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Rudi Kurniadi Kadarsah
Departemen Anestesiologi Dan Terapi Intensif Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Dr. Hasan Sadikin Bandung
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Angka Kejadian Ventilasi Mekanis Berkepanjangan pada PAscabedah Pintas Arteri Koroner di RSUP Dr. Hasan Sadikin Bandung Tahun 2014-2016 Reza Widianto Sudjud; Rudi Kurniadi Kadarsah; Esther Dian Cahyaningtyas Hintono
Jurnal Anestesi Perioperatif Vol 8, No 1 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v8n1.2015

Abstract

Bedah Pintas Arteri Koroner adalah salah satu tindakan intervensi untuk mengembalikan perfusi koroner. Pascabedah jantung membutuhkan bantuan ventilasi mekanis yang apabila berkepanjangan akan meningkatkan mortalitas dan morbiditas. Tujuan penelitian ini adalah mengetahui angka kejadian ventilasi mekanis berkepanjangan pascabedah pintas arteri koroner berdasar atas usia, jenis kelamin, fraksi ejeksi ventrikel kiri preoperatif, waktu pintas jantung paru, kadar hemoglobin pascaoperasi, dan komorbiditas pada pasien di RSUP Dr. Hasan Sadikin Bandung tahun 2014–2016. Metode yang digunakan adalah deskriptif observasional dengan pendekatan retrospektif berdasar data rekam medis. Dari hasil penelitian ini diperoleh hasil angka kejadian ventilasi mekanis berkepanjangan adalah 69,7%. Penelitian ini menunjukkan angka kejadian ventilasi mekanis berkepanjangan pascabedah pintas arteri koroner berdasarkan usia ≤65 tahun adalah 68,1%, usia >65 tahun 75,7%, laki-laki 69,1%, perempuan 73,1%, fraksi ejeksi >50% sebesar 73,3%, fraksi ejeksi sebesar 66,3%, waktu pintas jantung paru ≤90 menit 47,7%, waktu pintas jantung paru >90 menit 81,6%, kadar hemoglobin pascaoperasi <10 g/dL sebesar 75%, kadar hemoglobin ≥10 g/dL sebesar 66,9%, pasien dengan komorbiditas 69,7% dan tanpa komorbiditas 69,8%. Sebagai simpulan, didapatkan angka kejadian ventilasi mekanis berkepanjangan lebih tinggi pada pasien usia >65 tahun, pasien perempuan, pasien dengan fraksi ejeksi ≤50%, waktu pintas jantung paru >90 menit dan kadar Hb pascaoperasi <10 g/dL Incidence Rates of Prolonged Mechanical Ventilation in Patients Post Coronary Arterial Bypass Grafting at Dr. Hasan Sadikin General Hospital Bandung in 2014–2016Coronary Artery Bypass Grafting (CABG) is an intervention to restore coronary perfusions. Postcardiac surgery requires mechanical ventilation, which, if prolonged, will increase morbidity and mortality.The purpose of this study was to determine the incidence of prolonged mechanical ventilation post-CABG based on age, sex, preoperative left ventricular ejection fraction (LVEF), cardio pulmonary bypass (CPB) time, postoperative hemoglobin levels, and patient comorbidity at Dr. Hasan Sadikin General Hospital Bandung in 2014-2016. The method used in this study was an observational descriptive retrospective approach based on medical records. The results of this study showed the incidence of prolonged mechanical ventilation incidence was 69.7%. This study showed that incidence of post-CABG prolonged mechanical ventilation based on age ≤65 years old were 68.1%, age >65 years old were 75.7%, men were 69.1%, women were 73.1%, LVEF ≤50% were 73.3%, LVEF >50% were 66.3%, CPB time <90 minutes were 47.5%, CPB time >90 minutes were 81.6%, postoperative hemoglobin level <10 g/dL were 75%, hemoglobin level ≥10 g/dL were 66.9%, patients with comorbidities were 69.7% and without comorbidities were 69.8%. In conclusion, there was higher incidence of prolonged mechanical ventilation in patients >65 years old, woman, with LVEF ≤50%, CPB time >90 minutes and postoperative hemoglobin level <10 g/dL.
Perbandingan antara Uji Mallampati Modifikasi dan Mallampati Ekstensi Sebagai Prediktor Kesulitan Intubasi Endotrakeal di Rumah Sakit Dr. Hasan Sadikin Bandung Girindro Andi Swasono; Suwarman Suwarman; Rudi Kurniadi Kadarsah
Jurnal Anestesi Perioperatif Vol 5, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (732.566 KB) | DOI: 10.15851/jap.v5n3.1168

