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All Journal Indonesian Journal of Rheumatology Bioscientia Medicina : Journal of Biomedicine and Translational Research Bioscientia Medicina : Journal of Biomedicine and Translational Research Jurnal Locus Penelitian dan Pengabdian
Liliriawati Ananta Kahar
Department Of Anesthesiology And Intensive Care, Faculty Of Medicine, Universitas Andalas, Padang, Indonesia
Aerospace Engineering Automotive Engineering Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Electrical & Electronics Engineering Immunology & microbiology Mathematics Medicine & Pharmacology Neuroscience

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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

Abstract

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

Abstract

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

Abstract

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.
Post Operative Management in Intensive Care of Obstructive Jaundice caused by Choledocholithiasis: A Case Report Liliriawati Ananta Kahar; Wiwi Monika Sari
Indonesian Journal of Rheumatology Vol. 13 No. 3: Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v13i3.257

Abstract

Introduction: Gallstones are a very common problem in the global population. 10%-25% of affected people may have specific symptoms, and 1%-2% of them may experience major complications. Case presentation: 83-year-old female patient complained of yellow in her eyes and skin. Patients also felt pain in the right upper abdomen. Laboratory examination revealed increased bilirubin serum. Abdominal Ultrasound examination showed Obstruction of the Bilier Ductus caused by a stone at ductus sisticus and sludge of the gallbladder. The patient was diagnosed with Jaundice obstruction caused by obstruction of the bile ducts due to a stone at the ductus sisticus with a history of nephrectomy, Hypertension, and type 2 diabetes. The patient underwent Laparoscopic cholecystectomy, ERCP, and stent biller, After the procedure, the patient was admitted to the intensive care unit. Conclusion: Understanding the patient's comprehensive medical and surgical history is fundamental in understanding the postoperative patient in the intensive care unit. Adequate resuscitation is necessary for good clinical perfusion and physiological stability of the patient.
Critical Care Management of Myasthenic Crisis: A Case Report Liliriawati Ananta Kahar
Indonesian Journal of Rheumatology Vol. 13 No. 3: Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v13i3.263

Abstract

Background: The annual incidence of myasthenia gravis is 1-2 cases in 100,000 population. 30% of all cases will develop bulbar or respiratory muscle weakness. About 15-20% of myasthenia gravis patients will develop myasthenia crisis. Case presentation: An 18-year-old female patient complained of difficulty swallowing two days ago difficulty swallowing solid and liquid food, and this complaint caused the patient to cough and choke. Complaints were accompanied by difficulty opening the eyelids, especially in the afternoon. Complaints were also accompanied by double vision, especially when looking to the right. There was a nasal sound, and the patient had difficulty pronouncing vocal letters. The patient was admitted to ICU, In the ICU patient was intubated and given plasma exchange therapy. Conclusion: Myasthenic crisis is a neurological emergency that requires prompt diagnosis and treatment. Adequate intensive care, judicious weaning, and extubation decisions, along with specifically targeted therapy, will improve the outcome of myasthenia gravis.
Critical Care Management of Fracture Dislocation of Cervical Spine: A Case Report Kahar, Liliriawati Ananta; 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

Abstract

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.
Challenges in the Management of Pulmonary Contusion with Multiple Rib Fractures and Associated Injuries: A Case Report Kahar, Liliriawati Ananta
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 12 (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.v8i12.1155

Abstract

Background: Pulmonary contusion, a common consequence of chest trauma, presents significant management challenges, especially when associated with multiple rib fractures and other injuries. These cases often require intensive care due to the high risk of complications and mortality. This report presents a case of a patient with pulmonary contusion, multiple rib fractures, and cerebral contusion to illustrate the complexities involved in managing such cases. Case Presentation: A 44-year-old male was admitted to the intensive care unit (ICU) following a motor vehicle accident. He presented with decreased consciousness, multiple rib fractures, severe lung contusion, and cerebral edema. The patient's condition was further complicated by the development of respiratory distress and hemodynamic instability. Conclusions: The management of pulmonary contusion with multiple rib fractures and associated injuries requires a multidisciplinary approach with careful attention to respiratory support, hemodynamic management, pain control, and early intervention for complications.
The Use of Trendelenburg Position in the Management of Retropharyngeal Abscess: A Case Report and Clinical Considerations Emilia Nissa Khairani; Liliriawati Ananta Kahar; Novialdi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 1 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i1.1180

