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All Journal Bali Journal of Anesthesiology Warta Penelitian Perhubungan Dinasti International Journal of Education Management and Social Science Jurnal Anestesi Obstetri Indonesia Jurnal Manajemen Transportasi & Logistik (JMTRANSLOG) Jurnal Neuroanestesi Indonesia Halal Tourism and Pilgrimage Islamic Marketing Review Jurnal Komplikasi Anestesi Jurnal Sistem Transportasi & Logistik
Sri Rahardjo
Program Doktor Manajemen dan Bisnis (MB-IPB)- Sekolah Pascasarjana IPB Pasca Sarjana Universitas Sahid Jakarta
Automotive Engineering Biochemistry, Genetics & Molecular Biology Civil Engineering, Building, Construction & Architecture Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Education Engineering Environmental Science Health Professions Immunology & microbiology Library & Information Science Medicine & Pharmacology Neuroscience Nursing Public Health Transportation Other

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Tatalaksana Anestesi pada Pasien Anak dengan Cystic Craniopharyngioma yang Menjalani Gamma Knife Radiosurgery Widiastuti, Monika -; Halimi, Radian Ahmad; Fuadi, Iwan; Rahardjo, Sri; Bisri, Tatang
Jurnal Neuroanestesi Indonesia Vol 10, No 2 (2021)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (3082.611 KB) | DOI: 10.24244/jni.v10i2.353

Abstract

Kraniofaringioma merupakan tumor otak jinak dengan karakteristik kistik dan kalsifikasi, yang letaknya dikeliingi oleh stuktur vital sehingga sulit untuk dilakukan reseksi total. Terapi kombinasi dengan Gamma knife radiosurgery (GKRS) merupakan pilihan terapi paling tepat. Prosedur GKRS yang kompleks meliputi banyak tahap dengan durasi 6-10 jam, memerlukan pemberian anestesi pada pasien yang tidak kooperatif. Kasus ini mengenai pasien anak perempuan berusia 4 tahun dengan cystic craniopharyngioma. Pasien dengan keluhan pandangan mata buram, dari pemeriksaan fisik didapatkan papil atrofi bilateral. Hasil magnetic resonance imaging (MRI) menunjukkan massa tumor yang menekan kelenjar hipofise inferior. Pasien menjalani prosedur GKRS selama 6 jam dengan anestesi sedasi sedang menggunakan Propofol 75 mcg/kg/menit. Hemodinamika selama prosedur stabil, tidak terjadi komplikasi. Pemilihan teknik anestesi dapat berupa anestesi umum atau sedasi, tergantung pada kondisi pasien, dokter anestesi, operator, dan fasilitas. Pertimbangan anestesi pada GKRS antara lain prosedur dilakukan di luar kamar operasi, durasi panjang, transportasi ke beberapa tempat seperti radiologi dan cathlab, imobilisasi kepala untuk mencegah pergeseran frame stereotaktik, pasien sendiri di dalam ruang radiasi, prinsip neuroanestesi pediatrik.Anesthetic Management of Pediatric Patient with Cystic Craniopharyngioma Underwent Gamma Knife RadiosurgeryAbstractCraniopharyngioma is a benign tumor characterized by cystic and calcification, surrounded by vital structures therefor it is difficult to perform total tumor resection. Combination with Gamma knife radiosurgery (GKRS) is the best treatment option. The complexities of GKRS consisting of several phases lasts for 6-10 hours. Anesthesia is needed for uncooperative patients. This is a case of a 4-year-old girl with cystic craniopharyngioma. The patient had chief complaint of blurry vision, physical examinations revealed bilateral papil atrophy. Result of MRI showed tumor mass compressing inferior hypophyse. Patient underwent the procedure under moderate sedation with Propofol at 75 mcg/kg/min for 6 hours. Intraoperative hemodynamic condition was stable without adverse events. Choice of anesthesia either general anesthesia or sedation, depends on the condition of patient, considerations from anesthesiologist dan neurosurgeon, dan availability of facilities. Unique considerations for GKRS are; a non-operating room anesthesia, long duration, transportation to other units such as radiology and cathlab, head of the patients need to be immobilized to prevent frame displacement, the patient will be alone in the treatment room, and principles of pediatric anesthesia and neuroanesthesia.
KAJIAN PENGEMBANGAN PELABUHAN DALAM MENDUKUNG IBU KOTA BARU BERDASARKAN KONSEP SMART CITY, SMART MOBILITY Malisan, Johny; Sujarwanto, Sujarwanto; Arief, Budi; Fadhil, Dimas Nu’man; Rahardjo, Sri
Jurnal Sistem Transportasi & Logistik Vol. 1 No. 1 (2021): Agustus
Publisher : Institut Transportasi dan Logistik Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54324/jstl.v1i1.628

