Djayanti Sari
Department Of Anesthesiology And Intensive Care, Faculty Of Medicine, Public Health And Nursing, Universitas Gadjah Mada, Jogjakarta, Indonesia

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Penggunaan Rumus Holliday Segar pada Pasien Pediatrik yang Dilakukan Anestesi Sari, Djayanti; Widyastuti, Yunita; Gunawan, Fanny
Jurnal Komplikasi Anestesi Vol 7 No 2 (2020): Volume 7 Number 2 (2020)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v7i2.7459

Abstract

Intravenous fluid theraphy in acute ill patient has been the subject of health practices for more than 50 years. The development of knowledge in dealing with patients and illness has raised questions about the validity of Holliday Segar formula. Many researchers found hyponatremia in pediatric patient who were hospitalized and received intravenous fluid theraphy using the Holliday Segar formula. This thread tries to review the use of the Holliday Segar formula based on research studies that have been conducted.
Penatalaksanaan Perioperatif Atresia Esofagus dengan Fistula Trakeoesofageal Sari, Djayanti; Widyastuti, Yunita; Fauzi, Rizqi Ahmad
Jurnal Komplikasi Anestesi Vol 7 No 3 (2020): Volume 7 Number 3 (2020)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v7i3.7471

Abstract

Esophageal atresia with trachheoesophageal fistula occurs in 1 in 3,000 to 5,000 births. Esophageal atresia is often associated with other congenital anomalies like ventricular septal defects, patent ductus arteriosus or tetralogy of fallot. We reported a neonatal patient with esophageal atresia. Surgery was performed 2 days after being treated at the NICU. The operation lasted for 2 hours 25 minutes. The anesthetic technique is GA, semi open with Jackson Reese, ETT number 3, controlled breathing. The premedication was 0.1 mg atropine sulphate and 5 µg fentanyl, induction and maintenance were sevoflurane and O2, and with 1mg atracurium muscle relaxant. Postoperatively, patient was transported to the NICU in an intubated condition. The problems of anesthesia management on patients with esophageal atresia are evaluation of aspiration pneumonia, gastric overdistence, difficulty in ventilating the patient, the presence of other congenital abnormalities, and postoperative intensive care. Early recognition, prevention of aspiration, and immediate delivery to tertiary health care center will improve infant morbidity and mortality significantly.
Perbandingan Luaran Pasien Level Of Care 3 yang Menggunakan Ventilator Sebelum dan Sesudah Operasional Ruang High Care Unit Di RSUP Dr. Sardjito Yogyakarta Suryaman, Rifandi; Widodo, Untung; Sari, Djayanti
Jurnal Komplikasi Anestesi Vol 8 No 1 (2021): Volume 8 Number 1 (2021)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v8i1.7493

Abstract

Background: Mortality rate in emergency department (ED) of Dr. Sardjito General Hospital did not achieve national target. Result of evaluation and analysis of this condition was established of High Care Unit for critical care management of patient in ED with the goal to decrease morbidity and mortality rate. Objective: To compare outcome such as mortality rate, MSOFA exit score, Length of Stay(LOS) in IMC, HCU, hospital and ventilator day at patients 3rd level of care (LOC) using ventilator before and after the implementation of HCU at the Dr. Sardjito General Hospital. Method: This research was an observational study using retrospective cohort analysis. Subjects had been collected from medical record included 198 meet the inclusion criteria; aged ≥18 years who were treated with critical illness with 3rd level of care (LOC) who used a ventilator in the HCU or IMC of RSUP dr.Sardjito. Exclusion criteria were patients with end-stage malignancies, patients with HIV / AIDS infections, patients with end-stage chronic disease and incomplete medical record. Result: Mortality rate in HCU (40.4%) and IMC (73.3%) with p = 0.000. MSOFA exit score in HCU (5.5) and IMC (7.4) with p= 0.001. HCU and IMC length of stay (LOS) showed no statistically signifcant difference. Hospital LOS in HCU (314.7) hours and IMC (210.6) hours with p = 0.000. Ventilator day in HCU (5.1) days and IMC (4.8) days and showed no statistically signifcant difference. Conclusion: Mortality rate and MSOFA exit score in HCU was lower than IMC. There was no significant difference between LOS in HCU and IMC. Hospital LOS in HCU group 314.7 hours and IMC group was 192.6 hours. Ventilator day in HCU group was 5.1 days and IMC group 4.8 days.
Determinan Prolonged Length Of Stay (PLOS) ICU pada Pasien Pediatrik yang Menjalani Pembiusan Di Masa Pandemi Covid-19 Hernawan, Agung Diky; Sari, Djayanti; Widyastuti, Yunita
Jurnal Komplikasi Anestesi Vol 10 No 2 (2022)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v10i2.8300

