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All Journal Jurnal Anestesiologi Indonesia Jurnal Anestesi Perioperatif 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 Sehat Indonesia (JUSINDO) Indonesian Health Journal Jurnal Widya Medika Folia Medica Indonesiana
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 Veterinary Other

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Incidence of Emergence Agitation in Pediatric Patient after General Anesthesia Andriyanto, Lucky; Utariani, Arie; Hanindito, Elizeus; Santoso, Kohar Hari Santoso Hari; Hamzah, Hamzah; Puspita, Eka Ari
Folia Medica Indonesiana Vol. 55, No. 1
Publisher : Folia Medica Indonesiana

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Abstract

Post anesthesia agitation is common problem in pediatric post anesthesia care unit. The incidences range from 10 to 80%. EA has been described as a dissociated state of consciousness in which the child is inconsolable, irritable, and uncooperative typically thrashing, crying, moaning or incoherent. This study was done to determine the incidence of emergence agitation and associated risk factors in pediatric patients who underwent general anesthesia. This descriptive and analytic study was performed on 105 pediatric patient aged 1-12 years that underwent general anesthesia for various elective diagnostic and surgeries at Dr. Soetomo Hospital between January and February 2016. The presence of emergence agitation was recorded using Pediatric Anesthesia Emergence Delirium (PAED) scale. The factors that linked with Emergence Agitation were recorded in a questionnaire. The data were analyzed using SPSS software with logistic regression. p - values less than 0.05 were considered as significant. Forty two (40%) children had Emergence Agitation. Preoperative anxiety (p = 0.006) and Pain (p=0.035) were associated with higher rates of post anesthetic emergence agitation. This study identified preoperative anxiety and pain as risk factors, which are associated with emergence agitation in children. To minimize the incidence of post anesthetic emergence agitation, these risk factors should be considered in the routine care by anesthetist.
Mortality Assessment of Pediatric Septic Patients Through Pediatric Sofa+Anion Gap and Pelod-2 Scores Siampa, Johaan Pawe; Utariani, Arie; Hanindito, Elizeus
Folia Medica Indonesiana Vol. 58, No. 4
Publisher : Folia Medica Indonesiana

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Highlight: • Sepsis and septic shock cause morbidity and mortality in pediatric patients. • The accuracy of pediatric sequential organ failure assessment and anion gap (pSOFA+AG) was compared with AG and pediatric logistic organ dysfunction-2 (AG+PELOD-2). • The mortality assessment of pediatric septic patients showed that pSOFA was more sensitive than PELOD-2, while pSOFA+AG was not more sensitive than PELOD-2. Abstract: Sepsis and septic shock are some of the causes of morbidity and mortality (50-60%) in pediatric patients treated in intensive care rooms. This study aimed to compare the accuracy of pediatric Sequential Organ Failure Assessment (pSOFA) score combined with anion gap (AG) score to Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score in the assessment of mortality in pediatric septic patients at the Resuscitation Room of Dr. Soetomo Geeneral Academic Hospital, Surabaya, Indonesia. This was a retrospective observational cohort study using pediatric sepsis diagnosis guidelines based on the 2016 Pediatric Sepsis Consensus and medical records between January-December 2018. All data of patients aged 1 month to 16 years with suspected infection at the Resuscitation Room were collected based on predisposing infections, signs of infection, and warning signs. Organ dysfunction was assessed by calculating the pSOFA+AG scores, PELOD-2 scores, and corrected anion gap (cAG) in the first 24 hours. Sepsis mortality was assessed by comparing the results of the pSOFA, pSOFA+AG, and PELOD-2. The results showed 94.9% sensitivity and 70.0% specificity (p<0.0001) in the pSOFA, 89.9% sensitivity and 71.3% specificity (p<0.0001) in the PELOD-2, 79.7% sensitivity and 65% specificity (p<0.0001) in the AG, 79.7% sensitivity and 73.8% specificity (p<0.0001) in the cAG, and 79.3% sensitivity (p<0.0001) in the pSOFA+AG. In conclusion, pSOFA was more sensitive than PELOD-2, while the use of pSOFA+AG was not more sensitive than PELOD-2 in assessing the mortality of pediatric septic patients.
Correlation between the use of albumin infusion and concentrations of serum albumin, proinflammatory cytokines (tnf-, il6) and sofa score in septic patients Utariani, Arie; Prasetyo, Budi; Nugraha, Jusak
Folia Medica Indonesiana Vol. 52, No. 4
Publisher : Folia Medica Indonesiana

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Abstract

Sepsis is a major problem causing high morbidity and mortality in patients who hospitalized in intensive care. In sepsis, there is a change in the distribution of albumin in the intravascular and extravascular compartment, so hipoalbumin is occured. Using albumin in septic patients from several studies that have been done are still controversial. Analyzing albumin infusion with changes in levels of albumin, cytokines and SOFA score in septic patients in intensive care dr. Soetomo. The design of this study is a prospective longitudinal observational. The study was conducted in the intensive care unit or ICU dr. Soetomo in February 2015. The inclusion and exclusion criteria were determined that obtained 15 research subjects. They were examined with serum albumin and proinflammatory cytokines as well as evaluating the SOFA score. Then, it measure with ANOVA test methods. Infusion of albumin positively correlated with increased levels of serum albumin and a negative correlation with the levels of IL6, TNF-a and SOFA score. It also found a correlation between changes in levels of albumin with changing levels of IL6 (p <0:01) and changes in SOFA score (p <0.05).
Comparison of Length of Stay and Deep Vein Thrombosis (DVT) Incidents in Dr. Soetomo Hospital Hanindito, Elizeus; Airlangga, Prananda Surya; Sulistiawan, Soni Sunarso; Semedi, Bambang Pujo; Andriyanto, Lucky; Utariani, Arie; Rehatta, Nancy Margarita
Folia Medica Indonesiana Vol. 54, No. 4
Publisher : Folia Medica Indonesiana