Abstract

The government has officially announced that the new capital city will be located in the province of East Kalimantan and will have a different infrastructure from the rest of Indonesia. This new region will apply digital technology that triggers the maritime industry to switch from traditional to digital processes as a consequence of development with the concept of smart city and smart mobility. This study aims to select and determine existing ports that meet the requirements to be developed to support development in the national capital region based on the concept of a smart city, smart mobility, as well as innovations that can be made to accelerate its development. In the conditions of the COVID-19 pandemic, the research was conducted online, using descriptive and qualitative methods. The results showed that the Semayang port and the Kaltim Kariangau Terminal (KKT) port were the selected ports, as well as other potential ports such as the Kampung Baru Tengah port and the Penajam Passer port. The two ports need to be developed towards a smart port that prioritizes efficiency and utilization of digital-based information system technology.
Analisis Pengaruh Kompetensi dan Kesejahteraan Karyawan Operasional Terhadap Utilisasi Fasilitas Bongkar Muat dan Dampaknya terhadap Produktivitas Terminal Peti Kemas Koja, Pelabuhan Tanjung Priok Parhusip, Veronica; Bimarso, Wahyono; Sulam, Munyati; Rahardjo, Sri; Afra, Syeda Maria Ahmad
Jurnal Sistem Transportasi & Logistik Vol. 2 No. 1 (2022): Agustus
Publisher : Institut Transportasi dan Logistik Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54324/jstl.v2i2.1033

Abstract

The purpose of this research is to analyze the effect of competency and prosperity of employees on facility utilization and the impact on terminal productivity. Container terminal is the means of trade for in and out of goods at the port. provision of terminal facilities such as docks, stacking yards, pools for docking and also goods handling equipment for loading and unloading. KSO container terminal Koja is a subsidiary of PT. Pelabuhan Indonesia II and cooperation with PT Hutchison Port Indonesia. Koja terminal serves loading and unloading of goods both nationally and internationally and has a strategically important role in the growth of industry and trade as well as a business sector that contributes to national development. The research was conducted on operational employees by using quantitative methods technical path analysis. The result concluded that there is a direct influence on the utilization of facilities, the effect is significant. There is a direct influence of competence on terminal productivity, the effect is significant. There is a direct influence of facility utilization on terminal productivity, the effect is significant. There is a direct effect of welfare on terminal productivity, the effect is significant. There is an effect of total competence on the productivity of the terminal through the utilization of facilities and there is the effect of total welfare on the productivity of the terminal through the utilization of facilities.
Efektivitas dan Efisiensi e-Procurement Pengadaan Barang Konstruksi Chamsudi, Danie Hayam Mada; Setyarto, Aries; Rahardjo, Sri; Sectio, Devin Igel; Bijaksana, Gena; Faturachman, Muhammad Rafli
Jurnal Sistem Transportasi & Logistik Vol. 1 No. 2 (2021): Desember
Publisher : Institut Transportasi dan Logistik Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54324/jstl.v1i2.1054

Abstract

Purpose of this study is to analyze the effectiveness and efficiency of PT Metal Bakrie Industries after implementing E-Procurement to its whole procurement activities. To achieve the right and targeted research objectives, the authors formulate a problem regarding whether there are differences in effectiveness and efficiency before and after using E-Procurement at PT Metal Bakrie Industries with effectiveness and efficiency as the independent variable and E-Procurement as the dependent variable. The total population of PT Bakrie Metal Industries staff itself is 38, but only 30 people are taken as samples in this study. The software used by researchers in processing this data is SPSS version 25. This study uses a quantitative approach with data analysis techniques including instrument testing (validity and reliability) and paired t test. Based on the results of this study, after implementing E-Procurement, effectiveness and efficiency were considered better than before implementing E-Procurement. In addition, based on the paired t test, it is said that there is a difference between effectiveness and efficiency before and after using E-Procurement.
Analisis Akuntabilitas dan Transparansi Sistem Elektronik Pengadaan Barang dan Jasa Pemerintah di LKPP Rahardjo, Sri; Bijaksana, Gena; Larasati, Kinanthi; Chamsudi, Danie Hayam Mada; Sitorus, Purbanuara Parlindungan; Kania, Dinar Dewi
Jurnal Sistem Transportasi & Logistik Vol. 2 No. 1 (2022): Agustus
Publisher : Institut Transportasi dan Logistik Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54324/jstl.v2i2.1262

