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Intensive Care Management of Eclampsia with HELLP Syndrome: A Case Report Liliriawati Ananta Kahar; Wiwi Monika Sari; Mentari Faisal Putri
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 7 No. 9 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v7i9.859

Background: The incidence of HELLP syndrome is approximately 0.1-1% of all pregnant women and 5.5% of patients admitted to the ICU. Hemolysis, elevated liver enzymes, and thrombocytopenia are the characteristics of HELLP syndrome. Case Presentation: A 38-year-old patient with diagnosed G4P3A0L3 31-32 weeks of preterm pregnancy + eclampsia on MgSO4 regimen, HELLP syndrome + twice previous Sectio cesarean + breech presentation. On physical examination, the general condition was blood pressure 199/103 mmHg. The results of laboratory tests post-op were hemoglobin 7,1 g/dL, leukocytes 15.930, hematocrit 24%, and platelets 38,000. The results of other laboratory tests showed decreased albumin levels (Alb 2,4), increased levels of total bilirubin 14,7, direct bilirubin 10,8 and indirect bilirubin 3,9, increased liver enzyme SGOT 2001 SGPT 513. Conclusion: HELLP syndrome is a threatening clinical problem. Appropriate and adequate management, especially in the Intensive care unit, is needed to prevent severe complications to reduce morbidity and mortality rates in patients with HELLP syndrome.

Intensive Management of Spontaneous Basal Ganglia Hemorrhage: A Case Report Liliriawati Ananta Kahar; Rico Ikhsani; Wiwi Monika Sari
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 7 No. 9 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v7i9.862

Background: Simultaneous non-traumatic bilateral basal ganglia haemorrhage is an infrequent entity. ICH accounts for 10 to 20 % of all cerebrovascular events in the US, with 30-day mortality up to 40%. The predisposing factors and pathophysiological processes leading to simultaneous bilateral basal ganglia development are not well known. Case presentation: A 43-year-old female patient was diagnosed with spontaneous intracerebral haemorrhage in the left basal ganglia and intraventricular haemorrhage. The patient underwent an urgent ICH evacuation craniotomy. After the procedure, the patient was treated in the intensive care unit. The patient was intubated for 4 days. Then, on the fifth day of stay in the ICU, a tracheostomy was performed on the patient. Conclusion: Spontaneous ICH has high mortality and morbidity. ICH management is mainly on timely targeted blood pressure management, effective and rapid reversal of coagulopathy to prevent hematoma expansion, and uncompromising intracranial pressure management.

Critical Care Management of Fracture Dislocation of Cervical Spine: A Case Report Liliriawati Ananta Kahar; Wiwi Monika Sari; Aldhimas Marthsyal Pratikna; Arif Gunawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 7 No. 9 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v7i9.865

Background: Spinal cord injuries affect nearly 1 million people every year, more than 90% of all cervical injuries require intubation, most cases also require tracheostomy, and nearly 40% are ventilator dependent. This study aimed to describe critical care management of fracture dislocation of spine. Case Presentation: A 27-year-old male patient complained patient came with complaints of weakness in both limbs 13 hours before admission. Initially, the patient was driving a motorbike then the patient was involved in an accident with a car after the incident, the patient also felt a bit short of breath, could not move both his leg and hand, and could not feel defecation or urination. Patient was diagnosed with Fracture dislocation of C4-C5. The patient underwent elective decompression stabilization. Patient admitted to ICU with the majority requiring assisted ventilation. After five days in the ICU, the patient was challenged to be released from the ventilator, so the patient was performed early tracheostomy Conclusion: Patients with cervical injuries require comprehensive care in the intensive care unit, especially in airway management and respiratory support, in addition to addressing the potentially catastrophic multisystem sequelae of nerve damage.

