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All Journal Jurnal Kedokteran Jurnal Respirologi Indonesia Jurnal Respirasi (JR) Respiratory Science Indonesian Journal of Cancer
Prasenohadi
Department Of Pulmonology And Respiratory Medicine, Faculty Of Medicine, Universitas Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Failure of Breathing in Heavy Preeklampsia With Peripartum Cardiomiopathy Desilia Atikawati; Diyan Ekawati; Pusparini Kusumajati; Prasenohadi Prasenohadi; Menaldi Rasmin
Jurnal Respirologi Indonesia Vol 37, No 4 (2017)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (514.006 KB) | DOI: 10.36497/jri.v37i4.88

Abstract

Physiological alterations during pregnancy generate higher risk of pulmonary edema and acute respiratory failure. Respiratory failure occurs in 0.2% pregnancy, particularly in postpartum period. Respiratory failure can be developed by specific conditions related to pregnancy, such as preeclampsia and peripartum cardiomyopathy. We present the case of 34-year-old female, with 36 weeks of pregnancy, that came with shortness of breath since an hour before admitted. Patient also had vaginal discharge in the last two hours before admitted. Fetal movement was active. Shortness of breath was accompanied with cough. Physical examination revealed hypertension (160/110 mmHg) and rales on both lungs. Blood gas analysis showed severe hypoxemia. Patient were intubated and underwent C-section afterwards. Chest x-ray showed heart enlargement. Echocardiography result showed fraction ejection 25%, global hypokinetic, mild mitral and tricuspid regurgitation, with conclusion of peripartum cardiomyopathy. This case illustrates respiratory failure in severe preeclampsia and peripartum cardiomyopathy. This condition leads to acute pulmonary edema that impairs ventilation/perfusion process. Mechanical ventilation can assure adequate oxygen delivery. Non-invasive ventilation (NIV) is well suited to short-term ventilatory support, and avoids the potential complications of endotracheal intubation and the associated sedation. (J Respir Indo. 2017; 37(4): 325-36)
Respiratory Failure in Pneumonia with Diabetic Ketoacidosis (DKA) Novita Maulidiyah; Sri Indah Indriani; Prasenohadi Prasenohadi; Menaldi Rasmin
Jurnal Respirologi Indonesia Vol 38, No 1 (2018)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v38i1.140

Abstract

The annual incidence rate of KAD is estimated to be between 4.6 and 8 per 1000 patients with diabetes. Based on the results of the physical examination, the patient was diagnosed as pneumonia with KAD. The mortality rate for community pneumonia on outpatients was 2%, inpatients was 5-20%, more so in patients in intensive care that was more than 50%. The problem in the patient is pneumonia. Resulting in pulmonary dysfunction which causes overload. Infections that can increase morbidity and mortality may be associated with Streptococcus infection (group B, S, pneumonia), Legionella and viral infections (influenza). The most common infections are pneumonia and urinary tract infections which account for between 30% and 50% of cases. Therefore, the choice of empiric antimicrobial therapy in diabetic patients with evidence of staphylococcal pneumonia (consistent with sputum smear results or associated soft tissue infection) should be guided by the prevalence of MRSA in the associated institutions. Respiratory failure is a complication of KAD and increases the mortality rate. and morbidity. Based on the high nasal carriage rate, there is an increased risk of staphylococcal pneumonia infection in diabetic patients. Community pneumonia is acute inflammation due to infection of the lung parenchyma acquired in the community. (J Respir Indo 2018; 38(1): 57-63)
Breath Failure in Obesity Wirya Sastra Amran; Putri Suci; Nina Aspiah; Menaldi Rasmin; Prasenohadi Prasenohadi; Agus Dwi Susanto
Jurnal Respirologi Indonesia Vol 38, No 2 (2018)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v38i2.167

Abstract

Based on calculations of over one million people in the world weighing excessively or known as obesity with body mass index (IMT) 25 kg / m2 or more. Obesity is the cause of morbidity, as is the case in the population of the United States an estimated 400,000 deaths caused due to obesity. Obesity especially abdominal obesity is a significant risk factor for cardiovascular diseases, type 2 diabetes, rheumatoid arthritis and cancer. The relationship between obesity and chronic respiratory illness began to increase and began to be recognized. The World Health Organization (WHO) predicts about 10% of the global population will be obese by 2015. (J Respir Indo 2018; 38(2): 123-33)
Penggunaan Penggunaan Kanula Hidung Arus Tinggi (KHAT) Untuk Proses Penyapihan Ventilasi Mekanis pada Pasien Penyakit Paru Kronik (Laporan Kasus) Prasenohadi; Muhamad Iman Nugraha; Aisyah Ayu Syafitri
Unram Medical Journal Vol 11 No 1 (2022): vol 11 no 1
Publisher : Faculty of Medicine Universitas Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29303/jku.v11i1.643