Abstract

This study aims to determine the implementation of transparency and accountability in the process of procurement of goods/services electronically as well as the inhibiting factors for implementing accountability of goods/services electronically. This study uses the E-Procurement method, implementing the principle of procurement of goods/services, the government will find it easier, especially transparency and accountability that are directly related to information systems and technology. The results obtained in this study are that the procurement process for goods/services is in accordance with existing regulations and the technical team as end users already feel that the electronic procurement process is transparent. on the LPSE LKPP website. The clinical impact of this research is the government that allows for vulnerability in the form of corruption. Therefore, the government obliges every Ministry/Institution/Regional Work Unit/Institution to carry out procurement activities of government goods/services electronically, which is then referred to as e-procurement.
Kajian Konsep Lund dan Konsep Rosner untuk Tatalaksana Cedera Otak Traumatik Berat Sumardi, Fitri Sepviyanti; Rachman, Iwan Abdul; Rahardjo, Sri
Jurnal Neuroanestesi Indonesia Vol 9, No 2 (2020)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2554.002 KB) | DOI: 10.24244/jni.v9i2.248

Abstract

Tatalaksana pasien dengan cedera otak traumatik (COT) berat mengalami perubahan berkesinambungan selama 30 tahun terakhir. Tatalaksana yang diarahkan di unit perawatan intensif (intensive care unit/ICU) mengacu pada tatalaksana klinis sebagai titik akhir terapi utama, bertujuan untuk mempertahankan variabel fisiologis tertentu secara ketat dalam rentang target yang telah ditentukan. Satu alternatif terhadap terapi konvensional ini adalah konsep Lund yang mengutamakan penurunan tekanan mikrovaskular. Konsep Lund termasuk suatu strategi target volume untuk mengendalikan tekanan intrakranial, berasal dari Universitas Lund Swedia, lebih dari 27 tahun yang lalu dan tetap masih kontroversi sampai saat ini. Sejak tahun 1996, American Brain Trauma Foundation dan European Brain Injury Consortium, yang mengacu pada konsep Rosner, telah menerbitkan dan memperbarui panduan untuk tatalaksana cedera otak traumatik. Para ahli sangat menyadari adanya patologi intrakranial multifaktorial yang terlihat pada pasien COT berat dan kompleksitas mekanisme cedera otak sekunder setelah trauma primer, akan menemukan bahwa revisi ini sulit untuk dipahami. Hubungan antara peningkatan tekanan intrakranial (TIK) dan hasil luaran klinis yang lebih buruk sudah terbukti. Menyederhanakan fisiologi otak setelah COT berat ke strategi tatalaksana pasien bedasarkan ambang batas adalah berkaitan erat dengan hubungan interaksi komplek antara: peningkatan TIK, aliran darah otak, dan metabolisme otak.Review of Lund Concept and Rosner Concept for Therapy of Severe Traumatic Brain InjuryAbstractThe management of patients with severe traumatic brain injury (TBI) has undergone continuous changes over the past 30 years. Management directed at the intensive care unit (ICU) refers to clinical management as the main end point of therapy, aiming to maintain certain physiological variables strictly within a predetermined target range. One alternative to this conventional therapy is the Lund concept which prioritizes the reduction of microvascular pressure. The concept of Lund includes a volume target strategy for controlling intracranial pressure, from Lund University in Sweden, more than 27 years ago and remains controversial to date. Since 1996, the American Brain Trauma Foundation and the European Brain Injury Consortium, which refers to the Rosner concept, have published and updated guidelines for the management of traumatic brain injury. Experts are well aware of the multifactorial intracranial pathology seen in severe TBI patients and the complexity of the mechanism of secondary brain injury after primary trauma will find that this revision is difficult to understand. The relationship between increased intracranial pressure (ICP) and worse clinical outcome has been proven. Simplifying the physiology of the brain after severe TBI to the patient's management strategy based on the threshold is closely related to the relationship between complex interactions: increased ICP, cerebral blood flow (CBF), and brain metabolism.
Anestesi Scalp Block dan Occipital Block pada Tindakan External Ventricular Drainage (EVD) pada Kehamilan 32 Minggu Arshad, Muhammad; Bisri, Dewi Yulianti; Rahardjo, Sri
Jurnal Neuroanestesi Indonesia Vol 9, No 2 (2020)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2596.58 KB) | DOI: 10.24244/jni.v9i2.243