Abstract

Background: In Indonesia, the utilization of ICU is not balanced, due to the limited ICU space or the length of time ICU patient care. ICU services include patients with organ dysfunction or post-anesthesia patients, especially pediatrics. Period 1 March 2020 Indonesia was hit by the COVID-19 pandemic. The need for ICU space increases, most of the infected patients fall into respiratory failure conditions both adults and pediatrics. Problems that are interconnected and become the basis for researchers in determining the determinants of PLOS ICU are post-anesthesia pediatric patients who need ICU care, limited ICU space and the problem of the COVID-19 pandemic. Objective: To identify the determinant factors of ICU Prolonged Length of Stay (PLOS) in pediatric patients undergoing anesthesia during the COVID-19 pandemic. Method: This research is a retrospective cohort observational study. The study sample was 173 pediatric patients undergoing anesthesia and postoperative care in the ICU at Dr Sardjito General Hospital for the period April 2020 - March 2021. The variables were tested using Student's t-test for numerical data, Chi square test for categorical/dichotomous data. The results of p <0.25 were followed by a logistic regression test. The results of p<0.05 were entered into the multivariate analysis and were considered significant. Results: The factors identified as the determinants of PLOS in the ICU Dr. Sardjito General Hospital were major surgery with a P value of 0.048 (OR 8.87), blood transfusions with a P value of 0.019 (OR 2.34) and mechanical ventilation with a P value of 0.010 (OR 3.44) ) is the most significant variable on PLOS in the ICU with a p<0.05. Conclusion: Major surgery, blood transfusions and mechanical ventilation/ventilators are the determinants of PLOS in the ICU of Dr. Sardjito General Hospital, pediatric patients undergoing anesthesia during the COVID-19 pandemic
Tatalaksana Nyeri Postoperatif pada Infant Widyastuti, Yunita; Sari, Djayanti; Hernandes, Crodia
Jurnal Komplikasi Anestesi Vol 5 No 2 (2018): Volume 5 Number 2 (2018)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v5i2.8311

Abstract

Postoperative acute pain is an unavoidable problem in postoperative conditions. Effective relief of pain is of the most importance to treating patients undergoing surgery. Effective pain management has significant physiological benefits. Manyways for pain management, althought opioid is general pain management and Regional block is a popular techniques in paediatric pain management recently, wether for surgery or need of adequate analgesic condition.
Manajemen Anestesi pada Percutaneus Endoscopic Lumbar Discectomy (PELD) dengan Dexmedetomidine Sari, Djayanti; Wisudarti, Calcarina Fitriani Retno; Ferdiansyah, David
Jurnal Komplikasi Anestesi Vol 10 No 1 (2022)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v10i1.8323

Abstract

The patient is 49 years old with a diagnosis of Hernia Nucleosus Pulposus (HNP) 4-5 lumbar vertebrae. The patient was scheduled to undergo the PELD procedure. The anesthetic technique used is total intravenous anesthesia (TIVA) with dexmedetomidine. The dose used is loading 1 mcg per kg body weight in 10 minutes followed by titration of 0.2-0.7 mcg/kg body weight/hour. During the procedure the operator requires confirmation from the patient to prevent complications of nerve injury. The action lasts about 2 hours in the prone position. The level of sedation was assessed by the Ramsay scale score. Hemodynamics during the procedure is stable and the patient is quite comfortable.
Hubungan Neutrophil-Lymphocyte Ratio (NLR) Terhadap Mortalitas dan Lama Rawat Inap Pasien COVID-19 Di RSUP Dr. Sardjito Khoeri, Fatkhur Roofi; Sari, Djayanti; Widyastuti, Yunita
Jurnal Komplikasi Anestesi Vol 10 No 1 (2022)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v10i1.8326

