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All Journal The Indonesian Biomedical Journal Majalah Anestesia dan Critical Care World Nutrition Journal Journal of Anaesthesia and Pain Bioscientia Medicina : Journal of Biomedicine and Translational Research Jurnal Neuroanestesi Indonesia Majalah Anestesia & Critical Care (MACC) Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education and Research Institute Jurnal Komplikasi Anestesi Frontiers on Healthcare Research

Rudyanto Sedono

Intensive Care Medicine, Department Of Anesthesiology And Intensive Care, Faculty Of Medicine Universitas Indonesia

Author-ID : 4419686

Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

Published : 12 Documents Claim Missing Document

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Perbandingan Kecepatan Penyuntikan Fentanil 5 Detik dan 20 Detik Terhadap Angka Kejadian Fentanyl-Induced Cough (FIC) Sedono, Rudyanto; Harijanto, Eddy; ., Safroni
Majalah Anestesia dan Critical Care Vol 34 No 1 (2016): Februari
Publisher : Perdatin Pusat

Show Abstract | Download Original | Original Source | Check in Google Scholar

Fentanil merupakan analgetik opioid yang hampir selalu digunakan sebagai ko-induksi di ruang operasi. Namunpenggunaan fentanil intravena bisa menimbulkan batuk yang dikenal juga sebagai fentanyl-induced cough (FIC).Batuk merupakan hal yang tidak diinginkan saat induksi karena bisa menyebabkan peningkatan tekanan intrakranial,tekanan intraokular dan tekanan intra-abdominal. Kejadian FIC salah satunya dihubungkan dengan kecepatanpenyuntikan fentanil. Penelitian ini bertujuan untuk membandingkan antara kecepatan penyuntikan fentanil 5 detikdan 20 detik terhadap angka kejadian dan derajat FIC pada pasien ras Melayu yang menjalani anestesia umum diRumah Sakit Cipto Mangunkusumo. Penelitian ini merupakan uji klinis acak tersamar ganda terhadap 124 pasienras Melayu yang menjalani operasi dengan anestesia umum di Rumah Sakit Cipto Mangunkusumo. Subjek dibagimenjadi 2 kelompok (kelompok kecepatan 5 detik dan kecepatan 20 detik). Pasien secara acak diberikan fentanil 2mcg/kgBB sebagai co-induksi dengan kecepatan penyuntikan 5 detik atau 20 detik. Insiden dan derajat FIC dicatatpada masing-masing kelompok. Derajat FIC dibagi berdasarkan jumlah batuk yang terjadi, yaitu ringan (1–2 kali),sedang (3–5 kali) dan berat ( >5 kali). Analisis data dilakukan dengan uji Chi-square dan uji Kolmogorov-Smirnovsebagai uji alternatif. Insiden FIC pada kelompok 20 detik lebih rendah secara bermakna dibandingkan kelompok5 detik, 8,07% vs 29,03% (p<0,05). Derajat FIC antara kedua kelompok secara statistik tidak berbeda bermakna(p>0,05). Insiden dan derajat FIC lebih rendah pada kelompok 20 detik dibanding dengan kelompok 5 detik padapenggunaan fentanil 2 mcg/kgBB sebagai co-induksi. Kata kunci: Fentanil, fentanyl-induced cough (FIC), kecepatan penyuntikan Fentanyl, an analgesic opioid, is commonly used by anaesthesiologists in the operating room as co-induction.However, co-induction of intravenous fentanyl bolus is associated with coughing, known as fentanyl-inducedcough (FIC). Coughing during anesthesia induction is undesirable as it is associated with increased intracranial,intraocular, and intraabdominal pressures. Incidence of FIC is associated with injection rate of fentanyl. Thisstudy compared the incidence and severity of FIC between 5 seconds and 20 seconds fentanyl injection rate inMelayan race patients in Cipto Mangunkusumo hospital. This was a double blind randomized study in Melayanrace patients that underwent operations with general anesthesia at Cipto Mangunkusumo hospital. 