Abstract

Hidrosefalus adalah pembesaran ventrikel otak sebagai akibat peningkatan jumlah cairan serebrospinal (CSS) yang disebabkan oleh ketidakseimbangan antara produksi, sirkulasi dan absorbsinya. Perkiraan wanita hamil yang dilakukan operasi non obstetric sekitar 12%. Pasien obstetri dengan penyakit bedah saraf selalu dirawat di ICU. Insidensi operasi selama kehamilan dilaporkan 42% prosedur pembedahan terjadi pada trimester pertama, 35% pada trimester kedua, dan 23% pada trimester ketiga. Seorang wanita 35 tahun dengan usia kehamilan 3233 minggu datang ke IGD dengan penurunan kesadaran tanpa riwayat trauma, tidak dijumpai tekanan darah tinggi. Dari pemeriksaan CT-Scan ditemukan adanya hidrosefalus, sehingga dilakukan tindakan external ventricular drainage (EVD). Anestesi untuk pasien dalam keadaan hamil harus mempertimbangkan bayi dalam kandungan sehingga dilakukan pembiusan scalp block dan occipital block. Obat yang digunakan ropivakain HCl 0,375 % (sebanyak 10cc). Setelah operasi pasien dirawat di ruang pemulihan, 2 jam kemudian dirawat di ruang high care unit (HCU). Pencegahan terhadap hipoksia dan hipotensi adalah keharusan, walaupun periode hipoksemia yang pendek masih bisa ditoleransi. Hipoksemia maternal yang berkepanjangan akan menyebabkan vasokonstriksi sirkulasi uteroplasental yang pada akhirnya menurunkan perfusi sehingga menyebabkan hipoksemia, asidosis dan kematian janin.Scalp Block and Occipital Block Anesthesia for External Ventricular Drainage (EVD) in 32-Week PregnancyAbstractHydrocephalus is enlargement of the brain ventricles as a result of an increase in the amount of cerebrospinal fluid (CSS) caused by an imbalance between production, circulation and absorption. Estimates of pregnant women in non-obstetric surgery are around 12%. Obstetric patients with neurosurgery disorders are always treated in the ICU. The incidence of surgery during pregnancy was reported in 42% of surgical procedures occurred in the first trimester, 35% in the second trimester, and 23% in the third trimester. A 35-year-old woman with 32-33 weeks' gestation came to the emergency room with decreased consciousness yet no history of trauma and high blood pressure. Hydrocephalus were found in CT scan, and the external ventricular drainage (EVD) is taken. The patient has intrauterine pregnancy so the anesthesia choice is scalp block and occipital block. Ropivacaine HCl 0.375% (as much 10cc) was used. After surgery the patient was treated in the recovery room for 2 hours, and discharged to the high care unit (HCU) afterwards. Hypoxia and hypotension is a challenge in short periods of hypoxemia that can still be tolerated. Prolonged maternal hypoxemia prevention will cause uteroplacental circulation vasoconstriction which ultimately reduces perfusion, causing foetal hypoxemia, acidosis and death.
Ventilasi Mekanik yang Memanjang pada Pasien Cedera Otak Traumatik Berat dengan Subdural Hematoma Putri, Dini Handayani; Rachman, Iwan Abdul; Rahardjo, Sri
Jurnal Neuroanestesi Indonesia Vol 9, No 2 (2020)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2540.836 KB) | DOI: 10.24244/jni.v9i2.253

