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Penggunaan High-Flow Nasal Cannula (HFNC) pada penderita COVID-19; Sebuah tinjauan literatur Katarina, Ida
Wellness And Healthy Magazine Vol 3, No 1 (2021): February
Publisher : Universitas Aisyah Pringsewu (UAP) Lampung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30604/well.145312021

Abstract

Gejala klinis dari COVID-19 bervariasi mulai dari asimptomatis sampai gejala berat. Penderita umumnya bergejala ringan atau sedang (80%). Akan tetapi, 14% dari penderita berlanjut sampai gangguan respirasi hipoksemia yang memerlukan terapi oksigen, 5% diantaranya memerlukan bantuan respirasi lanjutan. Seiring dengan meningkatnya kasus COVID-19, kebutuhan untuk intubasi dan ventilasi mekanis juga meningkat. High-flow nasal cannula (HFNC) mulai direkomendasikan sebagai lini pertama bantuan oksigenasi pada kasus gagal napas hipoksemia. HFNC dapat membersihkan dead space faring, reduksi usaha respirasi, efek PEEP (Positive End-Expiratory Pressure), pemberian fraksi oksigen inspirasi yang konstan, dan perbaikan pembersihan mukosiliar. Selain memberikan udara yang hangat dan lembab, HFNC nyaman dipakai sehingga penderita kooperatif. Penggunaan HFNC masih menjadi perdebatan dikarenakan resiko aerosolisasi dan penyebaran virus. HFNC juga tidak dapat menggantikan fungsi NIV maupun bantuan ventilasi mekanis. Indeks ROX digunakan sebagai prediktor apakah terapi HFNC berhasil atau gagal. Indeks ini membantu mencegah terjadinya intubasi terlambat.  Abstract: Clinical symptoms of COVID-19 vary from asymptomatic to severe. Symptoms are generally mild or moderate (80%). However, 14% of patients proceed to hypoxemia respiration failure that requires oxygen therapy, 5% of whom require advanced respiratory support. Along with the increasing cases of COVID-19, the need for intubation and mechanical ventilation has also increased. High-flow nasal cannula (HFNC) therapy begins to be recommended as the first line of oxygenation support in cases of hypoxemia respiratory failure. HFNC can washout the pharyngeal dead space, reduce respiration efforts, PEEP (Positive End-Expiratory Pressure) effect, provide a constant inspiring oxygen fraction, and improve mucosal cleansing. In addition to providing warm and humid air, HFNC is comfortable to wear so that patients are cooperative. The use of HFNC is still debated due to the risk of aerosolization and the spread of the virus. HFNC also cannot replace NIV or mechanical ventilation support. ROX index is used as a predictor of whether HFNC therapy is successful or not. This index helps prevent late intubation.
Anesthesia Approach for Nephrectomy in Full-Term Neonate with Suspected Wilms Tumor and Patent Foramen Ovale: A Case Report Katarina, Ida; Otniel Adrians Labobar; I Putu Kurniyanta
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 2 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i2.919

Abstract

Background: Nephrectomy for Wilms tumor presents a considerable challenge in pediatric anesthesia. This study aimed to describe the anesthesia approach for nephrectomy in a full-term neonate with suspected Wilms tumor and patent foramen ovale. Case presentation: A 25-day-old male neonate was referred with a longstanding intraabdominal mass present since birth. Echocardiography revealed a patent foramen ovale with a diameter of 2.7 mm and a left-to-right shunt. The patient also had a diagnosis of partial ileus obstruction, likely caused by the tumor's pressure on the left kidney. Preoperative fasting adhered to a "6-4-3-1" regimen. Normoglycemia was maintained throughout the perioperative period. The case was managed under general anesthesia without the use of the rapid sequence induction technique. Caudal analgesia was administered using 1.14 ml of 0.175% bupivacaine. Vigilant monitoring of blood loss, prevention of hypothermia, and effective pain management are vital aspects of the surgical procedure. For postoperative pain management, analgesia and morphine infusion were employed. The patient was then transferred to the neonatal intensive care unit (NICU) for observation for any signs of complications related to anesthesia and surgery. Conclusion: Nephrectomy in neonates is one of the challenges of pediatric anesthesia. Pre-anesthesia preparation in relation to hypertension control, analgesia plan and postoperative care site, transfusion strategy, and management of intravascular extension.
Anesthesia Approach for Nephrectomy in Full-Term Neonate with Suspected Wilms Tumor and Patent Foramen Ovale: A Case Report Katarina, Ida; Otniel Adrians Labobar; I Putu Kurniyanta
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 2 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i2.919

Abstract

Background: Nephrectomy for Wilms tumor presents a considerable challenge in pediatric anesthesia. This study aimed to describe the anesthesia approach for nephrectomy in a full-term neonate with suspected Wilms tumor and patent foramen ovale. Case presentation: A 25-day-old male neonate was referred with a longstanding intraabdominal mass present since birth. Echocardiography revealed a patent foramen ovale with a diameter of 2.7 mm and a left-to-right shunt. The patient also had a diagnosis of partial ileus obstruction, likely caused by the tumor's pressure on the left kidney. Preoperative fasting adhered to a "6-4-3-1" regimen. Normoglycemia was maintained throughout the perioperative period. The case was managed under general anesthesia without the use of the rapid sequence induction technique. Caudal analgesia was administered using 1.14 ml of 0.175% bupivacaine. Vigilant monitoring of blood loss, prevention of hypothermia, and effective pain management are vital aspects of the surgical procedure. For postoperative pain management, analgesia and morphine infusion were employed. The patient was then transferred to the neonatal intensive care unit (NICU) for observation for any signs of complications related to anesthesia and surgery. Conclusion: Nephrectomy in neonates is one of the challenges of pediatric anesthesia. Pre-anesthesia preparation in relation to hypertension control, analgesia plan and postoperative care site, transfusion strategy, and management of intravascular extension.