124 subjectswere included in the study and divided into 2 groups (5 seconds and 20 seconds group). Subjects were randomizedto receive co-induction fentanyl 2 mcg/kgBW with either 5 second or 20 seconds injection rate. The incidenceand severity of FIC were recorded in each group. Based on the number of coughs observed, cough severity wasgraded as mild (1–2), moderate (3–5), or severe (>5). Data was analyzed by Chi-square and Kolmogorov-Smirnovtest. The incidence of FIC was significantly lower in the 20 seconds group than in the 5 seconds group, 8,07%vs 29,03% (p<0,05). The severity of FIC wast statistically not significant in both groups (p>0,05). Incidence andseverity of FIC was lower in the 20 seconds group compared with the 5 seconds group in co-induction usingfentanyl injection 2 mcg/kgBW. Key words: Fentanyl, fentanyl-induced cough (FIC), rate of injection Reference Lin CS, Sun WZ, Chan WH, Lin CJ, Yeh HM, Mok MS. Intravenous lidocaine and ephedrine, but not propofol, suppress fentanyl induced cough. Can J Anesth 2004; 5: 654–9. Horng HC, Wong CS, Hsiao KN, Huh BK, Kuo CP, Cherng CH, et al . Pre-medication with intravenous clonidine suppresses fentanyl induced cough.Acta Anaesthesiol Scand 2007; 51: 862–5. Yu J, Lu Y, Dong C, Zhu H, Xu R : Premedication with intravenous dexmedetomidine–midazolam suppresses fentanyl-induced cough. Ir J Med Sci. 2012; 181:517–20. Fauzi R. Keefektifan Dilusi Fentanil 10 mcg/ml Terhadap Efek Batuk yang Ditimbulkannya. Tesis Fakultas Kedokteran Universitas Indonesia Program Studi Anestesiologi dan Terapi Intensif, Jakarta Juni 2008. Hlm. 18–23. Lin JA, Yeh CC, Lee MS, Wu CT, Lin SL, Wong CS. Prolonged injection time and light smoking decreases the incidence of fentanylinduced cough. Anesth Analg. 2005;101: 670–4. Stellato C, Cirillo R, Paulis A, Casolaro V, Patella V, Mastronardi P, et al. Human basophil/ mast cell releasability. IX. Heterogeneity of the effect of opioids on mediator release. Anesthesiology 1992;77:932–40. Agarwal A, Azim A, Ambesh S, Bose N, Dhiraj S, Sahu D. Salbutamol, beclomethasone, or Sodium  \ chromoglycate suppress coughing induced by i.v. fentanyl. Can J Anaesth. 2003;50:297–300. Phua WT, Teh BT, Jong W: Tussive effect of a fentanyl bolus. Can J Anaesth. 1991;38: 330–4. Bailey P: Possible Mechanism (s) of Opioid-induced Coughing. Anesthesiology. 1999;90:335. Ai Q, Hu Y, Wang YJ, Wu S, Qin Z, Wang J, et al . Pentazocine pretreatment suppreses fentanyl-induced cough. Pharmacol Rep 2010; 62: 747–50. Yu H, Yang XY, Zhang X, Li Q, Zhu T, Wang Y, et al . The effect of dilution and prolonged injection time on fentanyl-induced coughing. Anesthesia. 2007;62:919–22. Hung KC, Chen CW, Lin CH, Weng HC, Hsieh: The effect of pre-emptive use of minimal dose fentanyl on fentanyl-induced coughing. Anaesthesia 2010; 65: 4–7. Kim JE, Min SK, Chae YJ, Lee YJ, Moon BK, Kim JY. Pharmacological and nonpharmacological prevention of fentanylinduced cough: a meta-analysis. J Anesth. 2014;28:257–66. Schaperrneier D, Hopf HB. Fentanyl-induced

Nitrogen Balance and Its relation with Energy and Protein Intake in Criticaly Ill Elderly Patients Niken Churrniadita; Luciana Budiati Sutanto; Rudyanto Sedono
World Nutrition Journal Vol. 1 No. 1 (2017)
Publisher : Indonesian Nutrition Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25220/WNJ.V01i1.0002

