Ratna Farida Soenarto
Departemen Anestesiologi Dan Terapi Intensif Fakultas Kedokteran Universitas Indonesia/Rumah Sakit Cipto Mangunkusumo

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Magnesium as Immediate Management for Suspected Intraoperative Malignant Hyperthermia Crisis: A Case Report from Indonesia Farida Soenarto, Ratna; Kusuma Manggala, Sidharta; Montolalu, Gabriela; Listyana, Tia; Kurniawan, Celine
Majalah Anestesia & Critical Care Vol 43 No 2 (2025): Juni
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 | DOI: 10.55497/majanestcricar.v43i2.437

Abstract

Background: Malignant hyperthermia (MH) is a life-threatening disorder triggered by certain anesthetics and characterized by a hypermetabolic state in skeletal muscles. Magnesium sulfate is gaining recognition as a crucial adjunct in the immediate management of MH, particularly when dantrolene is not readily available. This case report presents a successful use of magnesium during an MH crisis, emphasizing its potential as a life-saving intervention in resource-limited settings. The report adds to the growing evidence supporting magnesium's role in early MH management, especially when there is a delay in dantrolene administration.Case Illustration: A 2-year-old healthy boy underwent Achilles tendon lengthening under general anesthesia. Post-induction, the patient developed signs of increased sympathetic activity, muscle rigidity, and hypercarbia. Due to dantrolene unavailability, 400 mg of magnesium sulfate was administered, which successfully reduced muscle rigidity and stabilized hemodynamics. Dantrolene was later given, further improving the patient's condition. The patient was extubated 28 hours later and fully recovered, highlighting the critical role of magnesium in managing this crisis.Conclusion: Early detection and management of MH are crucial for patient survival. In the absence of dantrolene, MgSO4 serves as an effective alternative for immediate intervention. This experience underlines the importance of having alternative treatment strategies in resource-limited settings and stresses the need for continued education and preparedness for MH crises.
One-Hour Sepsis Bundle Compliance on Serial SOFA Scores and 28-Day Mortality: A Prospective Investigation in Bekasi Regency Referral ICUs Marina S.A, Mega Ayu M; Sugiarto, Adhrie; Soenarto, Ratna Farida; Irfan, Ahmad
Scientific Journal Vol. 5 No. 3 (2026): SCIENA Volume V No 3, May 2026
Publisher : CV. AKBAR PUTRA MANDIRI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56260/sciena.v5i3.348

Abstract

Background: Sepsis mortality remains high in intensive care units (ICUs). This study aims to evaluate compliance with the implementation of the One hour sepsis bundle and changes in SOFA scores to predict 28-day mortality rates, knowing the 28-day mortality rate and to identify strong mortality factors mortality in sepsis patients in the ICU two of Type B Hospital, Bekasi Regency. Methods: A prospective observational cohort study was conducted in the ICUs of two Type B hospitals in Bekasi Regency in 2025. Sixty adult sepsis patients with with characteristics, SOFA score, One hour sepsis bundle compliance, Temperature, Respiratory rate (RR), Capillary refill time (CRT), Lactate level examination on admission, 24th hour and 5th day. Data were analysed using bivariate analysis.Results: The 28-day mortality rate was 81.7%. Bundle compliance showed no significant correlation with SOFA score changes or 28-day mortality rates. Bivariate analysis proved that 24-hour and 5-day SOFA, 24-hour and 5-day ΔSOFA, GCS components and renal function in 5-day SOFA scoring were significantly correlated with 28-day mortality rates. Conclusion: Compliance with the One hour sepsis bundle did not significantly affect the 28-day mortality rate. 24-hour and 5-day CRT examinations, 24-hour and 5-day SOFA scoring, 24-hour and 5-day SOFA ∆, day-5 temperature examination, day-5 lactate and Δ lactate levels, SOFA GCS scoring components and renal function can affect the 28-day mortality rate of sepsis patients in the ICU of Type B Hospital, Bekasi Regency.