Permana, Septian Adi
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Sepsis-Induced Coagulopathy as a Risk for Postoperative Arterial Thrombosis: A Case Report Permana, Septian Adi; Swastikasari, Dewi
JAI (Jurnal Anestesiologi Indonesia) Vol 17, No 1 (2025): JAI (Jurnal Anestesiologi Indonesia)
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.57473

Abstract

Background: Venous thromboembolic disease and arterial thrombosis are recognized as common causes of hospital mortality, especially in postoperative patients, those who are immobilized, and individuals with sepsis. Coagulopathy is a significant factor due to the interaction between inflammation and coagulation, stemming from widespread endothelial damage.Case: We report manifestations of sepsis-induced coagulopathy (SIC) in a 64-year-old woman who was treated at the intensive care unit (ICU) of RSUD Dr. Moewardi with peripheral arterial disease. The patient was treated for 20 days in the ICU with a multidisciplinary approach. The patient's clinical outcome was good and planned for follow-up during outpatient care.Discussion: Thrombosis and inflammation are distinct yet closely interconnected physiological processes. In a normal physiological context, the activation of the coagulation system by inflammation is a component of the body's defense mechanism against pathogens, aiming to restrict their spread within the bloodstream. This protective response involves the interaction between innate immune cells and platelets.Conclusion: By gaining a deeper insight into sepsis-associated coagulopathy (microthrombopathy), we can develop effective treatments that specifically target the microthrombotic pathway involved in endothelial damage.
Convalescent Plasma Treatment for Moderate to Critical Ill COVID-19 Patients – A Safe but Futile Treatment: A Non-Randomized Comparative Study Aphridasari, Jatu; Soetjahjo, Bintang; Joko, Agus; Sidharta, Rina; Harsini, Harsini; Arifin, Arifin; Permana, Septian Adi; Saraswati, Kunti; Adhiputri, Artrien; Marwanta, Sri; Laqif, Abdurahman; Danuaji, Rivan
Indonesian Journal of Medicine Vol. 8 No. 4 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/theijmed.2023.08.04.08

Abstract

Background: In a number of cases of viral infection, convalescent plasma therapy has been effective. Reportedly, the use of convalescent plasma as a therapy for COVID-19 patients with severe and life-threatening disorders is beneficial at this time. This study aims to assess the effectiveness and safety of convalescent plasma transfusions in hospitalized COVID-19 patients. Subjects and Method: This was a clinical trial employing a non-randomized comparative study. A historical control group (21 samples) and convalescent plasma transfusions (21 samples) was selected consecutively from hospitalized COVID-19 patients between May 6th, 2020, and May 6th, 2021 at Dr. Moewardi General Hospital. We assessed and quantified viral clearance in the laboratory. Statistical analysis is performed in SPSS version 20.0. Results: Plasma was taken from fifteen convalescent donors. In the plasma convalescent treatment group, there was a statistically significant difference between outcome and severity degree (p = 0.005). In addition, there was a substantial discrepancy between the result group and the control group (p 0.005). Significant differences in post-treatment NLR between the control and treatment groups (p 0.005). In addition, there were statistically significant differences between the control and treatment groups in post-treatment hsCRP levels (p 0.005). In addition, there were statistically significant differences (p 0.005) between all groups' inflammatory markers and outcomes. Conclusion: Using convalescent plasma to treat patients with COVID-19 is a rather safe practice. Our analysis demonstrated that the administration of convalescent plasma did not enhance survival or clinical outcomes for COVID-19 patients with moderate to severe disease. Keywords: COVID-19, convalescent therapy, critical ill
PERBANDINGAN KARAKTERISTIK KLINIS PASIEN COVID 19 VARIAN OMICRON DAN VARIAN DELTA DI RUMAH SAKIT UMUM DAERAH DR. MOEWARDI SURAKARTA Permana, Septian Adi; Purwoko, P; Thamrin, Muhammad Husni; Anggoro, Pandu
Indonesian Basic and Experimental Health Sciences Vol. 12 No. 1 (2023): November
Publisher : Rumah Sakit Umum Daerah Dr. Moewardi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/ibehs.vol12iss1pp10-28

