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Ari Santri Palinrungi
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Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience

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The Association of Cumulative Fluid Balance and Sepsis Patient Mortality During Treatment in the Intensive Care Unit Gusriadi B; Syamsul Hilal Salam; Hisbullah Hisbullah; Syafri Kamsul Arif; Muhammad Rum; Ari Santri Palinrungi
Nusantara Medical Science Journal Volume 7 Issue 2, July - December 2022
Publisher : Faculty of Medicine, Hasanuddin University.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/nmsj.v7i2.20229

Abstract

Introduction: Fluid management in sepsis patients is crucial, especially in the first three hours after sepsis diagnosis is established. However, excessive fluid administration will increase patient mortality. This study’s purpose is to determine the correlation among cumulative fluid balance and mortality in patients with sepsis and/or septic shock admitted to the Intensive Care Unit (ICU) of Dr. Wahidin Sudirohusodo Central Hospital, Makassar. Methods: This comes about as an analytical observational study with a retrospective method. The population involved in this study was patients diagnosed with sepsis and septic shock who were treated in the ICU of Dr. Wahidin Sudirohusodo Central Hospital, Makassar from January to December 2021 with a total sample of 56 people. Data were analyzed using Mann-Whitney and Chi-Square statistical tests with a significance level of α=0.05. Data were studied using SPSS 25.0 (SPSS, Inc. Chicago, IL). Results: The mean cumulative fluid balance in septic patients was -1299.51±5228.34 ml. Based on the fluid balance category, 24 people (42.9%) had a positive balance and 32 people (57.1%) had a negative balance. There was a correlation among cumulative fluid balance and mortality in sepsis patients hospitalized in the ICU of Dr. Wahidin Sudirohusodo Central Hospital (p < 0.001), out of 24 patients with a positive balance, the non-survivors percentage was 66.7% and 33.3% of patients survived, while out of 32 patients with a negative balance, the percentage of non-survivors was 18.7% and 81.3% of patients survived. Conclusions: There is a correlation among cumulative fluid balance and mortality of septic patients in the ICU. A positive cumulative fluid balance will cause a higher mortality rate or risk of death compared to a negative cumulative fluid balance.
Renal Replacement Therapy sebagai Intervensi Dini pada Tatalaksana Ketoasidosis Diabetik Gusti Andhika Kusuma; Haizah Nurdin; Syamsu Hilal Salam; Ari Santri Palinrungi
UMI Medical Journal Vol 8 No 1 (2023): UMI Medical Journal
Publisher : Fakultas Kedokteran Universitas Muslim Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33096/umj.v8i1.204

Abstract

Ketoasidosis diabetikum (KAD) adalah gangguan metabolik akut yang secara primer ditandai dengan peningkatan badan keton dalam sirkulasi yang berlanjut menjadi ketoasidosis berat dengan hiperglikemia tidak terkontrol akibat defisiensi insulin. Ketoasidosis diabetik menyebabkan tingkat morbiditas dan mortalitas yang tinggi meskipun terapi diabetes telah berkembang. Aspek krusial dari tata laksana KAD meliputi pemberian cairan dan elektrolit, dalam jumlah adekuat, dan pemberian insulin secara terus menerus. Pasien dengan KAD sering datang dalam keadaan asidosis metabolik berat dan hiperkalemia yang disertai dengan penurunan kesadaran dan gangguan pernapasan sehingga memerlukan tindakan yang tepat dan perawatan intensif. Laporan kasus ini mengenai perempuan umur 20 tahun mengalami penurunan kesadaran. Pada pemeriksaan ditemukan kadar glukosa darah: 742 mg/dL, dan dari analisis gas darah menunjukkan asidosis metabolik berat (pH: 7,13; HCO3: 4,1 pCO2: 10,9) dan keton urine (+). Terapi KAD yang diberikan diruang ICU meliputi koreksi dehidrasi, terapi insulin untuk kontrol glukosa darah, menejemen infeksi dan koreksi ketidakseimbangan elektrolit serta terapi intervensi lain seperti ventilasi mekanik dan CRRT. Setelah perawatan hari kelima kondisi pasien mulai stabil dan dapat pindah ke perawatan ruangan. Penatalaksanaan yang tepat pada pasien KAD dapat memberikan keluaran yang baik pada pasien.
Co-Authors Gusriadi B Gusti Andhika Kusuma Haizah Nurdin Hisbullah Hisbullah Muhammad Rum Syafri Kamsul Arif Syamsu Hilal Salam Syamsul Hilal Salam