Gene Families of AmpC-producing Enterobacteriaceae Present in the Intensive Care Unit of Cipto Mangunkusumo Hospital Jakarta Lucky Hartati Moehario; Thomas Robertus; Anis Karuniawati; Rudyanto Sedono; Delly Chipta Lestari; Andi Yasmon
The Indonesian Biomedical Journal Vol 11, No 1 (2019)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v11i1.552

BACKGROUND: Antibiotic resistance has become a worldwide problem. Among Asia countries, Indonesia has high prevalence of multi-drug resistant organisms mainly due to Gram-negative bacilli Enterobacteriaceae. This study aimed to find out whether gene family of AmpC and AmpC/ESBL-producing Enterobacteriaceae were present in the Intensive Care Unit (ICU) of Cipto Mangunkusumo Hospital, Jakarta, Indonesia.METHODS: Specimens were obtained from several body sites of adult patients with infection hospitalised in ICU of Cipto Mangunkusumo Hospital. VITEK®2 was used to identify the microorganisms. Antibiotic susceptibility tests were conducted using VITEK®2 and disc diffusion technique according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Double disc synergy (DDS) test method was employed to detect AmpC activity. Gene families of ampC were identified using multiplex polymerase chain reaction (PCR).RESULTS: Forty five isolates were identified as putative AmpC, extended-Spectrum β-lactamases (ESBL) and AmpC/ESBL-producing Enterobacteriaceae. Klebsiella pneumoniae (n=32) were predominant, followed by Escherichia coli (n=6), Enterobacter cloacae (n=5) and Enterobacter aerogenes (n=2). AmpC activity was detected in 9 isolates, in which 4 isolates were AmpC producing and 5 isolates were AmpC/ESBL. In vitro, AmpC-producing Enterobacteriaceae showed good susceptibility to many antibiotic tested, while those of AmpC/ESBL-producing only to Amikacin. The gene families of ampC were DHA, EBC and CIT identified from 6 isolates.CONCLUSION: DHA, EBC and CIT gene families were identified from AmpC and AmpC/ESBL-producing Enterobacteriaceae in the ICU of Cipto Mangunkusumo Hospital. While the AmpC-producing was still susceptible to almost all antibiotics tested, the AmpC/ESBL-producing showed resistant except for Amikacin.KEYWORDS: Enterobacteriaceae, β-lactamases, AmpC, ESBL

Relationship between Neutrophil to Lymphocyte Ratio with Diaphragm Thickness in Critical Patients Agustina Haloho; Rudyanto Sedono; Adhrie Sugiarto; Zulkifli Zulkifli
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 4 No. 2 (2020): Bioscientia Medicina: Journal of Biomedicine and Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v4i2.121

Abstract Background: The cause of weaning failure is multifactorial. One of the causes was Ventilator Induced Diaphragm Dysfunction (VIDD) due to thinning process of the diaphragm thickness. Decreased diaphragm muscle mass might occur due to inflammatory process. Methods: The study was an observational analytic study from September 2018 to January 2019 in Mohammad Hoesin Hospital, Palembang â€“ Indonesia. Ethical appoval for the study was obtained from Ethics Committee and subjects were recruited after signing the informed consents. Only 30 subjects were involved in the end of the study. About 6 mL of blood sample from cubital vein was withdrawn from each subject to measure neutrophils and lymphocytes. Patientsâ€™ diaphragm thickness was measured by using ultrasonography on 0th, 3rd, 5th day. Collected data were then analyzed with STATA 15. Results: The chi-square test showed that the relationship of NLR (neutophil to lymphocyte ratio) of the 0th day to the decrease in diaphragm thickness on the 3rd day was not significant (p = 0.254), while the decrease in diaphragm thickness on the 5th day was significant (p = 0.015). Subjects with initial NLR values >7 had a significant higher risk of having decreased diaphragm thickness compared to subjects with initial NLR values â€‹â€‹â‰¤7 (RR = 1.62 (0.99-2.64); p-value = 0.003). Conclusion: Neutrophil to lymphocyte ratio affected the decrease of diaphragm thickness in patients using mechanical ventilation.

