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All Journal Jurnal Ilmu keperawatan Mutiara Medika: Jurnal Kedokteran dan Kesehatan Jurnal Ilmu dan Riset Akuntansi Jurnal Analisa Akuntansi dan Perpajakan Budapest International Research and Critics Institute-Journal (BIRCI-Journal): Humanities and Social Sciences Jurnal Anestesi Obstetri Indonesia Jurnal Neuroanestesi Indonesia Jurnal Riset Perbankan, Manajemen dan Akuntansi Best Journal of Administration and Management Jurnal Komplikasi Anestesi

Bambang Suryono, Bambang

Rumah Sakit Umum Pusat Dr.Sardjito, Yogyakarta

Author-ID : 551672

Religion Arts Humanities Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Other

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Prediktor Outcome pada Cedera Kepala Traumatik (Glukosa, Laktat, SID, MDA, Cerebral Extraction Ratio for Oxygen/CERO2 ) Suyasa, Agus Baratha; Sudadi, Sudadi; Rahardjo, Sri; Suryono, Bambang
Jurnal Neuroanestesi Indonesia Vol 1, No 4 (2012)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Latar Belakang: Jaringan tubuh memiliki kebutuhan yang berbeda terhadap glukosa. Otak memiliki kebutuhan yang paling besar terhadap glukosa. Otak sangat rentan terhadap iskemia yang menunjukkan bahwa otak memiliki laju metabolik yang tinggi. Mekanisme injury iskemia adalah perubahan biokimia dan perubahan fisiologis yang terjadi karena ganguan sirkulasi. Perubahan-perubahan tersebut seperti: (1) Hilangnya phospat energi tinggi, (2) Asidosis karena proses anaerob yang menghasilkan laktat dan (3) No Reflow karena oedem otak. Penggunaan kadar laktat sebagai indikator iskemia jaringan, telah banyak dilakukan dalam berbagai penelitian. Hasil-hasil penelitian tersebut menunjukkan bahwa kadar laktat dapat digunakan sebagai penanda awal untuk memprediksi resiko komplikasi, mortalitas post operatif dan kejadian MOF (Multiple Organ Failure). Belakangan banyak dibicarakan mengenai hubungan perubahan SID dengan outcome klinis yang buruk. Mereka menemukan bahwa SID/SIG merupakan prediktor kuat terhadap outcome pasien. Stres oksidatif merupakan salah satu mekanisme yang terlibat dalam kerusakan saraf akibat iskemia dan reperfusi, diperkirakan karena terbentuknya lipid peroksidase. MDA digunakan sebagai penanda dari peroksidasi lipid, terutama untuk proses-proses yang berhubungan dengan stress oksidatif. Rasio ekstraksi oksigen serebral (CERO2) dapat dipergunakan sebagai indikator adanya iskemia otak. Subyek dan Metode: Sebelas pasien cedera kepala traumatik dengan GCS awal 5-12 yang menjalani operasi kraniotomi evakuasi, dilakukan pengamatan terhadap kadar glukosa, laktat, SID, MDA, nilai CERO2 serta outcome (nilai APS Score) dari pre operasi sampai 3 hari pasca operasi di ICU. Sample darah diambil dari vena jugularis interna dan arteri radialis. Hasil pengamatan dianalisa untuk melihat hubungan antara variabel pengamatan dengan outcome. Hasil: Ditemukan hubungan yang kuat antara variable kadar laktat, MDA, CERO2 terhadap outcome pasien secara umum. Namun terdapat variasi jika analisa dilakukan menurut kondisi waktu pengamatan. Hari ke-2 adalah waktu yang paling ideal untuk melihat pengaruh kadar laktat terhadap outcome sedangkan untuk melihat hubungan MDA dan CERO2 terhadap outcome, waktu pengamatan paling ideal hari ke-3. Simpulan: Variabel kadar laktat, MDA dan OER menunjukkan hasil yang menjanjikan sebagai prediktor outcome pada pasien dengan cedera kepala traumatik pasca kraniotomi walaupun belum dapat di simpulkan dan dijadikan acuan secara luas. Perlu suatu penelitian multicentre dengan jumlah sample yang lebih banyak serta desain penelitian yang baik untuk mendapatkan hasil yang benar-benar dapat di jadikan acuan secara luas mengenai variabel prediktor serta waktu pengamatan sehingga dapat memberikan informasi yang baik tentang prognosis outcome pasien cedera kepala traumatik, yang tetap berdasar pada patofisiologi cedera kepala serta kaskade kematian sel karena cedera otak sekunder.Predictor of Outcome in Traumatic Brain Injury (Glucosa, Lactate, SID, MDA, Cerebral Extraction Ratio for Oxygen/CERO2) Background: The tissue has a different requirement for glucose. The brain has the greatest need for glucose. The brain is very susceptible to ischemia suggests that the brain has a high metabolic rate. Mechanism of ischemic injury is the biochemical changes and physiological changes that occur due to circulatory disturbances. Such changes as: (1) The loss of high energy phosphate, (2) acidosis due to anaerobic process that produces lactic and (3) No Reflow because of brain edema. The use of lactate levels as an indicator of tissue ischemia, has been widely applied in various studies. The results of these studies indicate that the levels of lactate can be used as an early marker for predicting the risk of complications, postoperative mortality and the incidence of MOF (Multiple Organ Failure). Lately a lot of talk about the relationship SID changes with poor clinical outcome. They found that the SID / SIG is a strong predictor of patient outcome. Oxidative stress is one of the mechanisms involved in neuronal damage due to ischemia and reperfusion, presumably due to the formation of lipid peroxidation. MDA is used as a marker of lipid peroxidation, especially for processes associated with oxidative stress. CERO2 can be used as an indicator of cerebral ischemia.Subjects and Method: Eleven patients with a traumatic head injury initial GCS 5-12 who underwent craniotomy with evacuation operations, was observed on levels of glucose, lactate, SID, MDA, the CERO2 and the outcome (the APS Score) from pre surgery to 3 days after surgery in the ICU. Blood samples taken from the jugular internal vein and radial artery. Observations were analyzed to see the relationship between the variables with the outcome observations.Results: Found a strong relationship between the variable: levels of lactate, MDA and CERO2 on patient outcomes in general. But there are variations between them according to the conditions when the analysis carried out observations. Day 2 is the most ideal time to see the effect on outcome of lactate levels whereas to see the relationship between the MDA and CERO2 to outcome, the observation idealy taken on day 3.Conclusion: The variables, levels of lactate, MDA and CERO2 showed promising results as a predictor of outcome in patients with traumatic brain injury after craniotomy, although not yet to be concluded and is widely used as a reference. Need a multicentre study with more number of samples and good research design to get the results that can really make a reference in a broad range of predictor variables and the observations so as to provide good information about the prognosis of outcome of patients with traumatic brain injury, who remain based on the pathophysiology of brain injury and cell death cascade of secondary brain injury.

