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All Journal Jurnal Anestesiologi Indonesia Jurnal Anestesi Perioperatif Folia Medica Indonesiana Indonesian Journal of Tropical and Infectious Disease Majalah Kesehatan FKUB Health Notions Bali Journal of Anesthesiology Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya Journal of Health Sciences Jurnal Respirasi (JR) PREPOTIF : Jurnal Kesehatan Masyarakat Indonesian Journal of Anesthesiology and Reanimation (IJAR) Jurnal Layanan Masyarakat (Journal of Public Service) Jurnal Syntax Transformation Indian Journal of Forensic Medicine & Toxicology Jurnal Neuroanestesi Indonesia Jurnal Widya Medika
Utariani, Arie
Anesthesiology And Reanimation Department Of Medical Faculty Of Universitas Airlangga / Soetomo General Hospital, Surabaya, Indonesia
Humanities Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Dentistry Earth & Planetary Sciences Education Environmental Science Health Professions Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Other

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Successful Anesthetic Management from Separation Surgery of Pygopagus Conjoined Twin; Lesson-Learning With A Teleanesthesia Adhi, Mahendratama Purnama; Utariani, Arie; Andriyanto, Lucky
Indonesian Journal of Anesthesiology and Reanimation Vol. 4 No. 1 (2022): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (27.927 KB) | DOI: 10.20473/ijar.V4I12022.37-46

Abstract

Introduction: The management of conjoined twins requires multidisciplinary teamwork. The complex problems in conjoined twin separation surgery are challenging for anesthesiologists without experience in the management of conjoined twins. Objective: To describe anesthetic management and utilization of teleanesthesia in conjoined twin separation surgery. Case Report: Sixty days-old pygopagus type conjoined twins, with a total body weight of 7030 grams. Both babies looked healthy, moved actively, found no respiratory function disorders, were hemodynamically stable and had no congenital abnormalities. The sacral region's computerized tomography scan (CT-scan) reveals conjoined twins with skin unification and subcutaneous in the perianal region and no internal-vertebral-spinal fusion. Two anesthesia teams performed the management of anesthesia. After confirming there was no cross-circulation with the atropine test, we alternately induced anesthesia by inhalation technique while maintaining spontaneous breathing. Anesthesia was maintained with sevoflurane 2.0-3.0 vol%, in a mixture of oxygen and air with a flow of 4 L/min using Jackson Reese. Circulating volume, hemodynamic stability, and normothermia were maintained intraoperatively. The separation surgery lasted 20 minutes, and the total surgical time for each baby was two hours. Awake extubation was performed immediately after the surgery was complete. Both babies underwent postoperative care at the PICU and were discharged on day 11. During the pre-operative for surgery, the local team conducted telemedicine consultations with the pediatric anesthesia team at Dr. Soetomo hospital and performed intra-anesthesia telementoring. Conclusion: Careful preparation and pre-operative evaluation, proper intra-anesthesia maintenance and monitoring, as well as good communication and teamwork, are keys to successful anesthesia management in conjoined twin separation surgery. Consultation and assistance from an experienced team during surgery using teleanesthesia are significantly beneficial to the anesthesiologist without experience in conjoined twin separation surgery.
Correlation of IL-1β Level and Body Temperature to the Severity of Acute Respiratory Distress Syndrome (ARDS) and Mortality in COVID-19 Patients Andriani, Inge; Utariani, Arie; Hamzah, Hamzah
Indonesian Journal of Anesthesiology and Reanimation Vol. 4 No. 1 (2022): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (463.629 KB) | DOI: 10.20473/ijar.V4I12022.22-36

Abstract

Introduction: IL-1β and IL-6 are cytokines that have major roles in cytokine storms and endogenous pyrogens. Several studies have also displayed the effectiveness of IL-1β inhibitors in COVID-19 patients in minimizing severity and mortality. Objective: This study aims to analyze the correlation between IL-1β and body temperature with ARDS severity and mortality in COVID-19 patients. Methods: This is an analytical observational study with a prospective cohort design. A total of 54 patients have met the inclusion criteria from July to September 2020. This study mainly applied the Spearman-Rho, Mann Whitney, free sample T2 test, and Chi-Square test. Results: The correlation between body temperature and IL-1β levels in COVID-19 patients with ARDS did not show a statistically significant difference towards mortality and ARDS severity, as shown by the p-value > 0.05 in the analysis tests of each of the variables studied. Nonetheless, the occurrence of ARDS (p = 0.022), the severity of ARDS (p = 0.001), application of mechanical ventilation (p = 0.00), secondary infection (p = 0.00), and length of stay (p = 0.042) were found to be statistically significant towards COVID-19 patients' mortality. Conclusion: Body temperature does not correlate with the occurrence of ARDS, the severity of ARDS, mortality, and IL-1β levels. IL-1β levels and transformation in IL-1β levels also do not correlate with mortality as well as the occurrence and severity of ARDS, but the use of mechanical ventilation, secondary infection, and length of stay were correlated with mortality in COVID-19 patients.
Pediatric Shock Profile in The Pediatric Intensive Care Unit (PICU) of Dr. Soetomo General Academic Hospital Anshori, Rafida; Setyaningtyas, Arina; Utariani, Arie; Kusumastuti, Neurinda Permata
Indonesian Journal of Anesthesiology and Reanimation Vol. 5 No. 1 (2023): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V5I12023.11-17

