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All Journal Medicina E-Jurnal Medika Udayana Bali Journal of Anesthesiology Bisma: Jurnal Bisnis dan Manajemen ISM (Intisari Sains Medis) : Jurnal Kedokteran Bioscientia Medicina : Journal of Biomedicine and Translational Research Bioscientia Medicina : Journal of Biomedicine and Translational Research Jurnal Anestesi dan Terapi Intensif Udayana
Putu Kurniyanta
Department Of Anesthesiology And Reanimation, Faculty Of Medicine, Udayana University, Sanglah General Hospital Denpasar Bali
Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Physics Other

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Journal : E-Jurnal Medika Udayana

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GAMBARAN KARAKTERISTIK PENDERITA SYOK SEPTIK DI RUANG TERAPI INTENSIF RUMAH SAKIT UMUM PUSAT (RSUP) SANGLAH DENPASAR PERIODE OKTOBER 2017–OKTOBER 2018 Jeremy Jonathan; I Putu Kurniyanta; Kadek Agus Heryana
E-Jurnal Medika Udayana Vol 9 No 10 (2020): Vol 9 No 10(2020): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2020.V09.i10.P14

Abstract

ABSTRAK Sepsis adalah keadaan disfungsi organ karena disregulasi respon tubuh terhadap infeksi. Sepsis yang tidak tertangani bisa menjadi syok septik, yaitu sepsis dengan abnormalitas metabolisme seluler dan sirkulatorik meskipun telah diresusitasi secara adekuat. Tingkat mortalitas syok septik sangat tinggi. Namun, data karakteristik pasien syok septik khususnya di Bali belum banyak diteliti. Oleh karena itu, penelitian ini bertujuan untuk mengetahui karakteristik pasien syok septik di ruang terapi intensif RSUP Sanglah periode Oktober 2017–Oktober 2018 berdasarkan usia, jenis kelamin, sumber infeksi, pola mikroorganisme, dan pemberian antibiotika. Penelitian ini menggunakan metode potong lintang deskriptif observasional. Pengambilan sampel dilakukan memakai total sampling. Pada 44 pasien yang terlibat, sebesar 40,9% pasien berasal dari rentang umur >65 tahun. Penyakit syok septik lebih banyak ditemukan pada laki-laki sebanyak 56,81%. Sumber infeksi terbanyak adalah infeksi sistem respirasi sebanyak 61,36%. Antibiotika yang paling sering digunakan ialah sefoperazon sebanyak 30%, dan antibiotika kombinasi yang paling sering digunakan yaitu sefoperazon-levofloksasin sebanyak 45,16%. Pada 26 pasien dengan hasil kultur, patogen terbanyak adalah Pseudomonas aeruginosa sebanyak 8%. Pada 18 pasien lainnya tidak ditemukan hasil kultur. Kata Kunci: Syok septik, karakteristik syok septik, pasien ruang terapi intensif.
MANAGEMENT OF EXTRIMITY FRACTURE IN EMERGENCY DEPARTMENT Putu Sukma Parahita; Putu Kurniyanta
E-Jurnal Medika Udayana vol 2 no 9 (2013):e-jurnal medika udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (194.771 KB)

Abstract

Fracture injuries in the extremities are accounted for 40% of the incidence of fractures in the United States and causes high morbidity (physical suffering, lost time, and mental stress). High-energy fractures of the lower limbs can also cause life threatening condition like major vascular injury, crush syndrome, and compartment syndrome. Initial treatment in the emergency room is essential to save lives and to save the fractured extremities. Primary survey (securing the airway, breathing and circulation) and the secondary survey will be able to quickly and accurately identify dangerous early complication of fractures, such as major arterial injury, crush syndrome and compartment syndrome.
INDEKS KOLAPSIBILITAS (CI) SEBAGAI PREDIKTOR HIPOTENSI PADA PASIEN DENGAN ANESTESI UMUM Pranata, I Made Harry; Adi, Made Septyana Parama; Suarjaya, I Putu Pramana; Kurniyanta, Putu
E-Jurnal Medika Udayana Vol 12 No 10 (2023): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2023.V12.i10.P02

