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All Journal E-Journal Widya Kesehatan dan Lingkungan SEAS (Sustainable Environment Agricultural Science) The Journal of Society Medicine (JSOCMED) Jurnal Komplikasi Anestesi
Suwarman
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Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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MOBILISASI DINI DI ICU Muhari, Andie; Suwarman; Oktaliansah, Ezra; Sitanggang, Ruli H
E-Journal Widya Kesehatan dan Lingkungan Vol. 2 No. 2 (2020)
Publisher : E-Journal Widya Kesehatan dan Lingkungan

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Abstract

Mobilisasi dini dan rehabilitasi pada pasien di perawatan ruang intensif harus dilaksanakan sesegera mungkin. Tindakan mobilisasi pada pasien di ruang perawatan intensif merupakan tindakan dasar keperawatan dan kebutuhan berdasar alasan klinis. Terjadinya gejala sisa jangka panjang termasuk terjadinya ICU-acquired muscle weakness (ICUAW) terjadi hingga 50% dari pasien yang dirawat dan berhubungan dengan kelemahan tubuh pada pasien dengan perawatan yang lama secara fungsi dan kualitas hidup. Risiko terjadinya perubahan kondisi dan atrofi otot sangat cepat pada keadaan tirah baring yang lama. Mobilisasi dini juga dapat mempercepat waktu pulih, mengurangi lama perawatan di ICU, mengurangi perawatan kembali ke ICU dan bahkan meningkatkan waktu survival rate. Mobilisasi dini pada pasien ICU secara konvensional dan mode baru pada perawatan penyakit kritis bertujuan untuk mengurangi efek buruk imobilisasi pada pasien kritis. Rehabilitasi fisik berjalan linier mulai dari aktifitas di tempat tidur, duduk, berdiri, dan berjalan. Penilaian fungsi di ICU berupa keluaran fungsi tubuh, kekuatan otot, massa otot, fungsi mobilitas, dan kualitas hidup. Tindakan fisioterapi penting dikerjakan di ICU untuk mengoptimalkan fungsi kardiopulmonal dan fungsi secara fisik. Fisioterapis harus mengikuti, mengevaluasi, dan memberikan terapi sejak fase akut hingga fase rehabilitasi.
TATALAKSANA PASIEN SEPSIS YANG DISEBABKAN OLEH PERITONITIS DIFUS ec. PERFORASI DUODENUM: (LAPORAN KASUS) Arvianto; Oktaliansah, Ezra; Suwarman
E-Journal Widya Kesehatan dan Lingkungan Vol. 3 No. 1 (2021)
Publisher : E-Journal Widya Kesehatan dan Lingkungan

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Infeksi intra abdomen adalah penyebab kedua tersering dari sepsis dan kematian akibat infeksi pada pasien-pasien yang dirawat di Intensive Care Unit (ICU). Faktor kunci yang menentukan keberhasilan terapi pada infeksi intra-abdomen adalah diagnosis segera, source control yang adekuat dan pemberian antibiotik yang tepat. Resusitasi yang adekuat dengan pemberian obat vasopresor dini bila pasien mengalami syok sepsis merupakan tindakan yang sangat penting. Pemberian antibiotik empiris untuk kasus sepsis maupun syok sepsis akibat infeksi intraabdomen complicated dapat mengikuti panduan The Infection Diseases Society of America (IDSA) atau panduan antibiotik di Indonesia. Perawatan pasca operasi di ICU harus dilakukan dengan optimal, diantaranya dengan memberikan dukungan ventilasi mekanik dan terapi cairan yang tepat. Tujuan penulisan ini adalah untuk mendeskripsikan dan mendokumentasikan keberhasilan tatalaksana penanganan perforasi difus dengan komplikasi sepsis yang disebabkan oleh perforasi duodenum, di ruang perawatan intensif Rumah Sakit Gatot Soebroto Jakarta pada bulan Agustus 2020. Metode yang digunakan adalah laporan kasus dengan pendekatan retrospektif kemudian dianalisis secara deskriptif. Pasien dirawat 2 hari dengan ventilasi mekanik dan pindah ruangan setelah 3 hari dirawat di ruang perawatan intensif. Dapat disimpulkan bahwa angka mortalitas sepsis akibat perforasi difus masih tinggi disebabkan komplikasi dan kebutuhan pengelolaan kondisi kritis di ruang perawatan intensif dalam jangka waktu panjang.
PENGELOLAAN AKUT KIDNEY INJURY DISEBABKAN SEPSIS DI ICU Marisi, Suhud; Suwarman; Maskoen, Tinni
E-Journal Widya Kesehatan dan Lingkungan Vol. 3 No. 1 (2021)
Publisher : E-Journal Widya Kesehatan dan Lingkungan

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Acute Kidney Injury (AKI) is a syndrome that consists of several clinical conditions, due to sudden kidney dysfunction. Sepsis and septic shock are the causes of AKI and are known as Sepsis-Associated AKI (SA-AKI) and account for more than 50% of AKI cases in ICU, with a trend towards a poor prognosis. Acute Kidney Injury (AKI) is characterized by a sudden decrease in kidney function over several hours / day, which results in the accumulation of creatinine, urea and other waste products. The main goals of AKI management are to prevent further kidney damage and to keep the patient alive until the kidney function returns to normal. SA-AKI is a condition often faced by patients with sepsis in the ICU. The method used is based on a literature review regarding the reduction in mortality or success in patient management, in the BEST Kidney trial subgroup analysis, the probability of death in hospital was 50% higher in AKI sepsis compared with non-sepsis AKI. The understanding of sepsis and endotoxin that can cause SA-AKI is not fully known, the conclusion is that rapid identification of the incidence of SA-AKI, antibiotics and appropriate fluid therapy are crucial actions in the management of SA-AKI. The availability of organ support modalities such as CRRT in ICU care can help patients with sepsis survive due to frequent kidney organ failure.
Resistance Evaluation of Some Rice Varieties by Feeding Activity of Brown Planthopper Population in Java Willing Bagariang; Wayan Murdita; Suwarman; Ahmad Imroni
SEAS (Sustainable Environment Agricultural Science) Vol. 5 No. 2 (2021)
Publisher : Warmadewa University Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (323.065 KB) | DOI: 10.22225/seas.5.2.3913.79-87