Intensive Care Management of Eclampsia Complicated with Acute Kidney Injury: A Case Report Liliriawati Ananta Kahar; Wiwi Monika Sari; Rizky Rivonda Bennovry; Muhammad Ryfki Syahredi Adnani
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 7 No. 10 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v7i10.872

Background: Pre-eclampsia-related AKI occurs in 21% of all pregnancies, with 4% associated with severe eclampsia. The most common cause of AKI is eclampsia, which affects about 3-5% of pregnancies. Case presentation: The patient came to the hospital with seizures three times at home, whole body seizures, duration 1-2 minutes, and after a seizure, the patient was unconscious. The patient had a seizure in the hospital twice, 5-10 minutes. She has had a history of hypertension during pregnancy (210/112 mmHg). The patient was diagnosed with decreased consciousness due to eclampsia antepartum on Primipara 31-32 weeks of preterm pregnancy on a maintenance dose of MgSO4 regimen + oligohydramnion patient was performed emergency section cesarean. After Termination, the patient was admitted to ICU. The patient was assisted by a mechanical ventilator. Conclusion: Critical care management is necessary for eclampsia with Acute Kidney Injury, adequate initial management, including hemodynamic stabilization, fluid balance, electrolyte correction, and possibly dialysis, is required to reduce morbidity and mortality.

Critical Care Management of Fracture Dislocation of Cervical Spine: A Case Report Liliriawati Ananta Kahar; Wiwi Monika Sari; Aldhimas Marthsyal Pratikna; Arif Gunawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 7 No. 10 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v7i10.878

Background: Spinal cord injuries affect nearly 1 million people every year. More than 90% of all cervical injuries require intubation, most cases also require tracheostomy, and nearly 40% are ventilator dependent. Case presentation: A 27-year-old male patient complained patient came with complaints of weakness in both limbs 13 hours before admission. Initially, the patient was driving a motorbike, and then the patient was involved in an accident with a car. After the incident, the patient also felt a bit short of breath, could not move both his leg and hand, and could not feel defecation or urination. The patient was diagnosed with fracture dislocation of C4-C5. The patient underwent elective decompression stabilization. Patients admitted to ICU, with the majority requiring assisted ventilation. After five days in the ICU, the patient was challenged to be weaned from the ventilator, so the patient performed an early tracheostomy. Conclusion: Patients with cervical injuries require comprehensive care in the intensive care unit, especially in airway management and respiratory support, in addition to addressing the potentially catastrophic multisystem sequelae of nerve damage.

Intensive Management of Postoperative Septic Shock in Patient with Secundum Atrial Septal Defect: A Case Report Liliriawati Ananta Kahar; Wiwi Monika Sari; Rizki Oktavian
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 7 No. 7 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v7i7.839

Background: Sepsis is a life-threatening organ dysfunction caused by an abnormal inflammatory response to infection. This study aimed to describe the intensive management of postoperative septic shock in secundum atrial septal defect patients. Case presentation: A 28-year-old woman complaining of pus discharge and reddish swelling in the scar after a cesarean section operation. The patient has a history of pulmonary hypertension and secundum ASD. While in the ICU, examination of vital signs found the patient was weak, compost mentis conscious, blood pressure 80/55 mmHG (MAP 63), Respiration 28 times per minute, pulse 114 times per minute, temperature 38.6°C with 98% oxygen saturation with NRM 10 L/ and laboratory examinations obtained hemoglobin 8.6, leukocytes 14.870, platelets 236.000, hematocrit 24, albumin 2.4 and procalcitonin > 100. Conclusion: This study reported that septic shock is a life-threatening condition, especially in patients with congenital heart disease. Appropriate, rapid, and comprehensive treatment and addressing the source of infection are essential in managing sepsis shock.

Intensive Management of A 21-Year-Old Male Patient with Acute Respiratory Failure Due to Near Drowning: A Case Report Liliriawati Ananta Kahar; Kornelis Aribowo; Clarissa Hasana Hasmi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 7 No. 7 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v7i7.840

Background: The mechanism of near drowning involves decreased lung compliance and aspiration of water into the lungs, which damages surfactants and disrupts alveolar capillary membranes. This leads to the development of alveolar oedema, and ventilation-perfusion mismatch, which causes hypoxemia leading to acute respiratory distress syndrome (ARDS) and cause other organ dysfunction and death. Case presentation: The patient was found drowned by his friends while on vacation and swimming in the river. Initial physical examination in the ED obtained a Glasglow coma scale (GCS) score of 14/15 (E3-V5-M6), blood pressure 124/70 mmHg, and pulse 124 beats/min. The patient breathed spontaneously 25 breaths/min with oxygen saturation (SpO2) of 90% on room air. The patient was initially managed with oxygenation using a non-rebreathing mask (NRM semi-fowler positioning and peripheral access. Chest X-ray and other radiologic examinations, including a brain CT scan, were performed before the patient was immediately transferred to the ICU, and there was no evidence of other trauma. During the 9 days of intensive management in the ICU, there was a good improvement from GCS 14 to 15. Conclusion: Intensive management of a 21-year-old male patient with acute respiratory failure due to near drowning.

