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Survival Rate of Critically Ill Coronavirus Disease 2019 Patients on Tracheostomy in Indonesia Ramdhani, Aris; Aditianingsih, Dita; Zahra, Raihanita; Putra, Muhammad A; Soeharto, Wuryantoro; Kwa, Melvin D.B.
The New Ropanasuri Journal of Surgery Vol. 6, No. 2
Publisher : UI Scholars Hub

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Introduction. During COVID-19 global pandemic, tracheostomy is often performed on critically ill COVID-19 patients. There is no available data on the survival rate of critically ill COVID-19 patients on tracheostomy in Indonesia. This study aimed to find the survival rate of critically ill COVID-19 patients on tracheostomy in Indonesia. Methods. A descriptive survival analysis study enrolled critically ill COVID-19 patients in RSUI who underwent a tracheostomy procedure. Baseline data, including clinical characteristics and laboratory findings before tracheostomy, were recorded. Survival analysis was conducted using the Kaplan-Meier plot. Results. Forty-two subjects were enrolled in the study: 25 males (59.5%) and 17 females (40.5%). The median age was 57 (26 – 72) years. Subjects with diabetes mellitus or hypertension were 78.6% and 78.6% with BMI >25 kg/m2. The mean duration of intubation was 16.24 ±7.62 days, the median duration of tracheostomy before the outcome was 8 (0 – 53) days. There were 9.5% of subjects survived and were discharged. The median survival time was 8 (0 – 53). In the first 15 days after tracheostomy procedures, those who were deceased were 75% of the subjects. Conclusion. In this study, the survival rate of critically ill COVID-19 patients on tracheostomy remains low. Another study to evaluate the cause of the low survival rate of critically ill patients with COVID-19 on tracheostomy is required.
Effect of Ischemia-Reperfusion injury and Preconditioning on Lung Parenchyma after Acute Limb Ischemia Hutagaol, David; Susanti, Dhama S; Soeharto, Wuryantoro; Putra, Muhammad A; Wardoyo, Suprayitno; Makdinata, William; Setiawan, Moira
The New Ropanasuri Journal of Surgery Vol. 7, No. 1
Publisher : UI Scholars Hub

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Introduction. Acute limb ischemia, a sudden decrease of perfusion to the extremities, can compromise the survival of the limbs. Medical intervention and surgery are often needed to return perfusion. However, reperfusion injury can trigger oxidative stress and inflammatory response, leading to local and remote tissue damage, such as the lungs, which increases morbidity and mortality. This research aims to study the effects of hypothermia and remote ischemic preconditioning (RIPC) on the lung parenchyma after being exposed to reperfusion after acute limb ischemia in rabbits. Method. Eighteen New Zealand White rabbits were divided into three groups of 6. The femoral artery was ligated to induce ischemia. The hypothermia group was given cooling pads to maintain a temperature of 28°C for 4 hours, and the RIPC group was assigned RIPC before ligation for 5 minutes in three cycles. Both groups underwent reperfusion for eight hours. Evaluation of histologic characteristics was performed independently by a pathologist. Results. The mean scores for the control group, hypothermia group, and RIPC group were 12.03 + 1.43 (severe injury), 8.03 + 3.03 (moderate injury), and 4.80 + 2.61 (mild injury), respectively. In addition, there was a significant difference between lung parenchymal damage in the control group and hypothermia group (p = 0.015) and between the control group and RIPC group (p = 0.000). Conclusion. Both hypothermia and RIPC have a protective effect on lung parenchyma exposed to remote reperfusion injury after lower limb ischemia, where RIPC protects the lungs to a higher degree.