Abstract

Background: COVID-19 is a viral-caused disease which has become pandemic disease with broad clinical manifestation. Neutrophyl Lymphocyte Ratio (NLR) may represent immune system dysregulation, a warning sign in mild COVID-19 patient and was predicted to have relation to mortality and length of stay. NLR is a simple blood test and applicable in daily clinical practice. Method: This study is an observational, cohort retrospective by taking secondary data from confirmed COVID-19 patient’s medical record during April 2020 – Maret 2021. NLR cut-off point was concluded using ROC and Youden’s Index. Survival Kaplan Meier analysis was used to determine the relation between NLR, mortality, and length of stay (LOS). This relation was analyzed using univariat and Cox regression multivariat analysis Method: This study is an observational, cohort retrospective by taking secondary data from confirmed COVID-19 patient’s medical record during April 2020 – Maret 2021. NLR cut-off point was concluded using ROC and Youden’s Index. Survival Kaplan Meier analysis was used to determine the relation between NLR, mortality, and length of stay (LOS). This relation was analyzed using univariat and Cox regression multivariat analysis. Result: 273 samples was included in the study. With 7,62 cut-off point, it was found that 190 samples had NLR <7,62 and 83 samples had NLR >7,623. Multivariat analysis shown that samples with higher NLR independently and significantly had higher mortality risk (HR 3,345, p<0,001). Samples with NLR > 7,62 significantly had longer LOS (23 vs 19 days, respectively). However, multivariat analysis shown that NLR did not correlate with LOS (p=0,090). Summary: High NLR >7,62 independently and significantly correlate with higher mortality risk. Univariat analysis shown that higher NLR correlate with LOS in COVID-19 patients, but did not affect LOS.
Validasi Skor Skrining COVID-19 RSUP Dr. Sardjito Yogyakarta Ulfa, Dinda; Sari, Djayanti; Kurniawati, Juni
Jurnal Komplikasi Anestesi Vol 9 No 3 (2021)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v9i3.8336

Abstract

Background: Dr. Sardjito’s hospital Covid-19 screening score is a tool to assess patients who are suspected of being infected using RT-PCR swab examination. Unfortunately, there has never been researched regarding the validity. Objective: Validating the Dr. Sardjito’s hospital Covid-19 screening score to assess patients suspected of Covid-19 infection which was confirmed by the results of the RT -PCR swab at the Dr. Sardjito Hospital Yogyakarta. Method: This study used an observational retrospective cohort design. Patients who were included in the inclusion criteria were those aged >18 years, from 24th April 2020 to 31th December 2020. Result: The number of study samples was 705 patients. Discrimination ability of Dr. Sardjito’s hospital Covid-19 screening scoring was assessed by AUC and the result was 0,556 (CI 95%: 0,51-0,61. Calibration ability obtained HL test value p=0.001 (p<0.05). Conclusion: Dr. Sardjito’s hospital Covid-19 screening scoring has a very weak discrimination ability and poor calibration, so the Dr. Sardjito’s hospital Covid-19 screening scoring is invalid in predicting the results of RT-PCR swab at Dr. Sardjito Hospital Yogyakarta.
Pengaruh Fisioterapi Terhadap Parameter Hemodinamik pada Pasien Kritis Di ICU RSUP Dr. Sardjito Hanafi, Irham; Sari, Djayanti; Jufan, Akhmad Yun
Jurnal Komplikasi Anestesi Vol 9 No 2 (2021)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v9i2.8346

Abstract

Background: Critically ill patients undergoing treatment in the ICU experience long-term immobilization. Giving physiotherapy to patients is a recommendation to mobilize critically ill patients early to prevent complications. Monitoring vital signs is important to ensure that physiotherapy is safe and that the patient is protected from the adverse effects of physiotherapy. The recording of hemodynamic changes has never been done in Dr. Sardjito General Hospital. Objective: To determine the effect of passive motion physiotherapy on hemodynamic parameters in critically ill patients admitted to the ICU. Method: This study used a quasi-experimental interventional design. Patients who entered the inclusion criteria were patients who were treated in the ICU and aged over 18 years in June and July 2021. Hemodynamic data were taken from bedside monitors and ICON devices. Results: The number of research subjects was 32 patients. Passive motion physiotherapy resulted in a lower SVV value (10.84 ± 6.19; p = 0.014) than at baseline (12.91 ± 6.19) and after rest (12.25 ± 5.21). Other parameters, HR, RR, SBP, DBP, MAP, SV, SI, CO, CI, SVR, and DO2 did not produce statistically significant changes. Conclusion: Passive motion physiotherapy has no effect on hemodynamic parameters in critically ill patients admitted to the ICU Dr. Sardjito General Hospital. Passive motion physiotherapy resulted in lower SVV compared to baseline and resting conditions.
Manajemen Perioperatif pada Pasien Varises Esofagus yang Menjalani Endoskopi Sari, Djayanti; Widodo, Untung; Mi’raj, Geza Getar
Jurnal Komplikasi Anestesi Vol 8 No 2 (2021): Volume 8 Number 2 (2021)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v8i2.8357

Abstract

Esophageal varices are a condition in which there is distension of the submucosal veins that project into the esophageal lumen in patients with portal hypertension. Endoscopic examination is needed in cases of esophageal variceal bleeding to confirm a diagnosis, assess varicose veins and plan their management. We report a 12-year-old patient with grade 3 esophageal varices who underwent an endoscopy procedure. Management of anesthesia in esophageal varices patients undergoing endoscopy needs to pay attention to the depth of anesthesia and to keep the patient’s airway secure to avoid hypoxemia.