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All Journal Jurnal Anestesiologi Indonesia Majalah Anestesia dan Critical Care Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia World Nutrition Journal The New Ropanasuri Journal of Surgery Bioscientia Medicina : Journal of Biomedicine and Translational Research Jurnal Neuroanestesi Indonesia Majalah Anestesia & Critical Care (MACC) Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education and Research Institute Jurnal Komplikasi Anestesi
Dita Aditianingsih
Departemen Anestesi Dan Terapi Intensif; Fakultas Kedokteran; Universitas Indonesia/ Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo; Jakarta
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Sepsis-Akut Kidney Injury pada Urosepsis Palu, Raphael Putra; Aditianingsih, Dita; Sudarsono
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.v5i2.7328

Abstract

Sepsis is a life-threatening condition caused by a dysregulated immune response to infection. Sepsis mortality increases with acute kidney injury and patients with acute kidney injury worsen with sepsis. It is interesting to note that most of the clinical trials on sepsis treatment that derived from the results of translational researches are a failure. This is because of the complexity of human sepsis in comparison with animal models and the improper matching of the animal models to the individual patient. It is possible that the main mechanism of sepsis induction in each patient with the variety causes of sepsis might be different. Immune response to sepsis depends on genetic background, route of immune activation and organisms. Urosepsis is type of infection that cause AKI and septic shock. Specific treatment of sepsis induced acute kidney injury in individual patient according to the specific immune response characteristic might be a more proper strategy. Report the case of a female aged 50 years, entered into RSCM with primary complaints of unconsciousness, and diangnosed with acute kidney injury et causa urosepsis. Complications acute kidney injury, inbalance electrolite and pneumonia were arised. Monitoring macrocirculation, tissue perfusion parameters, antibiotic and intermitten hemodialisis were performed in patient to recover.
Developing “do it yourself” Phantom for Teaching Seldinger Technique in Vascular Access Placement to General Practitioners Hafidz, Noor; Sedono, Rudyanto; Aditianingsih, Dita; Sugiarto, Adhrie; Manggala, Sidharta Kusuma
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 7 No. - (2023): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v7i-.201

Abstract

Establishing a vascular access is a crucial aspect in managing critically ill patients in the Intensive Care Unit (ICU). The skill in placing vascular access varies among healthcare professionals. Clinical experience and level of training among nurses, general practitioners, and intensivists are the determinants of skill in placing vascular access. Training to establish vascular access using the Seldinger technique needs practice using a vascular phantom or a cadaver. Commercially sold phantoms are difficult to get, and an alternative training phantom is needed. We built a simple “do-it-yourself” model of a vascular phantom using “easy-to-find” material that can be used to practice the Seldinger technique. We used a synthetic polyurethane sponge 16x16 cm in size as a base and a polyvinyl alcohol sheet of the same size. We used 22 F urinary catheters trimmed to 12 to represent blood vessels. The final product is a piece of the urinary catheter embedded in the sponge and then covered by polyvinyl alcohol to simulate the epidermis. The phantom can be used in training programs to improve the skill of general practitioners in placing advanced vascular access. 13 general practitioners were involved in this training, and 100% said that this phantom could simulate the experience. “Do-it-yourself” phantom for vascular access training can be used ro practice the Seldinger technique and can simulate the real experience.
Analisis Xpert® -Carba-R pada Skrining Enterobacterales Resisten Karbapenem di Unit Perawatan Intensif di Rumah Sakit Rujukan Nasional di Jakarta Saharman, Yulia Rosa; Sania, Nina; Aditianingsih, Dita
Majalah Kedokteran Indonesia Vol 74 No 5 (2024): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.74.5-2024-1696

Abstract

Introduction: Carbapenem-resistant Enterobacterales (CRE) represent a significant global health problem due to their high resistance to antibiotics. Traditional methods for identifying resistance genes, such as Real-Time PCR (RT-PCR), are accurate but time-consuming and involve complex techniques. This study aimed to compare the Cepheid Xpert® Carba-R test with RT-PCR, used as the gold standard, to determine its effectiveness in rapidly identifying carbapenem resistance genes in CRE. Method: The study was performed from January to June 2022, involving patients admitted to the Intensive Care Unit (ICU) at Dr. Cipto Mangunkusumo National Hospital. Rectal or perirectal swabs were collected upon ICU admission. If patients tested negative for CRE upon admission, repeat swabs were taken at discharge or death, with a maximum length of stay (LOS) of 14 days in the ICU. Genotypic identification of carbapenem resistance genes, including KPC, NDM, OXA-48, VIM, and IMP, was performed using the Cepheid Xpert® Carba-R and compared to RT-PCR. Additionally, phenotypic identification through bacterial culture was performed using the Vitek method. Result: Out of 102 ICU patients, 10.23% (22/215 isolates) were found to be positive for CRE, with the most common bacterial isolates being Escherichia coli (148/215, 68.83%) and Klebsiella pneumoniae (53/215, 24.65%). CRE was found in 1 of 148 E. coli isolates (0.67%) and in 21 of 53 K. pneumoniae isolates (39.62%). The most frequently detected carbapenem resistance gene was OXA-48 (16/22, 72.73%), followed by NDM (6/22, 27.27%). The Xpert® Carba-R test demonstrated a sensitivity and specificity of 100%, with positive predictive value (PPV) and negative predictive value (NPV) both equal to 1. A discrepancy was observed between the phenotypic and genotypic identification, with 27 phenotypically identified CRE isolates compared to 22 genotypically confirmed ones. Conclusion: The Cepheid Xpert® Carba-R test provides a reliable, rapid alternative for identifying carbapenem resistance genes in CRE, demonstrating perfect sensitivity and specificity in this study. This study indicates that Xpert® Carba-R can be an alternative in the rapid identification of CRE resistance genes.
Efek perbedaan Volume Tidal Ventilasi Mekanik Selama Operasi terhadap Rasio PaO2/FiO2 Pascakraniotomi Elektif Aditianingsih, Dita; Sedono, Rudyanto; Baktiar, Yoshua
Jurnal Neuroanestesi Indonesia Vol 5, No 3 (2016)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (100.344 KB) | DOI: 10.24244/jni.vol5i3.77