Abstract

Ventilasi mekanis adalah suatu alat bantu pernapasan yang digunakan untuk memberikan oksigen dengan tekanan positif. Ventilasi mekanis diindikasikan pada pasien dengan gagal napas akut berat ataupun pada pasien yang mengalami Acute Respiratory Distress Syndrome (ARDS). Penggunaan ventilasi mekanis jangka panjang merupakan salah satu faktor yang dapat menyebabkan tingginya angka mortalitas dan morbiditas pada pasien yang di rawat di Respiratory Intensive Care Unit (RICU). Penyapihan ventilasi mekanis merupakan tujuan akhir penggunaan ventilasi mekanis. Proses penyapihan dengan menggunakan kanul hidung arus tinggi dapat mengurangi risiko terjadinya kejadian kegagalan penyapihan dan mengurangi risiko terjadinya reintubasi pasien. Kami melaporkan kasus seseorang dengan diagnosis sindrom obstruksi pasca infeksi tuberkulosis dan penyakit paru obstruktif kronik dengan gagal napas hiperkapnia disertai dengan penurunan kesadaran akibat keracunan CO2 dan digunakan ventilasi mekanis sebagai tatalaksana. Kanula hidung arus tinggi digunakan pada pasien sebagai bagian dari proses penyapihan ventilasi mekanis. Penggunan kanula hidung arus tinggi (KHAT) diperuntukkan untuk mempercepat proses penyapihan dan mengurangi risiko terjadinya reintubasi pada pasien.
Primary Pulmonary Sarcoma Coinfected with Pulmonary Tuberculosis: A Case Report Dea Putri Audina; Sita Laksmi Andarini; Hana Khairina Putri Faisal; Prasenohadi Prasenohadi; Jamal Zaini; Herawati Hidajat
Indonesian Journal of Cancer Vol 17, No 3 (2023): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i3.991

Abstract

Introduction: Pulmonary tuberculosis (TB) and malignancy are conditions with similar respiratory diseases and they are even known to coexist simultaneously. Therefore, accurate diagnosis of each disease is crucial to ensure precise treatment. This case study showed the coexistence of pulmonary TB and primary pulmonary sarcoma.Case Presentation: A 62-year-old male presented with a 3-month history of dyspnea, which worsened within 3 days. Before hospitalization, there were complaints of left chest pain, fatigue, loss of appetite, weight loss within 5 months, and night sweats. The patient who was a heavy smoker had experienced hemoptysis in the past 5 months. Upon physical examination, an increased respiratory rate and decreased oxygen saturation level. Furthermore, there were asymmetrical thorax movements, dull percussion on the left side, and decreased vesicular breathing sound on the left hemithorax, with no rhonchi or wheezing. A chest x-ray showed a destroyed left lung, while scanning confirmed left lung atelectasis and indicated a suspected mass within or around the left bronchus causing total obstruction in the main left bronchus. The bronchoscopy procedure identified a mass blocking the left main bronchus. However, a biopsy yielded inconclusive results. A rapid molecular test of TB detected Mycobacterium tuberculosis, which was discovered to be Rifampicin sensitive. As a result, the patient was treated daily with 4 fixed drug combinations for anti-TB. Despite the treatment, the complaint was not resolved within the next 3 months, as there was still a disease of cough in the form of mass-like phlegm, which uncovered a malignancy focus cell with differential diagnosis of pleomorphic sarcoma and sarcomatoid carcinoma.Conclusions: Lung malignancy not only overlapped with but also occurred simultaneously alongside lung TB. Therefore, it was crucial to establish a clear diagnosis in patients with chronic respiratory disease.
Magnesium and Phosphate Ion Levels in Mechanically Ventilated Patients Treated at Persahabatan Hospital’s Intensive Care Unit (ICU) and Respiratory Intensive Care Unit (RICU) in 2018 Filemon Suryawan Handjaja; Menaldi Rasmin; Prasenohadi Prasenohadi; Ernita Akmal
Jurnal Respirologi Indonesia Vol 43, No 3 (2023)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v43i3.456

