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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 Eduvest - Journal of Universal Studies
Liliriawati Ananta Kahar
Department Of Anesthesiology And Intensive Care, Faculty Of Medicine, Universitas Andalas, Padang, Indonesia
Aerospace Engineering Automotive Engineering Biochemistry, Genetics & Molecular Biology Computer Science & IT Decision Sciences, Operations Research & Management Electrical & Electronics Engineering Health Professions Immunology & microbiology Mathematics Medicine & Pharmacology Neuroscience Social Sciences

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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.
Critical Care Management of Systemic Lupus Erythematosus with Autoimmune Hemolytic Anemia and Thrombocytopenia in Pregnancy: A Case Report Ananta Kahar, Liliriawati
Eduvest - Journal of Universal Studies Vol. 5 No. 11 (2025): Eduvest - Journal of Universal Studies
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/eduvest.v5i11.52433

Abstract

Autoimmune diseases like Systemic Lupus Erythematosus (SLE) in pregnancy pose significant management challenges, particularly when complicated by severe hematological manifestations such as autoimmune hemolytic anemia (AIHA) and thrombocytopenia, which necessitate intensive care. This case report aims to describe the comprehensive intensive care management and outcomes of a pregnant patient with suspected SLE presenting with severe AIHA and thrombocytopenia. A qualitative case study design was employed. The research focused on a single, purposively selected 21-year-old primigravida at 30–31 weeks gestation. Data were collected from medical records and analyzed descriptively to document the patient's clinical presentation, diagnostic workup, multidisciplinary therapeutic interventions, and subsequent progress. The patient presented with severe anemia (Hb 5 g/dL) and thrombocytopenia (platelets 125,000/mm³). Management involved pregnancy termination, multiple packed red cell transfusions, high-dose corticosteroids (methylprednisolone), and mechanical ventilation. Following this aggressive regimen, the patient was successfully extubated on day 3 with hemodynamic stability and improved hematological parameters (Hb 9.6 g/dL). This case highlights that a multidisciplinary approach combining prompt delivery, immunosuppression, and intensive supportive care is crucial for favorable maternal outcomes. It underscores the importance of early recognition and aggressive treatment of autoimmune complications in pregnancy to prevent life-threatening consequences.
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