Perbandingan Pengajaran Menggunakan Laringoskop Video dengan Laringoskop Konvensional Terhadap Keterampilan Mahasiswa Kedokteran dalam Melakukan Intubasi pada Manikin Rudyanto Sedono; Raden Besthadi Sukmono; Nurul Huda El Muhammady
Majalah Anestesia & Critical Care Vol 38 No 3 (2020): Oktober
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif (PERDATIN) / The Indonesian Society of Anesthesiology and Intensive Care (INSAIC)

Latar Belakang. Intubasi endotrakea merupakan keterampilan penting yang perlu dikuasai oleh seorang dokter. Saat ini pengajaran intubasi pada mahasiswa kedokteran di Indonesia menggunakan laringoskop konvensional. Dalam beberapa tahun terakhir, laringoskop video mulai digunakan dalam pelayanan dan pendidikan kedokteran di dunia. Penelitian ini bertujuan untuk mengetahui sarana pengajaran yang lebih baik dalam proses pelatihan keterampilan intubasi mahasiswa kedokteran di Indonesia. Metode. Penelitian ini bersifat eksperimental, acak, tidak tersamar, tidak berpasangan. Penelitian dimulai setelah mendapat persetujuan dari Manajer Pendidikan dan Komite Etik Penelitian Kesehatan FKUI-RSCM. Subjek pada penelitian ini melibatkan 40 mahasiswa kedokteran preklinik FKUI semester 2 yang tidak pernah mendapat kuliah atau pelatihan intubasi sebelumnya. Subjek dibagi menjadi empat kelompok pelatihan, yaitu dua kelompok laringoskop video dan dua kelompok laringoskop konvensional. Setelah dilatih selama 120 menit melakukan intubasi pada maneken, subjek diuji melakukan intubasi menggunakan laringoskop konvensional untuk mendapatkan data waktu intubasi dan jumlah upaya intubasi. Hasil penelitian. Nilai median waktu intubasi kelompok laringoskop video 151,5 (55-383) detik dan kelompok laringoskop konvensional 56,5 (23-251) detik, dengan nilai p<0,001. Jumlah upaya intubasi kelompok laringoskop video 1 (1-3) kali dan kelompok laringoskop konvensional 1 (1-4) kali, dengan nilai p=0,114. Kesimpulan. Pengajaran dengan laringoskop video tidak terbukti lebih baik dibandingkan dengan laringoskop konvensional terhadap keterampilan mahasiswa kedokteran FKUI dalam melakukan intubasi.

Uji Kesesuaian Hasil Penilaian Status Volume Intravaskular Antara Diameter Vena Cava Inferior (IVC) dengan Vascular Pedicle Width (VPW) Rudyanto Sedono; Amir S. Majdid; Farahniar Hamidiana
Majalah Anestesia & Critical Care Vol 38 No 2 (2020): Juni
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif (PERDATIN) / The Indonesian Society of Anesthesiology and Intensive Care (INSAIC)

Latar Belakang: Kondisi hipovolemia atau hipervolemia dapat meningkatkan angka morbiditas dan mortalitas. Baku emas penilaian status volume intravaskular adalah pemeriksaan immunoassay yang bersifat invasif, sulit, dan lama sehingga klinisi mencari teknik yang tidak invasif, mudah, dan singkat. Pemeriksaan diameter inferior vena cava (IVC) dengan ultrasonografi (USG) dan vascular pedicle width (VPW) dengan radiografi dada merupakan teknik noninvasif yang mulai digunakan untuk menilai status volume intravaskular. Pemeriksaan VPW dapat dilakukan di instansi yang tidak memiliki ultrasonografi (USG). Uji kesesuaian IVC dan VPW dalam menilai status volume intravaskular hanya pernah dilakukan pada pasien dengan ventilasi mekanik. Penelitian ini bertujuan untuk mengetahui kesesuaian hasil penilaian status volume intravaskular antara teknik USG diameter IVC dengan teknik radiografi dada VPW pada pasien bernapas spontan. Metode: Penelitian ini merupakan uji klinis observasional analitik potong lintang untuk mengetahui kesesuaian hasil penilaian status volume intravaskular dengan metode IVC dan VPW pada pasien di Instalasi Gawat Darurat (IGD). Penelitian dilakukan setelah mendapatkan persetujuan etik dan tanda tangan subjek pada lembar informed consent. Sebanyak 39 subjek dilibatkan dalam penelitian ini. Pengukuran VPW dari hasil radiografi dada di IGD dilanjutkan dengan pengukuran diameter serta collapsibility index IVC dengan USG. Data yang terkumpul dianalisis lebih lanjut dengan secara statistik dengan menghitung Koefisien Kappa. Hasil: Nilai median diameter IVC 1,1 cm (0,46–3 cm). Nilai median collapsibility index IVC 33% (10,2–100%). Nilai median VPW 5,7 cm (3,5–10,8 cm). Tidak ada kesesuaian antara diameter rerata IVC dengan VPW (koefisien Kappa -0,085). Tidak ada kesesuaian antara diameter maksimal IVC dengan VPW (koefisien Kappa -0,123). Kesesuaian juga tidak didapatkan dari collapsibility index dengan VPW (koefisien Kappa 0,069). Simpulan: Tidak didapatkan kesesuaian antara penilaian status volume intravaskular dengan metode pengukuran diameter IVC dan metode pengukuran VPW. Kata Kunci: Status volume intravaskular; inferior vena cava; vascular pedicle width