Abstract

Background: History shows that respiratory system has a long and complicated arrangement so that many factors can affect a human’s ability to breathe. Some electrolytes often considered as most important are sodium (Na+), potassium (K+), calcium (Ca2+) and chloride (Cl-). Other than that, magnesium (Mg2+) and phosphate (PO43-) are also important in all processes, especially at the neuromuscular junction and in muscle cells as adenosine triphosphate (ATP). Some researchers have found that PO43- affected patients’ clinical condition and ventilator weaning success, although Mg2+ gave inconsistent results. Until now, there have not been any studies or data about the significance of Mg2+ and PO43- in ventilator weaning in Indonesia.Methods: This was a cross sectional study with total sampling. A vein blood sample was taken after ICU/RICU admission at Persahabatan Hospital. Blood sample was taken consecutively until it reached a minimum of 30 subjects (pilot study). All patients found with mechanical ventilation were included, except for patients with complicated procedure (e.g. avian influenza, multidrug-resistant tuberculosis). Blood sample was analyzed for Mg2+, inorganic phosphate (Pi) and other additional tests. Failure in weaning was defined as reintubation within 48 hours after extubation or failure in the spontaneous breathing trial (SBT).Results: Of the 31 subjects evaluated, there were 3 patients with weaning failure. The median Mg2+ value was 0.5 (0.5-2.6) in successfully weaned patients and 0.6 (0.6-2.7) in patients with weaning failure, lower than its normal value. The mean Pi value was 4.21±1.17 (normal value) in successfully weaned patients and 5.43±0.47 (high value) in patients with weaning failure. Further analysis found that no significant relation was found between weaning and patient’s characteristics other than heart rate and Ca2+, although it was not clear if there were some biases which could affect these results. Low Mg2+ value was observed in 23 subjects, no low Pi value was seen in all subjects, high Mg2+ value was found in 1 subject, high Pi value was observed in 11 subjects, and the rest was in the normal range.Conclusion: The median Mg2+ value in both weaning groups (successful and failed) were below the normal limit at 0.5 (0.5-2.6) and 0.6 (0.6-2.7). Mean Pi value in the successful weaning group was 4.21±1.17 (within normal range), and the value in failed weaning group was 5.43±0.47 (above normal range).
Bronchoalveolar Lavage (BAL) in Pulmonary Alveolar Proteinosis and Sarcoidosis Prasenohadi Prasenohadi
Jurnal Respirologi Indonesia Vol 43, No 4 (2023)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v43i4.607

Abstract

Bronchoalveolar lavage (BAL) is a minimally invasive procedure using flexible fiber optic bronchoscopy guidance that is safe, easily performed, and well tolerated. Bronchoalveolar lavage procedure is important to diagnose or differentially diagnose patients with a clinical appearance and radiological findings that are not specific. Mechanisms related to lung disorders such as inflammation, fibrosis, and abnormal material could be obtained by BAL fluid. Non-infection lung disorders such as pulmonary alveolar proteinosis (PAP) and sarcoidosis may be diagnosed by BAL. BAL in non-infection lung disease has diagnostic and therapeutic functions. As diagnostic function, BAL could be a tool to obtain a lower respiratory tract sample, and lavage from the respiratory track could be a therapeutic function of BAL.
Re-expansion Pulmonary Edema Prasenohadi Prasenohadi; Wahyu Subekti
Respiratory Science Vol. 4 No. 1 (2023): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v4i1.130

Abstract

Re-expansion pulmonary edema (RPE) is a rare complication of pleural puncture (thoracentesis) and chest tube insertion. The incidence of RPE is low (1%), but mortality can be up to 20%. The main pathophysiological mechanism is pulmonary edema due to increased permeability and increased hydrostatic pressure in the pulmonary capillaries. Risk factors include duration of lung collapse (>3 to 7 days), size of pneumothorax (>30%), volume of aspirated air or fluid (>1.5 to 3 L), excessive negative intrapleural pressure, diabetes mellitus, and chronic hypoxemia. Prevention includes limiting the volume of aspirated air or fluid (<1.5 L), air or fluid evacuation in a controlled manner, and preventing excessive negative intrapleural pressure. Treatment is supportive care through cardiovascular and respiratory monitoring, oxygen and decubitus positioning. 
Preparation and Findings in Diagnostic and Therapeutic Flexible Fiberoptic Bronchoscopy Procedures in Patients with COVID-19 Irandi Putra Pratomo; Hario Baskoro; Dicky Soehardiman; Prasenohadi Prasenohadi; Tutug Kinasih; Ahmad Fauzi; Ike Maretta; Nachita Putri; Kentaro Tokumo
Jurnal Respirasi Vol. 9 No. 1 (2023): January 2023
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v9-I.1.2023.72-79