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Abstract

Vein thrombosis may occur both in deep and superficial vein of all extremities. Ninety percent of vein thrombosis may progress into pulmonary embolism which is lethal. Deep vein thrombosis (DVT) is frequently found in critically ill patients in ICU, especially patients who are treated for a long time. This study aims to analyse the comparison between length of stay and DVT incidents in critically ill patients. A cross-sectional study was employed. We include all patients who were 18 years or older and were treated in ICU of Dr Soetomo public hospital for at least 7 days. The patients were examined with Sonosite USG to look for any thrombosis in iliac, femoral, popliteal, and tibial veins and Well's criteria were also taken. This study showed that length of stay is not the only risk factor for DVT in patients treated in ICU. In our data, we found out that the length of treatment did not significantly cause DVT. Other risk factors such as age and comorbidities in patients who are risk factors may support the incidence of DVT events. The diagnosis of DVT is enforced using an ultrasound performed by an expert in the use of ultrasound to locate thrombus in a vein. Length of treatment is not a significant risk factor for DVT. Several other factors still need to be investigated in order for DVT events to be detected early and prevented.
Comparison of Continuous Fentanyl and Levobupivacaine Epidural Anesthesia for Perioperative Pain Following Laparotomy in Children Aged 6– 12 Years Bahtiar Ahmad; Kohar Hari Santosa; Arie Utariani; Lucky Andriyanto
Jurnal Sehat Indonesia (JUSINDO) Vol. 8 No. 1 (2026): Jurnal Sehat Indonesia (JUSINDO)
Publisher : CV. Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59141/-.v8i1.549

Abstract

Postoperative pain management in pediatric patients is a clinical challenge because uncontrolled pain can trigger systemic inflammatory responses, slow recovery, and increase the risk of postoperative morbidity. Surgical trauma stimulates the release of proinflammatory cytokines such as interleukin-6 (IL-6) and affects hematologic inflammatory parameters, including neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). This study aimed to assess differences in the effectiveness of continuous fentanyl administration and epidural levobupivacaine on inflammatory responses and postoperative pain intensity in pediatric patients undergoing laparotomy. This comparative analytical study involved 30 pediatric patients aged 6–12 years who underwent elective laparotomy and were divided into two groups, namely continuous fentanyl (n=15) and epidural levobupivacaine (n=15). The parameters assessed included IL-6, NLR, and PLR levels, as well as pain intensity using the Numerical Rating Scale (NRS), which was measured in the preoperative and postoperative periods. Statistical analysis was conducted to assess differences within and between groups. The baseline characteristics of the subjects were homogeneous (all p>0.05). The median PLR increased from 136.2 (79.5–411.4) to 161.3 (90.6–616.2) (p=0.106), and the median NLR increased from 1.98 (0.98–19.94) to 2.11 (0.80–28.91) (p=0.643), with no significant differences between groups. IL-6 levels increased significantly overall (p=0.018), significantly in the fentanyl group (p=0.028) but not in the levobupivacaine group (p=0.225). NRS scores decreased significantly in both groups (p<0.001), with a greater reduction in the epidural levobupivacaine group in the early postoperative period (ΔNRS −4 vs −3.07±1.10; p=0.030). Both analgesic modalities were effective in reducing postoperative pain. Epidural levobupivacaine provided better early postoperative pain control and showed a more stable inflammatory response profile compared with continuous fentanyl.
The Platelet-To-Albumin Ratio and the Mean Platelet Volume-To-Albumin Ratio as Predictors of Disease Severity and Mortality in Pediatric Sepsis Patients Okky Hudaya; Lucky Andriyanto; Arie Utariani
Indonesian Health Journal Vol. 5 No. 2 (2026): Indonesian Health Journal
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/ihj.v5i2.898

Abstract

Pediatric sepsis remains a critical emergency condition with high morbidity and mortality rates, particularly in low- and middle-income countries. Early identification of patients at risk of severe outcomes is essential to guide timely interventions. This study aimed to evaluate the prognostic value of Platelet-to-Albumin Ratio (PAR) and Mean Platelet Volume-to-Albumin Ratio (MAR) in predicting disease severity and 7-day mortality among pediatric sepsis patients in the emergency room. A retrospective observational study was conducted on 101 pediatric patients admitted to Dr. Soetomo Hospital, Surabaya, from January 2020 to January 2025. PAR and MAR were measured on days 1, 3, and 5, and severity was assessed using PELOD-2 scores. Statistical analyses included ROC curves, Spearman correlations, and Kruskal–Wallis tests. Results demonstrated that MAR consistently showed superior predictive performance compared to PAR, with AUC values improving from 0.711 on day 1 to 0.905 on day 5, and significant correlations with PELOD-2 scores (p<0.001). PAR showed limited and inconsistent predictive ability. The findings indicate that MAR is a reliable and practical biomarker for early risk stratification and monitoring of pediatric sepsis severity. Future research should validate MAR in multicenter prospective studies and explore its integration with clinical scoring systems for enhanced prognostic accuracy.
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 Bahtiar Ahmad 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 Kohar Hari Santosa Kun Arifi Abbas Kusuma, Edward Putra Lucky Andriyanto 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 Okky Hudaya 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 Siampa, Johaan Pawe Soni Sulistiawan Soni Sunarso Sulistiawan Sudarmanto, Aisya Azzahra Sulistiawan, Soni Sunarso Sulistiawan, Soni Sunarso Teguh Sylvaranto Teuku Aswin Husain Virda Maharani