Effect of Financial Performance on Company Value With Corporate Social Responsibility as Moderating Variable Nuuril Imaama, Rahmatika; Fadjrih Asyik, Nur; Suryono, Bambang
Best Journal of Administration and Management Vol 1 No 1 (2022): Best Journal of Administration and Management
Publisher : International Publisher

This study aims to examine the effect of financial performance as measured by the Current Ratio (CR), Quick Ratio (QR), and Return On Investment (ROI), on firm value (PBV) with Corporate Social Responsibility (CSR) as moderating. This type of research is quantitative research. The sample in this study was obtained using a purposive sampling method, namely the selection of a sampling with certain criteria. Based on the purposive sampling method, 261 samples were obtained from 87 manufacturing companies listed on the Indonesia Stock Exchange (IDX) for the 2018-2020 period. The analytical method used is multiple linear regression analysis and Moderated Regression Analysis (MRA) Interaction Test with SPSS 25 tool. The results show that: 1) Current Ratio (CR) has a negative effect on firm value, 2) Quick Ratio (QR) has an effect on positive effect on firm value, 3) Return On Investment (ROI) has a positive effect on firm value, 4) Corporate Social Responsibility (CSR) is able to moderate the effect of Current Ratio (CR) on firm value, 5) Corporate Social Responsibility (CSR) is not able to moderate the effect of Quick Ratio (QR) on firm value, 6) Corporate Social Responsibility (CSR) is able to moderate the effect of Return On Investment (ROI) on firm value.