Pengaruh Kapasitas Vital Paksa, Hipertensi Pulmonal, Jumlah Perdarahan, Jumlah Cairan Intraoperasi, Transfusi Darah dan Lokasi Segmen Vertebra yang Terlibat Terhadap Lama Ventilasi Mekanik Pascaoperasi Koreksi Skoliosis Pendekatan Posterior Sedono, Rudyanto; Nugroho, Alfan Mahdi; Putranto, Qudsiddik Unggul
Majalah Anestesia & Critical Care Vol 40 No 1 (2022): Februari
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif (PERDATIN) / The Indonesian Society of Anesthesiology and Intensive Care (INSAIC)

Latar Belakang : Pasien yang menjalani operasi koreksi skoliosis pascaoperasi di RSCM mendapatkan lama ventilasi mekanik pascaoperasi yang beragam. Pemakaian ventilasi mekanik pascaoperasi koreksi skoliosis memengaruhi biaya perawatan dan waktu kontak pasien dengan keluarga. Identifikasi faktor-faktor yang dapat memengaruhi lama ventilasi mekanik diharapkan dapat memprediksi lama ventilasi mekanik pascaoperasi sehingga lebih efektif dalam penggunaan ventilasi mekanik. Penelitian ini dilakukan dengan harapan mengetahui faktor risiko lama ventilasi mekanik pascaoperasi koreksi skoliosis pendekatan posterior di RSCM. Tujuan : Mengetahui faktor-faktor risiko yang dapat memengaruhi lama penggunaan ventilasi mekanik pascaoperasi koreksi skoliosis pendekatan posterior. Metode : Penelitian ini adalah penelitian kohort retrospektif menggunakan data dari rekam medis. Lima puluh dua pasien yang menjalani operasi koreksi skoliosis pendekatan posterior antara januari 2011 hingga Juni 2016 dianalisis secara retrospektif. Dicatat lama pemakaian ventilasi mekanik pascaoperasi koreksi skoliosis pendekatan posterior. Faktor preoperasi dan intraoperasi yang dianalisis merupakan data yang biasa dicatat dalam rekam medis antara lain nilai kapasitas vital paksa preoperasi, hipertensi pulmonal, jumlah perdarahan, jumlah cairan intraoperasi, transfusi darah dan lokasi segmen vertebra. Data akan diolah menggunakan perangkat lunak SPSS dengan uji korelasi dan analisis multivariat regresi linier. Hasil : Mayoritas sampel adalah wanita (86,5%). Analisis korelasi didapatkan jumlah perdarahan (r=0,431; p<0,05) memiliki hubungan sedang dengan lama ventilasi mekanik, jumlah cairan intraoperasi (r=0,347; p<0,05) memiliki hubungan lemah dengan lama ventilasi mekanik. Dari analisis multivariat regresi linier didapatkan tidak ada variabel yang menjadi faktor risiko (p>0,05; R square=0,073). Kesimpulan : Dari variabel yang diteliti tidak ada yang merupakan faktor risiko lama ventilasi mekanik pascaoperasi koreksi skoliosis pendekatan posterior di RSCM.

