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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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Penyalahgunaan Alkohol dan Delirium pada Perawatan Intensif Jauharul Alam; Dhany Budipratama
Majalah Anestesia & Critical Care Vol 37 No 3 (2019): Oktober
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif (PERDATIN) / The Indonesian Society of Anesthesiology and Intensive Care (INSAIC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (227.871 KB)

Abstract

Pada pasien perawatan intensif, delirium yang dicetuskan oleh karena ketergantungan alkohol sering tidak mendapat perhatian yang seksama, namun pada kenyataannya terjadi pada sekitar 10% pasien di ICU. Delirium akibat ketergantungan alkohol merupakan maniftasi yang serius dari penyalahgunaan alkohol dan berhubungan erat dengan berbagai komplikasi yang muncul dan keluaran yang buruk. Oleh karena itu, kondisi tersebut dapat dicegah, dan jika muncul agar dapat dikelola dengan segera, untuk menghindari sekuele negatif pada keadaaninfeksi, komplikasi kardiak dan disfungsi kongnitif jangka panjang.
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
Publisher : CoinReads Media Prima

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.
Pathogenesis and management of sepsis patients with disseminated intravascular coagulation Napitupulu, Olivia Des Vinca Albahana; Budipratama, Dhany
Jurnal Prima Medika Sains Vol. 6 No. 2 (2024): December
Publisher : Program Studi Magister Kesehatan Masyarakat Universitas Prima Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34012/jpms.v6i2.6261

Abstract

Sepsis is a life-threatening organ dysfunction caused by dysregulation of the body's response to infection, and is one of the leading causes of death in intensive care units. In sepsis, the systemic inflammatory reaction that occurs activates the coagulation system and increases the consumption of clotting factors, leading to a serious complication of coagulopathy known as disseminated intravascular coagulation (DIC). DIC is a clinicopathological syndrome that is a complication of various diseases characterized by the activation of systemic blood coagulation and intravascular fibrin production, which can cause thrombosis of small- and medium-sized blood vessels and can even cause organ function failure along with the consumption of platelets and coagulation factors, resulting in a clinical picture of bleeding. In 35% of severe sepsis cases, and in shock sepsis DIC causes high mortality, which is associated with increased severity of illness and serious organ failure with poor outcomes. This article aims to summarize the evolving understanding of DIC pathogenesis in patients with sepsis and its implications for current and future management strategies.
PERBANDINGAN TEKNIK PEMASANGAN PIPA NASOGASTRIK ANTARA MANUVER REVERSE SELLICK DENGAN MANUVER FLEKSI LEHER TERHADAP ANGKA KEBERHASILAN DAN DURASI WAKTU PEMASANGAN PADA PASIEN TERINTUBASI DI RSUP DR. HASAN SADIKIN BANDUNG Nasution, Muhammad Habibi; Budipratama, Dhany; T. Maskoen, Tinni
Jurnal Anestesi Perioperatif Vol 12, No 3 (2024)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v12n3.3838

Abstract

Pemasangan pipa nasogastrik (NGT) penting dilakukan pada beberapa pembedahan dan pada pasien di ruang rawat intensif (ICU). Pemasangan NGT menjadi sulit pada pasien terintubasi dan paling sering tertahan pada sinus priformis, kartilago aritenoid, dan esofagus yang tertekan oleh balon ETT. Manuver reverse Sellick merupakan teknik yang dilakukan dengan cara menggenggam kartilago krikoid lalu diangkat ke arah anterior dan manuver fleksi leher merupakan suatu cara menekukkan leher pasien semaksimal mungkin pada saat memasang NGT. Penelitian ini menggunakan metode prospektif analitik komparatif eksperimental dengan rancangan randomized clinical trial single blind study. Penelitian telah dilakukan di RSUP Dr. Hasan Sadikin Bandung (RSHS) terhadap 94 subjek. Analisis statistik data kategorik menggunakan Uji Chi Square dan uji normalitas dengan menggunakan Kolmogorov smirnov. Hasil uji statistik perbandingan tingkat keberhasilan pada kelompok manuver reverse Sellick dan kelompok manuver fleksi leher adalah 85,1% dan 74,5% dengan perbedaan yang tidak bermakna (p>0,05). Durasi pemasangan NGT pada kelompok manuver reverse Sellick dan kelompok manuver fleksi leher adalah 13,499±1,571 detik dan 20,5,06±3,051 detik dengan perbedaan signifikan (p<0,05; Tabel 2). Simpulan tingkat keberhasilan pada kelompok manuver reverse Sellick memiliki angka keberhasilan yang tidak berbeda signifikan dibanding dengan kelompok manuver fleksi leher. Durasi pemasangan dari kelompok manuver reverse Sellick lebih singkat dibanding dengan kelompok manuver fleksi leher.
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
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i7.224