Penatalaksanaan Perioperatif Cedera Kepala Traumatik Berat dengan Tanda Cushing Basuki, Wahyu Sunaryo; Suryono, Bambang; Saleh, Siti Chasnak
Jurnal Neuroanestesi Indonesia Vol 4, No 1 (2015)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Cedera kepala traumatik merupakan masalah utama kesehatan dan sosial ekonomi, penyebab kematian dan kecacatan di seluruh dunia. Meskipun ada cara diagnosis yang canggih dan penatalaksanaan yang mutakhir, prognosis pasien cedera kepala traumatik masih tetap jelek. Derajat keparahan cedera primer merupakan faktor utama yang menentukan luaran; sedangkan cedera sekunder karena hipotensi, hipoksemia, hiperkarbia, hiperglikemia, dan hipoglikemia setelah cedera awal menyebabkan kerusakan lebih lanjut dari jaringan otak dan memperjelek luarannya. Cedera kepala traumatik berat adalah cedera kepala dengan glasgow coma scale score antara 3 sampai 8. Tanda Cushing adalah tanda kenaikan tekanan intrakranial yang tinggi dan tanda herniasi. Penatalaksanaan cedera kepala difokuskan pada pengelolaan dan pencegahan cedera sekunder. Seorang wanita 54 tahun, berat badan 50 kg, tinggi badan 155 cm dibawa ke unit gawat darurat rujukan dari rumah sakit lain karena kecelakaan lalu lintas, jatuh dari sepeda motor. Dilakukan resusitasi dan stabilisasi; jalan nafas bebas; laju nafas 1016x/menit; tekanan darah 180/100 mmHg; laju nadi 5055x/menit; skor GCS E2M2V1; pupil kiri dan kanan isokor 3 mm, reaksi cahaya lambat. Pemeriksaan CT-Scan menunjukkan perdarahan intraserebral frontal basal kanan, ukuran 7,5 x 4,4 x 2,2 cm, perkiraan volume 40 cc, dan perdarahan kiri kecil; perdarahan subarahnoid mengisi sulkus temporal kanan; midline shift ke kiri 2,6 mm; dan edema serebri luas. Segera dilakukan kraniotomi evakuasi perdarahan untuk menyelamatkan pasien. Penatalaksanaan cedera kepala perioperatif meliputi evaluasi yang cepat, resusitasi pembedahan dini, dan tatalaksana terapi intensif dapat memperbaiki luaran penderita cedera kepalaPerioperative Management of Severe Brain Injury with Cushings SignTraumatic brain injury (TBI) is a major health and socioeconomic problem, as well as a common cause of death and disabilty worldwide. Despite modern diagnostic tools and advancement in the treatment, prognosis of TBI patients remains poor. Severity of primary injury is the determining factor of outcome in TBI. Secondary injury, caused by hypotension, hypoxemia, hypercarbia, hyperglycemia, and hypoglycemia, following primary injury can cause further brain damage and worsen patients outcome. Severe TBI is brain injury with Glasgow Coma Scale score (GCS) of 3 to 8. Cushings sign is a sign of high intracranial pressure and herniation. Management of TBI is focused on managing and preventing secondary injury. A 54 years-old female patient (50 kg, 155 cm) was admitted ro the emergency unit due to motorcycle accident. Upon resuscitation and stabilization, the airway was secured, respiratory rate 10-16 times/minute, blood pressure 180/100 mmHg, pulse 50-55 beats/minute, and GCS E2M2V1. Pupils were isochoric, with 3 mm diameter. Direct light reflex was slow. CT-scan revealed a 40 cc right frontobasal intracranial hemorrhage with a size of 7.5 x 4.4 x 2.2 cm3; subarachnoid hemorrhage was occupying the right temporal sulcus; 2.6 mm midline shift to the left; and extensive cerebral edema. Craniotomy for evacuation of intracranial hematoma was performed. Perioperative managements including rapid evaluation, early surgical resuscitation, and intensive care can improve patients outcome.

Pemantauan Neurofisiologis Intraoperatif selama Anestesia untuk Operasi Meningioma Foramen Magnum Firdaus, Riyadh; Suryono, Bambang; Saleh, Siti Chasnak
Jurnal Neuroanestesi Indonesia Vol 3, No 3 (2014)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Pemantauan neurofisiologis intraoperatif (Intraoperative neurophysiological monitoring/IONM) pada operasi yang rentan mencederai saraf sangat penting untuk menunjang proses keputusan medis intraoperatif dan pada akhirnya mengurangi angka morbiditas. Operasi meningioma foramen magnum sangat berisiko cedera saraf dan morbiditas sehingga menjadi kandidat yang cocok untuk penggunaan IONM. Cakupan manajemen anesthesia pada operasi yang menggunakan IONM adalah pertimbangan tentang pilihan dan dosis obat anestesia yang digunakan serta perhatian terhadap kestabilan homeostasis pasien. Pemahaman yang baik oleh dokter bedah, anestesi dan neurologi akan membuat tindakan operasi berjalan dengan lancar dan mencegah terjadinya komplikasi intra dan pascaoperasi. Seorang wanita umur 39 tahun dengan keluhan utama nyeri kepala belakang sejak 2 bulan yang lalu. Berdasarkan anamnesis, pemeriksaan fisik, dan pemeriksaan penunjang pasien di diagnosis tumor meningioma pada regio foramen magnum. Pasien dilakukan operasi kraniotomi removal tumor dengan panduan IONM dalam posisi park bench. Lama operasi kurang lebih 14 jam. Pascaoperasi pasien tidak dilakukan ekstubasi dan dirawat di ICU sehari.Intraoperative Neurophysiological Monitoring (IONM) during Anesthesia for Meningioma Foramen Magnum SurgeryIntraoperative neurophysiological monitoring (IONM) in a surgery that is prone to neuronal injury is very useful to guide intraoperative decision makings and to reduce morbidity. Foramen magnum tumor surgerycarries a very high risk for neuronal injury, and thereforeapplication of IONM would be advantageous. The termsof anesthetic management in IONM-guided-surgery are the selection of anesthetic agents with limitation of the dosageswhileremain focusingon stability of patients homeostasis. A thorough understanding and communication among surgeon, neurologist and anesthesiologist are important to createan uneventful procedure and to reduce intra and postoperative complications.A 39 years old female with severe headache for 2 months was diagnosed with meningioma at foramen magnum based on history, physical examination, and advanced examination procedures. The patient was underwent tumor removal guided by IONM on park bench position. The duration of surgery was 14 hours. The patient was not extubatedpostoperatively and admitted to ICU for a day.

