Paulus Sulistiono
RSUD Z.A Pagar Alam, Way Kanan, Lampung

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Perbandingan Laringoskopi Indirek Kaca Laring dengan Laringoskopi Indirek Video Smartphone dalam Menilai Visualisasi Laring dan Kenyamanan Pasien Sulistiono, Paulus; Prihartono, M. Andy; Yadi, Dedi Fitri
Jurnal Anestesi Perioperatif Vol 6, No 2 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (873.967 KB) | DOI: 10.15851/jap.v6n2.1254

Abstract

Salah satu pemeriksaan preoperatif yang dapat digunakan sebagai prediktor kesulitan intubasi adalah laringoskopi indirek.  Penelitian ini bertujuan menilai visualisasi laring dan kenyamanan pasien antara laringoskopi indirek kaca laring dan laringoskopi indirek video smartphone. Penelitian menggunakan  metode prospective randomized parallel trial, dilakukan di Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung pada bulan November–Desember 2017. Pasien dibagi menjadi kelompok laringoskopi indirek kaca laring (kelompok LIKL, n=22) dan kelompok laringoskopi indirek video smartphone (kelompok LIVS, n=22). Uji statistik menggunakan Uji Mann-Whitney. Hasil penelitian mengungkapkan visualisasi laring lebih jelas pada kelompok LIVS (1,73 SD±0,77) dibanding dengan kelompok LIKL (2,50 SD±0,86) dengan perbedaan signifikan (p<0,05). Kenyamanan yang lebih baik pada kelompok LIVS (skala di atas 5) dibanding dengan kelompok LIKL (skala di atas 5) dengan perbedaan signifikan (p<0,05). Simpulan penelitian ini adalah visualisasi laring dan kenyamanan pasien pada laringoskopi indirek dengan video smartphone lebih baik bila dibanding dengan laringoskopi indirek kaca laring.Kata kunci: Kaca laring, kesulitan intubasi, laringoskopi indirek, video smartphone  Comparison between Indirect Laryngoscopy Laryngeal Mirror and Indirect Laryngoscopy Smartphone Video in Evaluating Laryngeal Visualization and Patient ComfortIndirect laryngoscopy is an examination modality which can be performed during pre-operative phase as a predictor of difficult intubation. The purpose of this study was to compare indirect laryngoscopy using laryngeal mirror and indirect laryngoscopy using smartphone video in evaluating laryngeal visualization and providing convenience to patients during the examination procedure. This prospective randomized parallel trial was conducted at Dr. Hasan Sadikin General Hospital Bandung from November to December 2017. Patients were assigned to two study groups: those who underwent indirect laryngoscopy using laryngeal mirror (LIKL group, n=22) and those who underwent indirect laryngoscopy using smartphone video (LIVS group, n=22). Mann-Whitney test was utilized as the statistical test method. Result of this study showed that laryngeal visualization was significantly superior in LIVS group compared to LIKL group (1.73 SD±0.77 vs 2.50 SD±0.86, respectively, p value<0.05). Patient comfort was significantly superior in LIVS group compared to LIKL group (comfort score above 5 vs comfort score above 5, respectively, p value <0.05). Therefore, it is concluded that laryngeal visualization using indirect langryngoscopy with smartphone video is more comfortable than the one that uses direct laryngoscopy with laryngeal mirror.Key words: Difficult intubation, indirect laryngoscopy, laryngeal mirror, smartphone video
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.
Prognostic Value of Alactic Base Excess for 28 Day Mortality in Sepsis Patients: A Retrospective Prognostic Accuracy Study in an Intensive Care Unit Sulistiono, Paulus; Sudjud, Reza Widianto; Budipratama, Dhany
Jurnal Anestesi Perioperatif Vol 13, No 3 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v13n3.4591

Abstract

Introduction: Prognostication in sepsis is challenging. Serum lactate is widely used but cannot separate non-lactate contributions to metabolic acidosis. Alactic Base Excess (ABE) provides a more complete assessment of acid–base status. This study assessed ABE’s value in predicting 28-day mortality in sepsis patients.Methods: A retrospective study included 109 adult sepsis patients meeting Sepsis-3 criteria with arterial blood gas analysis within 24 hours of ICU admission. ABE was calculated from base excess and lactate. Prognostic performance was evaluated using ROC analysis, and association with mortality was assessed using odds ratios (OR).Results: Of 109 patients, 59 (54.1%) died within 28 days. Non-survivors had more negative median ABE than survivors (-7.04 vs. -0.15; p<0.001). Optimal ABE cut-off was ≤ -4.1. Patients with ABE ≤-4.1 had a higher risk of mortality (OR 38.6; 95% CI: 13.2–112.9; p<0.001).Discussion: ABE showed strong prognostic performance, reflecting non-lactate metabolic acidosis not captured by lactate alone. As it is derived from routine arterial blood gas analysis, ABE is practical for early risk stratification in critically ill sepsis patients.Conclusion: ABE demonstrates excellent prognostic value for 28-day mortality in ICU sepsis patients. An ABE ≤-4.1 is linked to significantly higher mortality and may serve as a readily available biomarker for early risk assessment and timely clinical decisions.