Tracheostomy as an Effort to Help Weaning Ventilated Obese Patient: A Case Report Liliriawati Ananta Kahar; Diflayzer; Wiwi Monika Sari
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 7 No. 8 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v7i8.850

Background: The prevalence of tracheostomy in the ICU was performed in 10%-15% of patients. Tracheostomy is performed in patients with prolonged intubation. The most compelling indications for tracheostomy are acute respiratory failure with prolonged or expected prolonged duration of mechanical ventilation and failure to wean from a mechanical ventilator. Case presentation: A 60-year-old female patient came to the emergency room of Dr. M. Djamil General Hospital with decreased consciousness 2 days before admission. Vital signs showed Sopor consciousness, RR: 30 x/min, and BMI: 39 kg/m2. Thorax examination of bronchovesicular breath sounds, rhonchi +/+, wheezing +/+. The patient was intubated and put on a ventilator, and admitted to the ICU. A tracheostomy on day 5 was performed on the patient. The patient was able to be weaned from the ventilator and then admitted to the neurology ward on day 18. Conclusion: Tracheostomy can help weaning patients from mechanical ventilation. In this case, a severely obese patient can be weaned from the ventilator with a tracheostomy.

Intensive Care Management of Preeclampsia: A Case Report Liliriawati Ananta Kahar; Wiwi Monika Sari; Mentari Faisal Putri
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 7 No. 8 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v7i8.853

Background: The prevalence of preeclampsia is around 5% - 15% of all pregnant women. It can cause severe complications and even death in the mother and fetus if not adequately managed. Case presentation: A 36-year-old housewife was admitted to the emergency department with a chief complaint of shortness of breath before hospital arrival. The patient also complained of headaches. From the physical examination, consciousness was compos mentis, blood pressure 162/100 mmHg, HR 90 x/min, RR 24x/min, SpO 96%. From abdominal ultrasound gravid 36-37 weeks according to biometry, fetal alive, gemelli, intrauterine, transverse lie right head dorsoinferior- breech presentation, the Laboratory in emergency room result, haemoglobin: 10,4, leukocyte, 13.020, thrombocyte 359.000, hematocrit 31, ureum: 11, creatinin: 0.5, glucose: 72, protein urine: +2. Conclusion: In patients with preeclampsia, proper diagnosis and appropriate treatment in the intensive care unit and management by a multidisciplinary team can prevent preeclampsia complications and improve preeclamptic patients' outcomes.

Intensive Care Management of Eclampsia with HELLP Syndrome: A Case Report Liliriawati Ananta Kahar; Wiwi Monika Sari; Mentari Faisal Putri
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 7 No. 9 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v7i9.859

Background: The incidence of HELLP syndrome is approximately 0.1-1% of all pregnant women and 5.5% of patients admitted to the ICU. Hemolysis, elevated liver enzymes, and thrombocytopenia are the characteristics of HELLP syndrome. Case Presentation: A 38-year-old patient with diagnosed G4P3A0L3 31-32 weeks of preterm pregnancy + eclampsia on MgSO4 regimen, HELLP syndrome + twice previous Sectio cesarean + breech presentation. On physical examination, the general condition was blood pressure 199/103 mmHg. The results of laboratory tests post-op were hemoglobin 7,1 g/dL, leukocytes 15.930, hematocrit 24%, and platelets 38,000. The results of other laboratory tests showed decreased albumin levels (Alb 2,4), increased levels of total bilirubin 14,7, direct bilirubin 10,8 and indirect bilirubin 3,9, increased liver enzyme SGOT 2001 SGPT 513. Conclusion: HELLP syndrome is a threatening clinical problem. Appropriate and adequate management, especially in the Intensive care unit, is needed to prevent severe complications to reduce morbidity and mortality rates in patients with HELLP syndrome.

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