Abstract

Intraoperative hypotension (IOH) is important to identify early because it is associated with high morbidity and mortality in old age. Ultrasonographic measurement of the inferior vena cava collapsibility index (IVCCI) can detect volume responsiveness in circulatory shock. The purpose of this study was to examine the collapsibility index (CI) as a predictor of hypotension in patients under general anesthesia. This study was an observational cross-sectional design in adult patients who underwent elective surgery under general anesthesia at Sanglah General Hospital from December 2021 to January 2022 using a consecutive sampling technique. Immediate postinduction changes in systolic and mean blood pressure were compared. The performance of the IVC CI as a diagnostic tool for predicting hypotension (systolic pressure?<?90?mmHg or a???30% drop from the baseline) was evaluated by ROC curve analysis. At the point of collapsibility index (CI) ? 47, there were 29 patients (96.7%) with hypotension. At the point of collapsibility index (CI) < 47, there was 1 patient (3.3%) with hypotension and 24 patients (100%) without hypotension. The cut-off level of collapsibility index (CI) is obtained with the Receiver Operating Curve (ROC) curve, below 0.985. The cut-off CI level for hypotension was 47.0 with a sensitivity of 96.7% and specificity of 100%. There is a significant relationship between IVC CI with a decrease in MAP before and after induction at 4,8, and 10 minutes (p<0,05). The collapsibility index (CI) 50 can be used as a predictor of the incidence of hypotension in patients under general anesthesia. Keywords : hypotension, collapsibility index, general anesthesia.
EFEKTIVITAS TEKNIK ANESTESI LOW FLOW DIBANDINGKAN TEKNIK ANESTESI INHALASI STANDAR PADA ANAK USIA 1-6 TAHUN YANG MENJALANI OPERASI DI PROF. DR. I.G.N.G. NGOERAH DENPASAR Kurniyanta, Putu; Suarjaya, Putu Pramana; Narakusuma, Fajar
E-Jurnal Medika Udayana Vol 12 No 6 (2023): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2023.V12.i06.P04

Abstract

Since the discovery of sevoflurane, it has been commonly used due to its many advantages, including its safety profile for pediatric anesthesia practice. However, currently no ideal recommendation for how much gas flow should be used during induction in children. High fresh gas flow (FGF) causes waste of anesthetic and oxygen gases, making it both uneconomical and environmentally polluting. To date, there have been very few studies on low FGF in children, so there is no best and efficient method for reducing the need for large amounts of induction gas. The aim of this study is to determine the effectiveness of the low low anesthesia (LFA) technique in reducing sevoflurane volume, induction time, and hemodynamics during surgery in children undergoing surgery. This is a case-control study conducted at Prof. Dr. I.G.N.G Ngoerah Hospital in Denpasar. Forty-six children aged 1 - 6 years underwent elective surgery and were anesthetized with sevoflurane and randomly divided into two groups: the case group using the low-flow anesthesia technique and the control group using the standard anesthesia technique. The case and control groups were statistically similar in terms of demographic data. However, the volume of sevoflurane used from the time of premedication to intubation was significantly different (p > 0.05) between the two groups (35.5 ml vs 44.5 ml). The induction times were not significantly different (209s vs 201s, p<0.05). Additionally, no significant difference was observed regarding hemodynamic stability during anesthesia. Keywords : anesthesia induction, hemodynamic stability, low flow anesthesia, sevoflurane
Co-Authors Adi, Made Septyana Parama Adinda Putra Pradhana Adiyana, I Made Bhasma Ahmad Roziq Christopher Ryalino Damayanti, Elok Elizeus Hanindito Estrada, Ronald I Gusti Agung Gede Utara Hartawan I Gusti Putu Sukrana Sidemen I Ketut Sinardja I Made Agus Kresna Sucandra I Made Darma Junaedi, I Made I Made Gede Widnyana I Made Subagiartha I Wayan Suranadi Jeremy Jonathan Kadek Agus Heryana Kadek Agus Heryana Putra, Kadek Agus Katarina, Ida Ketut Wibawa Nada Kurnia, Prajnaariayi Prawira Kusuma, Dian Reginalda Lesmana, Pita Mora Made Wiryana Marilaeta Cindryani, Marilaeta Mauritius Septa Narakusuma, Fajar Ni Luh Gede Apsari Pararesthi Ni Made Supradnyawati, Ni Made Novandi Kurniawan Otniel Adrians Labobar Pontisomaya Parami Pranata, I Made Harry Putu Pramana Suarjaya Putu Sukma Parahita Raden Andi Sularso, Raden Andi Sobhana Shanmuganathan Supono, Benny Thius, Adi Dharma Tjokorda Gde Agung Senapathi Utariani, Arie