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All Journal Jurnal Anestesi Perioperatif The Journal of Society Medicine (JSOCMED)
Pamugar, Bramantyo
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Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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Lung Protective Strategy in Acute Respiratory Distress Syndrome with Approach of Compliance and Mechanical Power Pamugar, Bramantyo; Budipratama, Dhany
Journal of Society Medicine Vol. 2 No. 10 (2023): October
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v2i10.96

Abstract

Introduction: Lung protective strategy was meant to decrese risk of ventilatory induced lung injury  without reducing benefit of ventilator. One of the approaches were the use of compliance and mechanical power (MP). Compliance was used to determine how large lung was recruited after ventilatory support. Mechanical power was used to determined enough ventilatory support to that patient. Case Report: We reported 36 years old female, whom admitted to ICU with diagnosis of acute respiratory distress syndrome  caused by community acquired pneumonia. Patient was given pressure controlled ventilation with driving pressure 15cmH2O, positive end expiratory pressure (PEEP) 5 cmH2O, respiratory rate of 20x/min. We used compliance and MP to decide ventilator setting which benefit the patient. At the initial ventilator setting compliance and MP were 15.67 cc/mmHg, and 9.21 joule/min respectedly. The PEEP was increase gradually to 12 cmH2O. Compliance and MP were also increase to 41.67 cc/mmHg and 32.91 joule/min respectedly. Driving pressure was decrease to meet desirable volume tidal 6cc/kg and desirable MP below 22 joule/min. The PEEP was maintained until pneumonia resolved. Patient was extubated in ninth day. Conclusion: It could be concluded that the use of compliance and MP would help customize ventilatory support the patient need. They would help critical care clinician in making decision to prioritize need of ventilatory support in each individual patient.
Uji Kesesuaian Pengukuran Berat Badan antara Metode Lorenz dan Metode Modifikasi PAWPER-XL MAC dengan Tempat Tidur Bertimbangan Khusus Pamugar, Bramantyo; Suwarman, Suwarman; Rismawan, Budiana
Jurnal Anestesi Perioperatif Vol 12, No 3 (2024)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v12n3.3826

Abstract

Berat badan aktual sangat penting di Intensive Care Unit (ICU). Baku standar penilaian berat badan aktual adalah timbangan khusus, namun timbangan ini tidak banyak tersedia di ICU. Alternatif lain untuk estimasi berat badan aktual dapat menggunakan metode antropometrik. Penelitian ini merupakan uji kesesuaian antara estimasi berat badan aktual menggunakan metode Lorenz dan modifikasi PAWPER-XL MAC dengan berat badan aktual menggunakan timbangan khusus baku standar. Penelitian ini adalah analitik observasional dengan potong lintang pada 83 pasien ICU rumah sakit Hasan Sadikin Bandung antara Agustus hingga November 2023. Uji kesesuaian menggunakan: uji t, P10, P20, mean percentage error (MPE), dan limit of agreement (LOA). Pasien metode Lorenz dan modifikasi PAWPER-XL MAC dengan rerata perawatan 2,00±1,704 dan rerata balans kumulatif 126,99±1483,62, didapatkan nilai p adalah 0,646 dan 0,717 secara berurutan, nilai P10 adalah 84,3% dan 71,1% secara berurutan, nilai P20 adalah 98,8% dan 95,2% secara berurutan, nilai MPE adalah 0,361 dan 0,463 secara berurutan, nilai LOA adalah -14,75 s/d 15,53 dan -18,12 s/d 19,04 secara berurutan. Semua berada dalam rentang yang direkomendasikan. Pengukuran estimasi berat badan aktual metode Lorenz dan modifikasi PAWPER-XL MAC sesuai dengan pengukuran berat badan aktual dengan tempat tidur bertimbangan khusus pada pasien-pasien ICU.
Co-Authors Budiana Rismawan Dhany Budipratama Suwarman Suwarman, Suwarman