Hubungan Rasio Netrofil Limfosit dengan Ketebalan Dinding Diafragma pada Pasien Kritis Haloho, Agustina Br; Sedono, Rudyanto; Sugiarto, Adhrie; Zulkifli
Jurnal Komplikasi Anestesi Vol 7 No 2 (2020): Volume 7 Number 2 (2020)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v7i2.7449

Background: The cause of weaning failure is multifactorial. One of the causes was Ventilator Induced Diaphragm Dysfunction (VIDD) due to thinning process of the diaphragm thickness. Decreased diaphragm muscle mass might occur due to inflammatory process. This study was aimed to find the relationship between neutrophil to lymphocyte ratio (NLR) with diaphragm thickness of critical patients in ICU. Methods: This was an observational analytic study from September 2018 to January 2019 in Mohammad Hoesin Hospital, Palembang – Indonesia. Ethical appoval for the study was obtained from Ethics Committee and subjects were recruited after signing the informed consents. Only 30 subjects were involved in the end of the study. About 6 mL of blood sample from cubital vein was withdrawn from each subject to measure neutrophils and lymphocytes. Patients’ diaphragm thickness was measured by using ultrasonography on 0th, 3rd, 5th day. Collected data were then analyzed with Stata 15. Results: The chi-square test showed that the relationship of NLR (neutophil to lymphocyte ratio) of the 0th day to the decrease in diaphragm thickness on the 3rd day was not significant (p = 0.254), while the decrease in diaphragm thickness on the 5th day was significant (p = 0.015). Subjects with initial NLR values >7 had a significant higher risk of having decreased diaphragm thickness compared to subjects with initial NLR values ≤7 (RR = 1.62 (0.99-2.64); p-value = 0.003). Conclusion: Neutrophil to lymphocyte ratio affected the decrease of diaphragm thickness in patients using mechanical ventilation.

Developing “do it yourself” Phantom for Teaching Seldinger Technique in Vascular Access Placement to General Practitioners Hafidz, Noor; Sedono, Rudyanto; Aditianingsih, Dita; Sugiarto, Adhrie; Manggala, Sidharta Kusuma
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 7 No. - (2023): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v7i-.201

Establishing a vascular access is a crucial aspect in managing critically ill patients in the Intensive Care Unit (ICU). The skill in placing vascular access varies among healthcare professionals. Clinical experience and level of training among nurses, general practitioners, and intensivists are the determinants of skill in placing vascular access. Training to establish vascular access using the Seldinger technique needs practice using a vascular phantom or a cadaver. Commercially sold phantoms are difficult to get, and an alternative training phantom is needed. We built a simple “do-it-yourself” model of a vascular phantom using “easy-to-find” material that can be used to practice the Seldinger technique. We used a synthetic polyurethane sponge 16x16 cm in size as a base and a polyvinyl alcohol sheet of the same size. We used 22 F urinary catheters trimmed to 12 to represent blood vessels. The final product is a piece of the urinary catheter embedded in the sponge and then covered by polyvinyl alcohol to simulate the epidermis. The phantom can be used in training programs to improve the skill of general practitioners in placing advanced vascular access. 13 general practitioners were involved in this training, and 100% said that this phantom could simulate the experience. “Do-it-yourself” phantom for vascular access training can be used ro practice the Seldinger technique and can simulate the real experience.