Abstract

Brown Planthopper (BPH), Nilaparvata lugens Stal (Hemiptera: Delpachidae) is the important pest of rice. The infestation of BPH reduced the rice yield on rice producer countries in Asia. In Indonesia, the area of BPH infestation frequently fluctuated over the year. BPH directly caused hopper burn and also vector of rice grassy stunt virus (RGSV) and rice ragged stunt virus (RRSV). This study aimed to evaluate the resistance of some rice varieties to different BPH population in Java. Three BPH populations collected from Karawang (West Java), Pekalongan (Central Java) and Kendal (Central Java) were used in this study. The rice resistance was evaluated by conducting honeydew test. There were eight rice varieties tested i.e Sembada 168, Ciherang, Inpari 32, Inpari 33, IR 64, TN1, Ratu Heenati and PTB 33 with five replications. A number of 200 female adults (five females per plot) were starved for 2 hours before inserting to pot containing one seedling. The BPH adults were allowed to feed 40-day-old plants for 48 hours. The area of honeydew excreted by BPH was measured using software Image J. We used analysis of variance (ANOVA) and cluster analysis with ward method and similarity index of Euclidean distance to analyze the rice resistance to BPH. The study indicated three groups of rice resistance level. The variety of Sembada 168 and TN1 were susceptible to BPH. Variety of Ciherang, Inpari 32, Inpari 33 and IR 64 were moderately resistant to BPH. However, PTB 33 and Ratu Heenati were strongly resistant to BPH population of Java.
Mengenali Medical Error dan Optimalisasi Patient Safety di Intensive Care Unit (ICU) Adiyanto, Bowo; Suwarman
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.v7i2.7458

Abstract

Characteristics of patients treated in the ICU are patients with critical conditions, acute, with many comorbidities, the number of actions and medications and treatments by multidisciplinary and multi-specialist. This condition is a challenge to be able to develop safety culture in the ICU. The safety culture in the ICU must be aware of and have high vigilance that the potential for medical errors is quite high in the ICU and has a severe impact on patients. Systematic strategies and multifactorial approaches are needed to improve patient safety and reduce medical errors at the ICU. Improving safety culture, ensuring commitment to national patient safety regulations, investing in safe infrastructure, optimizing the role of units in identifying potential errors and standardizing services according to the latest evidence base are the basic factors needed to support safe and quality patient care at ICU . It is important for the next stage to manage and measure the processes and outcomes in the service, and ensure that patients receive optimal therapy in accordance with evidence base practice. In addition to focusing on patient safety areas that have been regulated by national regulations, focus on areas with an appropriate evidence base to be applied in ICU care such as protocol development, checklists, care bundles, simulation-based education, and CUSP programs to optimize the role of units in the program patient safety. The efforts mentioned above to be able to succeed certainly require organization, leadership, multidisciplinary and multi-specialist cooperation, as well as individual service ends who are committed and consistent to the development of safety culture in the ICU.
Terapi Nutrisi Pasien di Intensive Care Unit (ICU) Santosa, Budi; Suwarman; Pradian, Erwin
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.v7i3.7480

Abstract

Nutrition is important in critical patient care. Malnutrition may lead to poor outcome of the patient in ICU, including increases morbidity, mortality, and length of stay. Patient in ICU also experienced increased metabolism and catabolism which can lead to malnutrition. Therefore, the provision of nutrition for patients in the ICU needs a special care. The nutritional requirement of critical ill patients depend on the severity of the disease and previous nutritional status. To achieve the demand of nutritional demand can be given enterally, parenterally or both.
Management af a Patient with Guillain-Barré Syndrome Miller Fisher Type and Hospital-Acquired Pneumonia in the Intensive Care Unit : a Case Report Suwarman; Natapraja, Tresna Kusumah
Journal of Society Medicine Vol. 3 No. 11 (2024): November
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i11.177

Abstract

Introduction: Guillain-Barré Syndrome (GBS) is an acute, flaccid polyneuropathy that occurs following an infection and is mediated by an autoimmune process. Patients with GBS frequently experience respiratory complications that necessitate mechanical ventilation. Neurological impairments associated with GBS, such as decreased airway patency, ineffective cough, and difficulty swallowing, increase the risk of pulmonary infections like hospital-acquired pneumonia (HAP). Case Report: We present the case of a 59-year-old woman who experienced respiratory failure due to GBS and HAP and required treatment in the Intensive Care Unit (ICU). The patient was managed with Therapeutic Plasma Exchange (TPE), which resulted in clinical improvement. It took 18 days for the patient to be weaned off mechanical ventilation. Conclusion: A detailed review of the management strategies for GBS and HAP is essential to enhance future treatment approaches and ensure they align with current literature.
Co-Authors Ahmad Imroni Arvianto Bowo Adiyanto Budi Santosa Budi Santosa Erwin Pradian Ezra Oktaliansah Marisi, Suhud Maskoen, Tinni Muhari, Andie Natapraja, Tresna Kusumah Sitanggang, Ruli H Wayan Murdita Willing Bagariang Willing Bagariang