Abstract

Introduction: Shock is a life-threatening condition caused by circulatory failure which increases morbidity and mortality rate. According to the western literature, about 2% of children are admitted to hospitals worldwide due to shock. Objective: This study aimed to describe the pediatric shock profile of patients in the Pediatric Intensive Care Unit (PICU) of Dr. Soetomo General Academic Hospital between 1 January to 1 December 2019. Methods: A total of 60 patients were selected as the participants using a descriptive method. Data collection was carried out by recording the exact time the participants first entered the PICU. Furthermore, data were collected based on gender, age, physical and laboratory examination, diagnosis of shock, patients' outcomes, as well as PRISM III score. Results: The results of this study that the males and children are 51.7% and 53.3%, respectively. At an infant age, the distribution of the highest average pulse and breathing frequency was 135 and 32.2, respectively. The highest average body temperature at the age of adolescents was 37.19°C. Furthermore, the patients' diagnoses were dominated by distributive shock with the highest PRISM III score ≥8 and deaths recorded of 76.6%, 60%, and 61.7%, respectively. The diagnosis results showed that distributive shock leads to the highest mortality with a PRISM III score of 51.7% and 53.3%. Conclusion: Distributive shock contributes to the patient's diagnoses and mortality rate with the highest score of PRISM III being ≥8. From this conclusion, the PICU needs to be more responsive to detect distributive shock in children.
The Difference in Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR), and Lactate Levels Between Sepsis and Septic Shock Patients Who Died in The ICU Rachmawati, Dwi; Utariani, Arie; Notopuro, Paulus Budiono; Semedi, Bambang Pujo
Indonesian Journal of Anesthesiology and Reanimation Vol. 5 No. 2 (2023): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V5I22023.64-71

Abstract

Introduction: Sepsis and septic shock are organ dysfunctions caused by the dysregulation of the body's response to infection and are the most common causes of death. Objective: This study aims to describe the neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and lactate levels in patients with sepsis and septic shock who died in the Intensive Care Unit (ICU). Methods: An observational retrospective study was conducted by examining the medical record data of sepsis and sepsis shock patients who were hospitalized in the ICU of Dr. Soetomo General Academic Hospital Surabaya from January to December 2019. Results: The study sample was 28 patients: 16 with sepsis and 12 with septic shock. Fifteen patients (53.6%) were women. The patients' mean age was 53.18 ± 13.61 years, and most patients (8 patients, 28.6%) belonged to the late adult age group (36-45 years). The most common comorbidities were diabetes mellitus and hypertension (30.8%). The highest incidence of infection in both groups occurred in the lungs (42.9%). Most of the patients had high SOFA scores, in the moderate (7-9) to severe (≥ 10) category (39.3%). Almost all patients (82.1%) were treated for less than one week. The hematological examination within the first 24 hours showed a leukocyte value of 16,995 (Leukocytosis) and a platelet value of 279,500 (Normal). The NLR of septic shock patients (31.38±55.61) was higher than the NLR of sepsis patients (23.75±22.87). The PLR of septic shock patients (534.02±1000.67) was lower than the PLR of patients (802.93±1509.89). Lastly, the lactate levels in septic shock patients (3.84±1.99) were higher than in sepsis patients (1.97±1.06). Conclusion: There were no significant differences in the NLR and PLR values "‹"‹between sepsis and septic shock patients, but there were significant differences in their initial lactate levels.
Co-Authors Abdul Kadir Munsy Achmad Basori, Achmad Adhi, Mahendratama Purnama Agustina Salinding Ainur Rahmah Akhyar Nur Uhud Alivery Raihanda Armando Andre Kurniawan Anna Erliana Oetarman Anna Surgean Veterini Anshori, Rafida Ardiansyah Arina Setyaningtyas Bambang Harjono Belindo Wirabuana Budi Prasetyo Christopher Ryalino Christrijogo Soemartono Waloejo Cindy Aprilia Eka Prasanty Dedi Susila Dharmawati, Ira Dian Raseka Parna Diska Hanifah Nurhayati Eka Prasetiyawan Elizeus Hanindito Fachry Abda El Rahman Hamzah Hamzah Hamzah Hamzah Hamzah Hamzah Hanif Hanif Hardiono Hardiono Herdiani Sulistyo Putri Imam Susilo Inge Andriani Johaan Pawe Siampa Jusak Nugraha Kapuangan, Christopher Khildan Miftahul Firdaus Kun Arifi Abbas Kusuma, Edward Putra Lucky Andriyanto Lupi Lestari M Yusuf Gunawan Mahendra Dwi Aditya Lopulalan Maulana Hanif Ibrahim Maulydia, Maulydia Meilissa Eka Susanti Muh Kemal Putra Muzaiwirin Muzaiwirin Nalini Nanang Nurofik Nasrulloh Nasrulloh Nenden Suliadiana Fajarini Neurinda Permata Kusumastuti Ninik Asmaningsih Soemyarso Notopuro, Paulus Budiono Nugroho Setia Budi Nurofik, Nanang Perdhana, Fajar Prananda Surya Airlangga Pratama Ananda Puspita, Eka Ari Puspita, Eka Ari Putu Kurniyanta R. Muhammad Aviv Pasa Rehatta, Nancy Margarita Retno Asih Setyoningrum Robby Dwestu Nugroho Rudi Iskandar Suryadani Rudy Vitraludyono Samuel Hananiel Rory Sandi Ardiya Rasitullah Santoso, Kohar Hari Santoso, Kohar Hari Santoso Hari SATRIYAS ILYAS Semedi, Bambang Pujo Setiawan, Philia Soni Sulistiawan Soni Sunarso Sulistiawan Sudarmanto, Aisya Azzahra Sulistiawan, Soni Sunarso Teguh Sylvaranto Teuku Aswin Husain Virda Maharani