Abstract

Evaluasi potensi intubasi sulit preoperatif sangat penting. Metode standar untuk menilai potensi intubasi sulit adalah metode Mallampati Modifikasi. Metode Mallampati Ekstensi merupakan metode Mallampati Modifikasi dengan ekstensi titik kranioservikal sehingga derajat bukaan mulut lebih lebar dan saluran napas terlihat lebih baik. Tujuan penelitian ini adalah mengetahui ketepatan penilaian Mallampati Ekstensi dibanding dengan Mallampati Modifikasi sebagai prediktor dalam menilai kesulitan intubasi endotrakeal menggunakan laringoskop Macintosh langsung berdasar atas uji Cormack Lehane. Desain penelitian ini adalah observasional analitik dengan metode potong lintang dan uji diagnostik chi square. Hasil penelitian terhadap 382 subjek pada bulan September 2016 hingga bulan Desember 2016 di Rumah Sakit Dr. Hasan Sadikin Bandung didapatkan jenis kelamin perempuan 69,9% dengan median usia 42 tahun. Frekuensi nilai uji Mallampati Ekstensi lebih banyak pada kelas yang lebih rendah dan berbeda secara signifikan dibanding dengan uji Mallampati Modifikasi. Kesesuaian penilaian kelas uji Mallampati Ekstensi dengan Cormack Lehane terdapat pada 318 subjek. Simpulan, uji Mallampati Ekstensi lebih baik daripada uji Mallampati Modifikasi sebagai prediktor menilai kesulitan intubasi endotrakeal menggunakan laringoskop langsung.Comparison between Modified Mallampati Test and Extended Mallampati Test as Predictor of Difficult Endotracheal Intubationat Dr. Hasan Sadikin Hospital BandungPreoperative evaluation of potentially difficult intubation is very important. The standard method for assessing potentially difficult intubation is the Modified Mallampati method. Extended Mallampati method is a Modified Mallampati method with cranioservical extension point that the degree of mouth opening is wider and airway becomes more visible. The purpose of this study was to determine the accuracy of the Extended Mallampati test compared to the Modified Mallampati test as predictors in assessing the difficulty of endotracheal intubation using direct Macintosh laryngoscope based on Cormack Lehane grading. This was a cross-sectional observational analytical study using chi square diagnostic test involving 382 subjects at Dr. Hasan Sadikin Bandung Hospital during the period of September 2016 to December 2016 with 69.9% women and  median age of 42 years. The frequency of the Mallampati Extension test scores was higher in the lower classes, which was significantly different from the results of the Modified Mallampati test. Better appropriateness of the Mallampati Extension test result with Cormack Lehane grading was found in 318 subjects. In conclusion, the Extended Mallampati test is better than Modified Mallampati test when it is used as a predictor in assessing difficult endotracheal intubation using direct laryngoscopy (Cormack Lehane test).  
GAMBARAN SKORING STS DAN EUROSCORE II SEBAGAI PREDIKTOR MORTALITAS PADA PASIEN BEDAH PINTAS ARTERI KORONER DI RSUP DR. HASAN SADIKIN BANDUNG PERIODE 2019–2020 Lusy Octavia Saputri; Rudi Kurniadi Kadarsah; Budiana Rismawan
Jurnal Anestesi Perioperatif Vol 10, No 3 (2022)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v10n3.2644