Efek perbedaan Volume Tidal Ventilasi Mekanik Selama Operasi terhadap Rasio PaO2/FiO2 Pascakraniotomi Elektif Aditianingsih, Dita; Sedono, Rudyanto; Baktiar, Yoshua
Jurnal Neuroanestesi Indonesia Vol 5, No 3 (2016)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Latar Belakang: Kraniotomi elektif memiliki insidens komplikasi paru pascaoperasi (25%) dan mortalitas (10%) yang tinggi; insiden ini lebih rendah pada pemakaian volume tidal rendah sebagai teknik proteksi paru. Penelitian ini meneliti efek volume tidal 6 mL/kg dan 10 mL/kg terhadap rasio PaO2/FiO2(sebagai parameter keparahan cedera paru) pascaoperasi pada kraniotomi elektif.Subjek dan Metode: Setelah mendapat izin Komite Etik FKUI/Rumah Sakit Cipto Mangukusumo dan konsen pasien, dilakukan uji klinis acak pada 52 pasien kraniotomi elektif yang dirandomisasi ke dalam 2 kelompok: ventilasi mekanik selama operasi dengan volume tidal 6 mL/kg (VT6) atau 10 mL/kg (VT10), lalu dilakukan analisis gas darah.Hasil: Rasio PaO2/FiO2 kelompok VT-6 dan VT10 secara berurutan: pada 1 jam pascainduksi 413,7 113,4 mmHg dan 401,5 106,3 mmHg (p0.05); pada akhir operasi, 466,6 94,6 mmHg dan 471,1 89,0 mmHg (p0.05), pada 24 jam pascainduksi, 418,8 108,8 mmHg dan 448,5 119,6 mmHg (p0.05); pada 48 jam pascainduksi, 414,9 88,1 mmHg dan 402,5 100,7 mmHg (p0.05 ). Tidak ada perbedaan signifikan insiden mortalitas dan komplikasi paru dan ekstraparu diantara dua kelompok.Simpulan: Tidak ada perbedaan signifikan antara volume tidal 6 ml/kg dan 10 ml/kg terhadap ratio PaO2/FiO2 pada pasien kraniotomi elektif.The Effect of Different Tidal Volume against Postoperative PaO2/FiO2 Ratio in Elective Craniotomy PatientsBackground: Elective craniotomy is associated with a high incidence of postoperative pulmonary complications/PPC (25%) and mortality (10%); in which these incidence went down with the administration of low tidal volume. This study investigated the effect of low tidal volume in intraoperative PaO2/FiO2 ratio in elective craniotomy patients.Subject and Methods: After approval from Ethics Committee Faculty of Medicine Universitas Indonesia, Ciptomangunkusumo Hospital and consent from patients,a randomized controlled trialwas done to 52 elective craniotomy patients. Subjects were ventilated with tidal volume 6 mL/kg (VT6) or 10 mL/kg (VT10) intraoperatively, then blood gas analyses wereperformed.Results: PaO2/FiO2 ratio of VT6 and VT10 respectively: at 1 hour postinduction, 413.7 113.4 mmHg and 401.5 106.3 mmHg (p0.05); at end of surgery, 466.6 94.6 mmHg and 471.1 89.0 mmHg (p0.05); at 24 hours postinduction, 418.8 108.8 and 448.5 119.6 mmHg (p0.05); at 48 hours postinduction, 414.9 88.1 mmHg and 402.5 100.7 mmHg (p0.05). There were no significant differences on mortality, lung and extralung complications observed between both groupsConclusions: There were no significant difference between tidal volume 6 ml/kg and 10 ml/kg against intraoperative PaO2/FiO2 ratio in elective craniotomy patients.

Co-Authors ., Safroni Agustina Haloho Alfan Mahdi Nugroho Amir S. Majdid Andi Yasmon Anis Karuniawati Baktiar, Yoshua Baktiar, Yoshua Ceva W. Pitoyo Christophorus Simadibrata Cleopas M. Rumende Delly Chipta Lestari Dita Aditianingsih Farahniar Hamidiana Gestina Aliska Hafidz, Noor Haloho, Agustina Br Harijanto, Eddy Heni Pujiastuti Jeo, Wifanto Saditya Khadafi Indrawan Luciana Budiati Sutanto Lucky Hartati Moehario Manggala, Sidharta Kusuma Muhammad K Azwar, Muhammad K Niken Churrniadita Nurul Huda El Muhammady Purwantyastuti Purwantyastuti Putranto, Qudsiddik Unggul Raden Besthadi Sukmono Riahdo J. Saragih Rianto Setiabudi, Rianto Solly Aryza Sugiarto, Adhrie Thomas Robertus Trisni U Dewi, Trisni U Wulung, Navy Gerard H. M. Lolong Yulia Rosa Saharman Zulkifli Zulkifli Amin

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