a productive cough suspected of pulmonary tuberculosis, with a positive GeneXpert test and negative AFB smear. He received anti–tuberculosis drugs for six months. Although the symptoms initially seemed to improve, the patient complained of dyspnea during moderate activities in the sixth month. Chest x–ray showed complete atelectasis of the left lung. Further investigation with thorax computed tomography and confirmation with bronchoscopy revealed total occlusion of the left main bronchus. Left pneumonectomy was successfully conducted. Conclusion. Endobronchial tuberculosis may progress to an advanced stage despite adequate anti–tuberculosis drugs. Therefore, early diagnostic strategies are required to prevent the progression of the disease, particularly due to the insidious nature of its pathophysiological process
Co-Authors Ardaya, Radhyaksa Dita Aditianingsih Ekasiwi, Rut HP Hutagaol, David Kwa, Melvin D.B. Makdinata, William Matthew Billy, Matthew Ramdhani, Aris Sari Rahmawati, Sari Setiawan, Moira Simbolon, Prabowo W Soeharto, Wuryantoro Sumarsudi, Karel HS Susanti, Dhama S Wardoyo, Suprayitno Zahra, Raihanita