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All Journal Syifa' MEDIKA: Jurnal Kedokteran dan Kesehatan The Journal of Society Medicine (JSOCMED)
Hendro, Rachmad Try
Unknown Affiliation
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Management of Acute Respiratory Distress Syndrome Due to Transfusion-Related Acute Lung Injury and Pulmonary Contusion in a Patient with Moderate Head Injury Post-Craniotomy Decompression, Epidural Hematoma, and Posterolateral Rib Fractures 2-6 Hendro, Rachmad Try; Pison, Osmond Muftilov
Journal of Society Medicine Vol. 4 No. 7 (2025): July
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i7.223

Abstract

Introduction: Acute Respiratory Distress Syndrome (ARDS) is characterized by acute onset within seven days of an insult, leading to impaired gas exchange, respiratory distress not attributed to cardiac pump dysfunction, and diffuse bilateral opacities on chest X-ray (CXR). ARDS can result from direct lung parenchymal injury, such as pulmonary contusion, or indirect mechanisms, such as transfusion-related acute lung injury (TRALI), which triggers inflammatory mediator release, causing capillary leakage and damage to type I and II pneumocytes. Case Description: A 50-year-old male was admitted to the Intensive Care Unit (ICU) following a craniotomy evacuation. On the second day of ICU care, after receiving four units of packed red cell (PRC) transfusion and subsequent extubation, the patient developed dyspnea, increased respiratory rate, elevated work of breathing, and desaturation. Clinical examination revealed decreased consciousness, tachycardia, tachypnea, and desaturation. Diagnostic imaging showed diffuse bilateral opacities without cardiac abnormalities. The patient was re-intubated and connected to a ventilator using a lung protective strategy. Broad-spectrum antibiotics and adequate tissue perfusion support were administered. The patient showed improvement and was discharged from the ICU. Conclusion: ARDS, whether caused by direct insults like pulmonary contusion or indirect mechanisms like TRALI, requires a lung protective strategy to preserve healthy lung tissue. Early recognition and appropriate ventilatory management are critical for improving outcomes in such cases.
The Association Between Changes in Red Cell Distribution Width and Mortality Among Sepsis Patients in the Intensive Care Unit at Hasan Sadikin Hospital, Bandung. Hendro, Rachmad Try; Pradian, Erwin; indriasari, indriasari
Syifa'Medika Vol 16, No 2 (2026): Syifa Medika: Jurnal Kedokteran dan Kesehatan
Publisher : Faculty of Medicine

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32502/sm.v16i2.10672

Abstract

Sepsis is a leading cause of mortality, especially in developing countries. Sepsis biomarkers are needed for diagnostic and prognostic purposes to determine therapeutic effectiveness. Currently, available biomarkers are expensive and not all are available, especially in remote areas. Red Cell Distribution Width (RDW) is a laboratory parameter commonly used to diagnose anemia and can describe the variability of red blood cell shape and size. In sepsis, inflammation and oxidative stress occur, resulting in changes in red blood cell age and maturation, which can affect RDW results. This study aims to examine the relationship between trends in RDW results and mortality in sepsis patients. This retrospective, observational, analytical study was conducted on 71 ICU patients at Dr. Hasan Sadikin General Hospital, Bandung, from 2024 to 2025. In this study, patients were divided into two groups: mortality and survival. RDW was assessed on the first and third days in both groups. The results of this study showed that RDW in the mortality group was higher than in the survival group, 80% and 41.9% (p = 0.001). In the mortality group, 85% of patients experienced a statistically significant increase in RDW on the third day compared to the survival group (p=0.0001) with positive moderat correlation (Contingency Coefficient 0.494). This demonstrates a positive moderate relationship between increased RDW and mortality in sepsis patients. Trend of changes in RDW values can be used to assess mortality risk in sepsis patients in the ICU. 
Co-Authors Erwin Pradian Indriasari, Indriasari Pison, Osmond Muftilov