Abstract

Cedera otak traumatik (COT) adalah suatu proses patologis pada otak yang berasal dari luar tubuh, yang dapat menyebabkan kerusakan permanen atau sementara dari fungsi otak. Salah satu perdarahan otak yang sering menyertai terjadinya COT berat adalah subdural hematoma (SDH). Pasien laki-laki 41 tahun, datang ke rumah sakit dengan penurunan kesadaran GCS E2M2V2 akibat kecelakaan. Pasien dilakukan tatalaksana dan diintubasi di IGD, hasil CT-Scan memperlihatkan SDH, dan edema serebri. Pasien dilakukan evakuasi hematom dengan anestesi umum, diinduksi dengan fentanil 100 ?gr, propofol 20 mg dan atracurium 20 mg intravena. Pemeliharaan dengan sevofluran, propofol kontinyu, fentanil dan atracurium intermiten. Pascaoperasi pasien mengalami ventilator associated pneumonia (VAP), diberikan antibiotik sprektum luas untuk pemulihan paru, pada hari ke 10 pasien dilakukan trakeostomi. Pasien dapat disapih dari ventilator hari ke 21 dengan GCS E4M4Vtrach tanpa kontak, dengan skor GOS (Glasgow Outcome Scale) 3, direncanakan untuk homecare. COT berat membutuhkan tatalaksana pascaoperasi yang lebih kompleks, antisipasi penggunaan ventilasi mekanik yang memanjang, risiko VAP serta pertimbangan pemasangan trakeostomi secara cepat hingga pemberian antibiotik yang adekuat untuk mendapatkan hasil luaran terbaik.Prolonged Mechanical Ventilation in Severe Traumatic Brain Injury Patients with Subdural HematomasAbstractTraumatic brain injury (TBI) is a pathological process in the brain that originates from outside the body, which can lead to permanent or temporary damage to brain function. One of the brain hemorrhages that often accompanies severe TBI is subdural hematoma (SDH). Male patient 41 years old, was admitted to our hospital with decreased of consciusness with GCS E2M2V2 due to a motorcycle accident. The patient was intubated in the emergency room and then performed head CT scan examination which showed SDH and cerebral edema as the result. Patients then underwent hematoma evacuation under general anesthesia, induced with fentanyl 100 g, propofol 20 mg and atracurium 20 mg intravenously. Maintenance of anesthesia with sevoflurane, continuous propofol, fentanyl and intermittent atracurium. Postoperatively the patient experienced ventilator associated pneumonia (VAP) and given broad-spectrum antibiotics for lung recovery, then on the 10th day tracheostomy was performed. Patients can be weaned from the ventilator on day 21st with GCS E4M4Vtrach without contact, with a GOS (Glasgow Outcome Scale) score of 3, and was planned for homecare. Severe TBI requires more complex postoperative management, anticipation of prolonged use of mechanical ventilation, risk of VAP and consideration of rapid tracheostomy installation to adequate antibiotic administration to obtain the best outcome.
Co-Authors A Himendra Wargahadibrata Adi Hidayat Adi, Erman Noor Adriman, Silmi Afra, Syeda Maria Ahmad Agnesha, Fahmi Ambarini, Ronia Anindita, Triatma Arief, Budi Arshad, Muhammad Aulyan Syah, Bau Indah Ayu, Rifana Bambang Suryono, Bambang Bestari, Viqy Esha Bhirowo Yudo Pratomo Bijaksana, Gena Bimarso, Wahyono Budianti, Nugrahaeni Calcarina Fitriani Retno Wisudarti Chamsudi, Danie Hayam Mada Christanto, Sandhi Dewi Yulianti Bisri Diana C. Lalenoh, Diana C. Diana Lalenoh Dinar Dewi Kania Edhie Budi Setiawan, Edhie Budi Fachrial, Peppy Fadhil, Dimas Nu’man Faturachman, Muhammad Rafli Firdaus, Riyadh Fithrah, Bona Akhmad Fitri Sepviyanti Sumardi Francis Tantri, Francis Fuadi, I Gunawan, Fanny Hamzah, Hanzah Handayani, Sri Hartono, Pinter Herlambang, Panji Hisam, Muhammad Yusuf Ida Bagus Krisna Jaya Sutawan Ikhwandi, Arif Indrawan, Rully Isngadi Iwan Abdul Rachman Iwan Fuadi Jasa, Zafrullah Kany Kadarisman, Muh Laksono, Buyung Hartiyo Lalenh, Diana C. Larasati, Kinanthi Liza, Helda Luky Adrianto Malisan, Johny Mangastuti, Rebecca Sidhapramudita Muhammad Thamrin Mulyono Nasution, Syahrial Nur, Muhammad Ikhwan Nuryawan, Iwan Oetoro, Bambang J. P, Inggita Dyah Parhusip, Veronica Permatasari, Endah Prasadja Ricardianto, Prasadja Prasetya, Sandie Prayunanto A.N, Eko Purwa Saputra, Datep Purwanto, Erfien Puspita, Amelia Tri Putra, Bina Putri, Dini Handayani Putu Pramana Suarjaya Radian Ahmad Halimi Rahayu, Solihah Sari Ratih Kumala Fajar Apsari Restu S, Meta Rini, Isworo Ruddy Suwandi Rudita, Muhammad Rumpoko, Triaji Mudo Saleh, Siti Chasnak Santoso, Arief Hariyadi Sectio, Devin Igel Septika, Rafidya Indah Setiandari, Kristina Setyarto, Aries Siti Helmyati Sitorus, Purbanuara Parlindungan Soeboer, Deni Achmad Subekti, Bambang Eko Sudadi Sudadi Sudadi Suharso, Pamungkas Hary Sujarwanto Sujarwanto, Sujarwanto Sulam, Munyati Sunartejo, Bayu Suyasa, Agus Baratha Syafruddin Gaus Tatang Bisri Widiastuti, Monika - Winarso, Achmad Wahib Wahju Wrgahadibrata, A Himendra Yosiyanto, Robi Yunita Widyastuti Yusmein Uyun Zaki, Wildan Arsyad