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All Journal Majalah Kedokteran Bandung Jurnal Anestesi Perioperatif E-Journal Widya Kesehatan dan Lingkungan Majalah Anestesia dan Critical Care Medica Hospitalia Jurnal Prima Medika Sains Majalah Anestesia & Critical Care (MACC) The Journal of Society Medicine (JSOCMED)
Dhany Budipratama
Departemen Anestesiologi Dan Terapi Intensif Fakultas Kedokteran Universitas Padjajaran/Rumah Sakit Dr. Hasan Sadikin Bandung
Dentistry Education Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Journal : The Journal of Society Medicine (JSOCMED)

 1 
Lung Protective Strategy in Acute Respiratory Distress Syndrome with Approach of Compliance and Mechanical Power Pamugar, Bramantyo; Budipratama, Dhany
Journal of Society Medicine Vol. 2 No. 10 (2023): October
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v2i10.96

Abstract

Introduction: Lung protective strategy was meant to decrese risk of ventilatory induced lung injury  without reducing benefit of ventilator. One of the approaches were the use of compliance and mechanical power (MP). Compliance was used to determine how large lung was recruited after ventilatory support. Mechanical power was used to determined enough ventilatory support to that patient. Case Report: We reported 36 years old female, whom admitted to ICU with diagnosis of acute respiratory distress syndrome  caused by community acquired pneumonia. Patient was given pressure controlled ventilation with driving pressure 15cmH2O, positive end expiratory pressure (PEEP) 5 cmH2O, respiratory rate of 20x/min. We used compliance and MP to decide ventilator setting which benefit the patient. At the initial ventilator setting compliance and MP were 15.67 cc/mmHg, and 9.21 joule/min respectedly. The PEEP was increase gradually to 12 cmH2O. Compliance and MP were also increase to 41.67 cc/mmHg and 32.91 joule/min respectedly. Driving pressure was decrease to meet desirable volume tidal 6cc/kg and desirable MP below 22 joule/min. The PEEP was maintained until pneumonia resolved. Patient was extubated in ninth day. Conclusion: It could be concluded that the use of compliance and MP would help customize ventilatory support the patient need. They would help critical care clinician in making decision to prioritize need of ventilatory support in each individual patient.
Management of a P3A0 Postpartum Patient with Peripartum Cardiomyopathy (PPCM), Acute Decompensated Heart Failure (ADHF), Respiratory Failure Due to Acute Pulmonary Edema, and Community-Acquired Pneumonia (CAP) in the ICU Sulistiono, Paulus; Budipratama, Dhany
Journal of Society Medicine Vol. 4 No. 7 (2025): July
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i7.224

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Introduction: Acute dyspnea following pregnancy is a rare condition often accompanied by significant comorbidities. Potential causes include pulmonary embolism, amniotic fluid embolism, pneumonia, aspiration, pulmonary edema, and other critical conditions. Pulmonary edema, in particular, may occur during pregnancy or the postpartum period, associated with preeclampsia, peripartum cardiomyopathy (PPCM), pre-existing cardiac disease, tocolytic therapy, or fluid overload. This case report highlights a complex clinical scenario involving these factors. Case Description: We present the case of a 36-year-old woman, P4A0, who developed progressive acute dyspnea six days postpartum following a normal delivery. Her condition rapidly progressed to respiratory failure, necessitating admission to the intensive care unit (ICU) and mechanical ventilation. Physical examination and diagnostic workup revealed acute pulmonary edema secondary to peripartum cardiomyopathy, complicated by acute decompensated heart failure (ADHF) and community-acquired pneumonia (CAP). Following tailored medical therapy, the patient’s condition improved, and she was discharged from the ICU on the fifth day in a stable condition. Conclusion: This case underscores the importance of early recognition and multidisciplinary management of acute dyspnea in the postpartum period, particularly when linked to PPCM, ADHF, and CAP. Timely intervention with mechanical ventilation and targeted therapy can lead to favorable outcomes, emphasizing the need for heightened awareness among clinicians managing postpartum patients.
Management of Sepsis Patients Due to Community-Acquired Pneumonia in the Intensive Care Unit Ardiayuman , Ardiayuman; Budipratama, Dhany
Journal of Society Medicine Vol. 4 No. 7 (2025): July
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i7.226

Abstract

Introduction: Sepsis, a life-threatening response to infection, remains a critical global health issue, often triggered by community-acquired pneumonia (CAP) in vulnerable populations such as the elderly. This condition frequently requires intensive care unit (ICU) admission, necessitating adherence to evidence-based guidelines like the 2021 Surviving Sepsis Campaign (SSC) and Infectious Diseases Society of America (IDSA) recommendations. This case report highlights the application of these protocols in managing a complex sepsis case, emphasizing the role of early intervention and multidisciplinary care in improving outcomes.  Case Description: A 67-year-old male, Mr. U, presented with a 3-day history of dyspnea and 1-day history of altered consciousness. Initial assessment revealed respiratory distress (respiratory rate 32/min, oxygen saturation 88% on room air, Glasgow Coma Scale 10), with chest radiography confirming CAP. Laboratory results showed a lactate level of 4.2 mmol/L and leukocytosis (18,000/mm³), indicating sepsis. In the ICU, the patient received oxygen therapy, followed by intubation due to worsening respiratory failure. Blood cultures were obtained, and empirical antibiotics (meropenem) were initiated within 1 hour per SSC guidelines. Fluid resuscitation (30 mL/kg crystalloids) and norepinephrine were administered for persistent hypotension. Bronchoscopy revealed purulent secretions, aiding diagnosis and management. After 5 days of ventilatory support and adjusted antibiotics, the patient stabilized and was transferred to a general ward.  Conclusion: This case illustrates successful sepsis management due to CAP using SSC 2021 and IDSA guidelines. The integration of early antibiotics, fluid resuscitation, vasopressors, ventilation, and bronchoscopy underscores the efficacy of a multidisciplinary approach. Timely intervention in the ICU significantly improved survival and recovery, highlighting the need for further research to optimize protocols for such critical cases. 
Co-Authors Ardiayuman , Ardiayuman Astri Astuti Aviryandi Wibawamukti Dewi Yulianti Bisri Erwin Pradian Ezra Oktaliansah Ezra Oktaliasah Fityan Aulia Rahman Gavrila Diva Amelis Gezy Weita Giwangkancana Ibnu Ibnu Ike Sri Redjeki Ike Sri Redjeki Jauharul Alam Napitupulu, Olivia Des Vinca Albahana Nasution, Muhammad Habibi Nataputra, Mario Nurita Dian Kestriani Pamugar, Bramantyo Paulus Sulistiono Putra, Rifki Dwi Anugrah Rani Septriana Riri Lestari Supandji, Mia T. Maskoen, Tinni Tinni Maskoen U. Kaswiyan U. Kaswiyan