Abstract

PENDAHULUAN Perkembangan SARS-CoV-2 telah ditandai dengan pengenalan "Variant Of Concern," atau perubahan sifat virus seperti penularan penyakit dan antigenisitas. VOC Delta SARS-CoV-2 40% -60% lebih mudah menular daripada VOC Alpha (B.1.1.7) dan dapat dikaitkan dengan peningkatan risiko rawat inap. TUJUAN Untuk mengetahui karakteristik klinis pasien COVID-19 varian Delta dan Omicron di High Care Unit (HCU) dan Intensive Care Unit (ICU) Rumah Sakit Dr Moewardi. METODE Penelitian deskriptif analitik kuantitatif dengan pendekatan retrospektif yang dilakukan pada Juni 2021-Maret 2022. Sampel penelitian adalah pasien terkonfirmasi positif COVID-19 yang di rawat di ICU dan HCU isolasi pada Agustus-Oktober 2021 dan Januari-Maret 2022. Diukur tanda vital, komorbid, hasil laboratorium, status intubasi dan mortalitas. HASIL Angka kematian pasien yang terinfeksi Covid-19 varian delta dan varian omicron masing-masing adalah 10% dan 10,8%. Varian Delta lebih signifikan berdampak terhadap CVA (p=0.001) dan penyakit jantung (p<0.001) dibandingkan pada CVA (p=0.015) dan penyakit jantung (p=0.190) pada pasien SARS-CoV-2 varian Omicron. Varian Omicron lebih signifikan berdampak terhadap sepsis (p=0.012) dibandingkan varian Delta (p=0.026). KESIMPULAN Tidak didaptakan perbedaan angka mortalitas antara varian COVID-19 omicron dan delta. Kematian pada kelompok omicron sebagian besar disebabkan penyakit komorbid, sedangkan pada kelompok delta, kematian disebabkan karena COVID-19 menyebabkan disfungsi endotel.
INDIVIDUAL CORRELATION OF OXYGEN DELIVERY WITH HAEMOGLOBIN LEVEL IN 20-YEAR-OLD WOMAN WITH HB 1.8 WITH INCOMPATIBLE CROSS-MATCH RESULTS: CASE REPORT STUDY Permana, Septian Adi; Yuliana, Friskha
Indonesian Basic and Experimental Health Sciences Vol. 12 No. 1 (2023): November
Publisher : Rumah Sakit Umum Daerah Dr. Moewardi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/ibehs.vol12iss1pp29-34

Abstract

BACKGROUND Clinical assessment of the delivery of tissue oxygenation is very challenging for clinicians to study. Anaemia reflects a decrease in oxygen carrying capacity in the blood which is very at risk of oxygen delivery (DO2) insufficiency and cellular hypoxemia, to assess tissue hypoxia in addition to being a reliable tool, the clinician must also adjust to the patient's clinical and hemodynamic. Blood transfusions are generally used to correct anaemia precisely and efficiently, but in certain circumstances that make it impossible for clinicians to perform blood transfusions, at that time we have to think of other methods of therapy in patients. METHODS 20-year-old woman came with anaemia, with a haemoglobin (Hb) level of 6.0 g/dl, a stable clinical condition and hemodynamic within normal limits, a blood transfusion was planned but the results of the Comb test was incompatible, so it was an absolute contraindication for transfusion. The patient experienced clinical changes that indicated the occurrence of tissue hypoxia when the Hb level was 2.0gr/dl. The clinician decided to maximize DO2, and reduce oxygen demand/consumption (VO2), so that there is a balance. The patient was treated with steroids, suspected autoimmune haemolytic anaemia (AIHA). On the eighth day of clinical treatment the patient improved, hemodynamically stable, and Hb increased. CONCLUSION Clinical valuation of the distribution of tissue oxygenation is very important for AIHA patient.