Abstract

Bedah pintas arteri koroner (BPAK) merupakan suatu prosedur pembedahan yang dilakukan pada pasien dengan penyakit arteri koroner. Skoring risiko seperti Society of Thoracic Surgeons (STS) dan European System for Cardiac Operative Risk Evaluation (EuroSCORE) banyak digunakan untuk memprediksi hasil luaran pascaoperasi jantung. Operasi jantung di RSUP Hasan Sadikin Bandung setiap tahun terus mengalami peningkatan dan masih terdapat mortalitas setiap tahun, sedangkan belum ada skoring resmi yang digunakan untuk memprediksi kejadian mortalitas maupun morbiditas pada pasien yang menjalani operasi bedah jantung di RSUP Hasan Sadikin Bandung saat ini. Penelitian ini merupakan penelitian deskriptif dengan pendekatan retrospektif menggunakan data dari rekam medis pasien yang menjalani BPAK di RSUP Dr. Hasan Sadikin Bandung dari periode januari 2019 sampai desember 2020, sebanyak 82 data rekam medis dilakukan perhitungan STS skor, EuroSCORE II, dan kejadian mortalitasnya. Pada penelitian ini didapatkan hasil STS Skor dan EuroSCORE risiko rendah sebanyak 69 pasien (84%), risiko sedang 11 pasien (14%), dan risiko tinggi 2 pasien (2%). Angka mortalitas BPAK sebanyak 9 orang (11%) dengan stratifikasi skor terhadap mortalitas pada kelompok risiko rendah sebesar 0%, risiko sedang sebesar 7 dari 11 orang dan risiko tinggi 2 dari 2 orang. Hasil yang didapatkan baik pada STS skor maupun EuroSCORE II menunjukkan tingkat kesamaan prediksi yang sama. Profile of STS and EuroSCORE II Scoring as Mortality Predictor in Coronary Artery Bypass Surgery Patients at Dr. Hasan Sadikin General Hospital Bandung, 2019–2020Coronary artery bypass graft surgery (CABG) is used to treat coronary artery disease patients. Risk scoring, such as the Society of Thoracic Surgeons (STS) and the European System for Cardiac Operative Risk Evaluation (EuroSCORE), have been commonly used to predict post-cardiac surgery outcomes. The number of cardiac surgeries at Dr. Hasan Sadikin General Hospital increases yearly, yet some mortalities persist. No official scoring system can be used to predict the mortality and morbidity incident in patients undergoing cardiac surgeries at Dr. Hasan Sadikin General Hospital. This study was a descriptive study with a retrospective approach using patients' medical record data who underwent Coronary artery bypass graft surgery at Dr. Hasan Sadikin Hospital from January 2019 to December 2020. The 82 medical record data were used to assess STS, EuroSCORE II, and mortality incidents. The result showed that STS score and EuroSCORE II with low risk were 69 patients (84%), moderate risk were 11 patients (14%), and high risk were two patients (2%). The number of CABG mortality was nine patients (11%), with a stratification score of mortality in the low-risk group was 0%, the moderate-risk group was seven people, and the high-risk group was 2 out of 2 patients. Both STS and EuroSCORE II showed similar results of prediction. 
Co-Authors Amrizal, Canang Irving Andy Pawana Destiara Ari Saptadi Ari Saptadi Budiana Rismawan Canang Irving Amrizal Dedi Fitri Yadi Dessy Sutoyo Destiara, Andy Pawana Doddy Tavianto Donny Prasetyo Priyatmoko Erwin Pradian Esther Dian Cahyaningtyas Hintono Girindro Andi Swasono Heni Herliani Listianto Indriasari Indriasari Iwan Fuadi Jansen Laory Listianto, Heni Herliani Lusy Octavia Saputri Maransdyka Purnamasidi Maransdyka Purnamasidi Mira Silviana Mira Silviana, Mira Reza Indra Putra Reza Indra Putra, Reza Indra Reza Widianto Sudjud Sutoyo, Dessy Suwarman Suwarman Suwarman Suwarman, Suwarman Swasono, Girindro Andi