Abstract

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
Publisher : CoinReads Media Prima

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. 
GAMBARAN POLA KUMAN, RESISTENSI, FAKTOR RISIKO, DAN TINGKAT MORTALITAS PADA PASIEN VENTILATOR ASSOCIATED PNEUMONIA DI GENERAL INTENSIF CARE RSUP HASAN SADIKIN BANDUNG PERIODE JANUARI 2022 - DESEMBER 2022 Oktaliansah, Ezra; Budipratama, Dhany; Putra, Rifki Dwi Anugrah
Jurnal Anestesi Perioperatif Vol 13, No 2 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851//jap.v13n2.4036

Abstract

Ventilator Associated Pneumonia (VAP) merupakan infeksi paru yang terjadi 48–72 jam setelah tindakan intubasi endotrakeal dan menjadi salah satu infeksi nosokomial paling sering di Intensive Care Unit (ICU), dengan prevalensi mencapai 70-80% dari seluruh kasus pneumonia di rumah sakit. Di Indonesia, insiden VAP tergolong tinggi, terutama disebabkan oleh Acinetobacter baumannii yang bersifat resisten terhadap berbagai antibiotik dan berkontribusi terhadap peningkatan angka mortalitas. Penelitian ini menggunakan metode observasional deskriptif dengan pendekatan retrospektif berdasarkan data rekam medis pasien VAP di ICU RSUP Dr. Hasan Sadikin Bandung periode Januari–Desember 2022. Dari 33 pasien yang diteliti, ditemukan 70 hasil kultur kuman, dengan 55 di antaranya tergolong Multidrug Resistant (MDR). Kuman yang paling dominan adalah Acinetobacter baumannii (85,7% MDR), diikuti Klebsiella pneumoniae (94,4% MDR) dan Pseudomonas aeruginosa (87,5% MDR). Angka mortalitas mencapai 60,6%, dengan tingkat kematian lebih tinggi pada pasien dengan kultur MDR. Faktor risiko yang sering ditemukan ialah hipertensi, penyakit serebrovaskular, dan gagal ginjal kronik. Pola resistensi tinggi teridentifikasi pada Acinetobacter baumannii terhadap cefazolin (95,7%) dan ampicillin-sulbactam (91,3%), Klebsiella pneumoniae terhadap cefazolin (97,0%) dan ceftriaxone (96,8%), serta Pseudomonas aeruginosa terhadap imipenem (94,7%) dan cefazolin (91,7%). Hasil ini menunjukkan perlunya peningkatan program penanganan VAP di RSUP Dr. Hasan Sadikin.
Comparison of Preemptive Post-Intubation 15 Mg/KgBW Paracetamol to 0.35 Mg/KgBW Meperidine in Incidence of Post-Anesthetic Shivering Nataputra, Mario; Bisri, Dewi Yulianti; Budipratama, Dhany
Majalah Kedokteran Bandung Vol 55, No 3 (2023)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v55n3.3047

Abstract

Post anesthesia shivering (PAS) is a repetitive involuntary movement of one or more muscle groups as a result of a decrease in core body temperature. Pharmacological therapy in preventing PAS may include meperidine and paracetamol. This study compared the effectiveness of paracetamol to meperidine in reducing the incidence of post-anesthesia shivering. This study used an experimental randomized double-blind comparative analytic design on patients underwent exploratory laparotomy surgery under general anesthesia at Dr. Hasan Sadikin General Hospital Bandung, Indonesia, from September 2021 to August 2022. Patients with 50 ASA 1-2 physical status were included and divided into two groups. One group received 15 mg/kg group paracetamol and the other received 0.35 mg/kg meperidine. Data on tympanic membrane temperature and hemodynamics before and after induction and after extubating were collected. Furthermore, data on the results of the assessment of the incidence and grade of shivering in each treatment group were also collected. The results of this study showed that there was a decrease in the frequency of PAS in patients receiving intravenous 15 mg/kg paracetamol (p<0.05), as well as less side effects in the form of nausea and vomiting (p < 0.05). The incidence and degree of shivering after general anesthesia using intravenous 15 mg/kg paracetamol was lower compared to the use of 0.35 mg/kg meperidine. In the meperidine group, the decrease in body temperature was lower than in the paracetamol group, while the incidence of nausea and vomiting in the paracetamol group was lower than in the meperidine group. In conclusion, paracetamol reduces the incidence of post-anesthesia shivering better than meperidine.
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