Abstract

Background: Retropharyngeal abscess (RPA) is a serious deep neck space infection that can lead to life-threatening complications such as airway obstruction, mediastinitis, and sepsis. The Trendelenburg position, where the patient's head is lower than their feet, has been traditionally used in the management of RPA to prevent aspiration of pus in case of abscess rupture. However, the optimal positioning for patients with RPA remains a topic of debate. Case presentation: A 51-year-old male patient presented to the emergency room with a 5-day history of progressive dysphagia and neck swelling. He was diagnosed with a ruptured retropharyngeal abscess extending to the mediastinum (descending necrotizing mediastinitis). The patient underwent surgical drainage and was subsequently admitted to the intensive care unit (ICU), where he was intubated and mechanically ventilated in the Trendelenburg position. Five days later, the patient developed pneumonia, suspected to be ventilator-associated pneumonia (VAP). Conclusion: The Trendelenburg position may be considered in the management of RPA to minimize the risk of aspiration. However, it is essential to weigh the potential benefits against the risks, including VAP, and to consider alternative positions such as the lateral Trendelenburg position, which may offer similar benefits with reduced risk. Further research is needed to determine the optimal positioning strategy for patients with RPA.
Challenges in Intensive Care Management of a Patient with Retropharyngeal Abscess and Mediastinal Extension: A Case Report Kahar, Liliriawati Ananta
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 4 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i4.1265

Abstract

Background: Retropharyngeal abscess (RPA) is a serious infection of the deep neck space that can extend to the mediastinum, leading to life-threatening complications. This case report highlights the challenges in managing a patient with RPA and mediastinal extension in the intensive care unit (ICU). Case presentation: A 44-year-old male with a history of diabetes mellitus presented with pain, difficulty opening the mouth, and fever. Imaging revealed a retropharyngeal abscess extending to the mediastinum. The patient underwent surgical drainage and was admitted to the ICU for postoperative management. Challenges encountered included airway management, hemodynamic instability, sepsis, and ventilator weaning. The patient required a multidisciplinary approach involving anesthesiologists, intensivists, infectious disease specialists, and surgeons. Conclusion: RPA with mediastinal extension is a challenging condition requiring prompt diagnosis, aggressive treatment, and meticulous intensive care management. A multidisciplinary approach is crucial for successful outcomes.
Comprehensive Management of Massive Transfusion in Postpartum Hemorrhage Patients Ananta Kahar, Liliriawati
Jurnal Locus Penelitian dan Pengabdian Vol. 4 No. 10 (2025): : JURNAL LOCUS: Penelitian dan Pengabdian
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/locus.v4i10.4913

Abstract

Postpartum hemorrhage (PPH) is one of the leading causes of maternal morbidity and mortality worldwide. This condition can cause significant blood loss in a short period of time, requiring rapid and appropriate intervention to prevent fatal complications. A 30-year-old female patient came to the hospital with G0P1A0H1 with bleeding from the birth canal, currently 37-38 weeks pregnant. After examination, the patient was found to have suspected placenta previa accreta. During surgery, grade 3 placenta accreta was found to have infiltrated the urinary bladder, and a joint operation was performed with the urology department. Intraoperative bleeding was approximately 2000 cc, and during the operation, 4 units of whole blood, 2 units of PRC, 4 units of FFP, and 4 units of cryoprecipitate were administered. Intraoperative hemodynamics fluctuated. After the operation, the patient was transferred to the ICU for monitoring. Management of postpartum hemorrhage (PPH) is based on rapid diagnosis and immediate replacement of lost blood volume, as well as restoration of the blood's ability to carry oxygen. In addition, prompt medical and surgical measures to address the underlying cause of bleeding are essential to prevent further blood loss
Co-Authors Aldhimas Marthsyal Pratikna Aldhimas Marthsyal Pratikna Arif Gunawan Arif Gunawan Clarissa Hasana Hasmi Diflayzer Emilia Nissa Khairani Kahfi Rakhmadian Kornelis Aribowo Kornelis Aribowo Mentari Faisal Putri Muhammad Ryfki Syahredi Adnani Novialdi . Prima Yudi Leo Reyhan Julio Rico Ikhsani Ridho Prasetiawan Rizki Oktavian Rizky Rivonda Bennovry Talitha Azalia Wiwi Monika Sari Wiwi Monika Sari Wiwi Monika Sari