Co-Authors Ade Ayu Sukmawati, Ade Ayu Afrianto, Kus Afrisa Adhita Putri, Afrisa Adhita Agus Wahyudi Akhmad Riduwan Akhsaniati, Novi Dwi Anang Didik Waluyo, Anang Didik Apriliani Issana Putri, Apriliani Issana Ardi Pramono Arifin, Sugeng Moh Ayu Putri Mustika Sari, Ayu Putri Mustika Azka Yahdiyani, Azka Bagir, Muhamad Baskoro, Ronggo Basuki, Wahyu Sunaryo Basuki, Wahyu Sunaryo Bhirowo Yudo Pratomo Binti Amaliyah Mufida, Binti Amaliyah Calcarina Fitriani Retno Wisudarti Chatarina Umbul Wahyuni Christantie Effendy Christanto, Sandhi Christanto, Sandhi Dibrata, Himendra Warga Difa, Rivenski Atwinda Djayanti Sari Djoko Adi Prasetio, Djoko Adi DWI RAHMAWATI Elita Rachmawati, Elita Endro Basuki Fadjrih Asyik, Nur FAHMI RIZALDI, FAHMI Fajarani, Septanti Fildzah Syahmina, Fildzah Firdaus, Riyadh Firdaus, Riyadh Fithrah, Bona Akhmad FRW, Calcarina Hermanto, Suwardi B. Heryanti, Chrisna Dwi Hidayat, Nopian Husein, Akhmad Syaiful Fatah Ichrom, Mochamad Ika Miftahul Jannah, Ika Miftahul Iskandar, Bintang Kusnardani Itla, Itla Lalenoh, Diana Christine Lalenoh, Diana Christine Lestari, Nurdika Dewi Luluk Atika Rahmawati, Luluk Atika Mahisa, Orizanov Mardiyah Anugraini, Mardiyah Mildawati, Titik Mulyono Mustikawati, Siti Rakhmah Nadiyah, Farah Nofa Prima Amalia, Nofa Prima Novanianto Rendra K.P., Novanianto Nur, Rifdhani Fakhrudin Nurdiansyah, Elba Nurul Isvatul Muvidha, Nurul Isvatul Nuryawan, Iwan Nuuril Imaama, Rahmatika Osman Sianipar Pangroso, Agung Pangroso Perbatasari, Inggita Dyah Pradipta, Dedik Norman Pratiwi, Argitania Diah Putri, Rahmita Ariami R. Rendra Okta Pratama Putra, R. Rendra Okta Pratama Rahmatisa, Dimas Rahmatisa, Dimas Rahmawati, Selvia Eka Ramayani, Julita Ratih Kumala Fajar Apsari Ratna Lutfiani Putri, Ratna Lutfiani Rudita, Muhammad RW, Calcarina Fitriani Saleh, Siti Chasnak Saleh, Siti Chasnak Sansoethan, Dithya Kusuma Sarosa, Pandit SATRIYAS ILYAS Septica, Rafidya Indah Septica, Rafidya Indah Silalahi, Antonius Sri Rahardjo Sudadi Sudadi Sudjito, M. H Sudjito, M. H Sulistyowati Sulistyowati Sutjipto Ngumar, Sutjipto Suyasa, Agus Baratha Suyasa, Agus Baratha Tatang Bisri Titin Rahayu, Titin Wahidahwati Wahidahwati Wariyanti, Wariyanti Widowati, Sari Ayu Widyaningrum, Chintya Wulandari, Novi Eka Yunita Kurniawati, Yunita Yusmein Uyun Zata Isma Rizki Amalina, Zata Isma Rizki

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