Abstract

Latar Belakang: Kraniotomi elektif memiliki insidens komplikasi paru pascaoperasi (25%) dan mortalitas (10%) yang tinggi; insiden ini lebih rendah pada pemakaian volume tidal rendah sebagai teknik proteksi paru. Penelitian ini meneliti efek volume tidal 6 mL/kg dan 10 mL/kg terhadap rasio PaO2/FiO2(sebagai parameter keparahan cedera paru) pascaoperasi pada kraniotomi elektif.Subjek dan Metode: Setelah mendapat izin Komite Etik FKUI/Rumah Sakit Cipto Mangukusumo dan konsen pasien, dilakukan uji klinis acak pada 52 pasien kraniotomi elektif yang dirandomisasi ke dalam 2 kelompok: ventilasi mekanik selama operasi dengan volume tidal 6 mL/kg (VT6) atau 10 mL/kg (VT10), lalu dilakukan analisis gas darah.Hasil: Rasio PaO2/FiO2 kelompok VT-6 dan VT10 secara berurutan: pada 1 jam pascainduksi 413,7 113,4 mmHg dan 401,5 106,3 mmHg (p0.05); pada akhir operasi, 466,6 94,6 mmHg dan 471,1 89,0 mmHg (p0.05), pada 24 jam pascainduksi, 418,8 108,8 mmHg dan 448,5 119,6 mmHg (p0.05); pada 48 jam pascainduksi, 414,9 88,1 mmHg dan 402,5 100,7 mmHg (p0.05 ). Tidak ada perbedaan signifikan insiden mortalitas dan komplikasi paru dan ekstraparu diantara dua kelompok.Simpulan: Tidak ada perbedaan signifikan antara volume tidal 6 ml/kg dan 10 ml/kg terhadap ratio PaO2/FiO2 pada pasien kraniotomi elektif.The Effect of Different Tidal Volume against Postoperative PaO2/FiO2 Ratio in Elective Craniotomy PatientsBackground: Elective craniotomy is associated with a high incidence of postoperative pulmonary complications/PPC (25%) and mortality (10%); in which these incidence went down with the administration of low tidal volume. This study investigated the effect of low tidal volume in intraoperative PaO2/FiO2 ratio in elective craniotomy patients.Subject and Methods: After approval from Ethics Committee Faculty of Medicine Universitas Indonesia, Ciptomangunkusumo Hospital and consent from patients,a randomized controlled trialwas done to 52 elective craniotomy patients. Subjects were ventilated with tidal volume 6 mL/kg (VT6) or 10 mL/kg (VT10) intraoperatively, then blood gas analyses wereperformed.Results: PaO2/FiO2 ratio of VT6 and VT10 respectively: at 1 hour postinduction, 413.7 113.4 mmHg and 401.5 106.3 mmHg (p0.05); at end of surgery, 466.6 94.6 mmHg and 471.1 89.0 mmHg (p0.05); at 24 hours postinduction, 418.8 108.8 and 448.5 119.6 mmHg (p0.05); at 48 hours postinduction, 414.9 88.1 mmHg and 402.5 100.7 mmHg (p0.05). There were no significant differences on mortality, lung and extralung complications observed between both groupsConclusions: There were no significant difference between tidal volume 6 ml/kg and 10 ml/kg against intraoperative PaO2/FiO2 ratio in elective craniotomy patients.
Co-Authors Achmad Noerkhaerin Putra Ahmad Imron Anindhita, Bintari Anne Suwan Djaja Ardiyan Ardiyan Baktiar, Yoshua Baktiar, Yoshua Bob Firman Djaja, Anne S. George Yohannes George, Yohanes W.H. George, Yohanes WH Hafidz, Noor Indro Mulyono Jefferson, Jefferson Kwa, Melvin D.B. Luciana Budiati Sutanto Luki Sumaratih Mandagi, Michael Manggala, Sidharta Kusuma Nurul Ratna Mutu Manikam Palu, Raphael Putra Pittara Pansawira Putra, Muhammad A Ramdhani, Aris Rudyanto Sedono, Rudyanto Rudyanto Soedono Sania, Nina Singal, Anna Maurina Soeharto, Wuryantoro Sudarsono Sugiarto, Adhrie Wahyu Ika Wardhani Yohanes W George Yulia Rosa Saharman Zahra, Raihanita