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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
Publisher : UI Scholars Hub

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Abstract

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
Publisher : UI Scholars Hub

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Abstract

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.