Abstract

The coronavirus disease 2019 (COVID-19), which has raised concerns about infection control for every clinical procedure, including flexible fiberoptic bronchoscopy (FFB), has drawn the attention of clinicians across the globe. A pulmonologist frequently conducts this procedure to diagnose and treat pulmonary diseases like COVID-19. This procedure involves direct airway observation and generates aerosol from the patient. However, it is considered a double-edged sword, as the risk of infection and instrument contamination always haunts its clinical benefit to the patients and the operators. Therefore, a guideline for preparing and indicating FFB in COVID-19 must be addressed appropriately by emphasizing the importance of infection prevention and control. Fortunately, several recommendations and findings have emerged over the past three years, which should support safe FFB procedures for its operators with controlled infection. This study summarizes the indication, objective, contraindication, risk, preparation, and findings in diagnostic and therapeutic FFB patients with COVID-19.
Obesity Hypoventilation Syndrome (Pickwickian Syndrome): A Literature Review Ramadhan, Alfin Ridha; Betcy, Betcy; Aurora, Ruth Grace; Prasenohadi, Prasenohadi; Alatas, Mohamad Fahmi
Respiratory Science Vol. 5 No. 1 (2024): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i1.155

Abstract

Obesity hypoventilation syndrome (OHS), also known as Pickwickian syndrome, is a respiratory disorder characterized by reduced alveolar ventilation and elevated daytime carbon dioxide levels, primarily associated with obesity. If untreated, OHS can progress to pulmonary hypertension (PH) and ultimately heart failure. The exact prevalence of OHS in the general population remains unclear, but studies estimate it to range from 8% to 12.3%, increasing with obesity prevalence. This review discusses the diagnostic criteria for OHS, the utility of the STOP-Bang questionnaire in screening, and advances in understanding the pathophysiology and management of OHS, focusing on heart failure with preserved ejection fraction (HFpEF). Accurate diagnosis of OHS is critical and requires a thorough approach involving an extensive patient medical history and physical examination to differentiate OHS from obstructive sleep apnea (OSA). Key diagnostic tests include serum bicarbonate levels and arterial blood gas (ABG) analysis, to confirm the hypercapnia and identify the severity of hypoventilation. Given the rising prevalence of obesity worldwide and the serious complications associated with untreated OHS, early and accurate identification of OHS is essential, as it can prevent the progression to severe pulmonary hypertension (PH) and the subsequent development of heart failure (HF).
Co-Authors Agus Dwi Susanto Ahmad Fauzi Aisyah Ayu Syafitri Alatas, Mohamad Fahmi Alatas, Mohammad Fahmi Alatas, Muhamad Fahmi Andromeda, Rossalyn Aniwdyaningsih, Wahju Aniwidyaningsih, Wahju Arif Santoso Baskoro, Hario Betcy, Betcy Bies, Asri Liqditta Dea Putri Audina Desianti, Ginanjar Arum Desilia Atikawati Desiyanti, Ginanjar Arum Dian Prastiti Utami Dicky Soehardiman Diyan Ekawati Elhidsi, Mia Ernita Akmal Eylin Rahardjo Faisal, Hana Khairina Putri Fauzi Ahmad Muda Filemon Suryawan Handjaja Flora Dameria Ginanjar Arum Herawati Hidajat Ike Maretta Irandi Putra Pratomo Kentaro Tokumo Kinasih, Tutug Martini, Ni Putu Laksmi Ananda Menaldi Rasmin Menaldi Rasmin Mohammad Fahmi Muhamad Iman Nugraha Nachita Putri Navratilova, Melfia Ni Putu Laksmi Ananda Martini Nina Aspiah Novita Maulidiyah Pusparini Kusumajati Putri Suci Ramadhan, Alfin Ridha Reisa, Tina Romi Beginta Ruth Emalian Sembiring Ruth Grace Aurora Sita Laksmi Andarini Soehardiman, Dicky Sri Indah Indriani Tina Reisa Tokumo, Kentaro Tutug Kinasih Wahyu Subekti Wirya Sastra Amran Zaini, Jamal