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All Journal Jurnal Anestesiologi Indonesia Jurnal Kedokteran Diponegoro Fokus Ekonomi BBM (Buletin Bisnis dan Manajemen) Journal of Anaesthesia and Pain COMSERVA: Jurnal Penelitian dan Pengabdian Masyarakat Majalah Anestesia & Critical Care (MACC) Ahmad Dahlan Medical Journal Jurnal Ilmiah Fokus Ekonomi, Manajemen, Bisnis & Akuntansi (EMBA) Fokus Abdimas MANGGALI Jurnal Komplikasi Anestesi
Untung Widodo, Untung
Unknown Affiliation
Humanities Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Education Environmental Science Health Professions Immunology & microbiology Industrial & Manufacturing Engineering Medicine & Pharmacology Public Health Social Sciences

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Efek Pemberian Ketamin Dosis 0,5 Mg/Kgbb Terhadap Onset Blokade Neuromuskular Oleh Atrakurium Al-Hilal, Said Rival; Sarosa H, Pandit; Widodo, Untung
Jurnal Komplikasi Anestesi Vol 5 No 2 (2018): Volume 5 Number 2 (2018)
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.v5i2.7332

Abstract

Background. Atracurium is a nondepolarizing muscle relaxant agent. The onset of this drug is slower than succinylcholine thus limiting its use. Various attempts had been made to accelerate the onset of the nondepolarizing muscle relaxants. Various reports suggest that ketamine is associated with a better intubation conditions. Aims. The aim of this study was to determine the effect of ketamine 0.5 mg.kg-1 on neuromuscular blockade onset of atracurium. Method. The method was a Randomized Controlled Trial (RCT) with double blinding. Eighty adult patients aged 18-65 years with physical status according to class I and II of ASA classification who were undergoing elective surgery under general anesthesia in November 2016 up to January 2017, patients who met the inclusion and exclusion criteria were randomly divided into two groups: K (Ketamine ) and group S (Saline Control). Group K was given ketamine 0.5 mg.kg-1 while the S was given Saline. Eight patients were otherwise drop out because of tool’s error. The Onset of atracurium was measured by using a Train of Four. Result. The results of this study were the onset of neuromuscular blockade by atracurium in the ketamine group significantly faster (160.500 ± 58.956 seconds vs 288.750 ± 135.038 seconds; p = 0.001). Hemodynamic 8 changes (∆MAP : 6,500±7,965 mmHg vs 10,750±14,655 mmHg & ∆pulse rate : 3,737±11,700 x/minute vs 4,333±12,254 x/min) was not statistically significant (p = 0.123 and p = 0.831). Conclusion: The administration of ketamine 0.5 mgkg-1 accelerate the onset of neuromuscular blockade of atracurium.
Hubungan antara Lama CPB dan Aortic Cross Clamp dengan Mortalitas dan Lama Rawat di ICU pada Pasien Pascaoperasi Katup Jantung di RSUP Dr. Sardjito Anggraini, Diana; Widodo, Untung; Pratomo, Bhirowo Yudo
Jurnal Komplikasi Anestesi Vol 5 No 2 (2018): Volume 5 Number 2 (2018)
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.v5i2.7333

Abstract

Background: CPB (cardiopulmonary bypass) results a non physiologic circulation and AOX (aortic cross clamp) causes a hypoxic condition of myocard. The length of CPB and AOX are probably factors that influence the ICU outcome after valvular heart surgery. Objective: To determine whether CPB and AOX time have significant effect on postoperative ICU length of stay (LOS) and ICU mortality. Methods: Data were collected from hospital medical record from period 2010 until 2016. After inclusion and exclusion 57 patients were analyzed for mortality and LOS in ICU. Results: Among 57 patients, 9 (15%) had ICU stay > 3 days, the mean+SD CPB was 119,2+32,5 min, AOX 92,7+27,7 min, while 7 (12,3%) had mortality in ICU, the mean+SD CPB was 113,7+37,3 min, AOX 79,3+36 min. Statistically showed that there were no correlation between duration of CPB and AOX with LOS and mortality in ICU, but we found that increased LOS in patient with comorbid (CHF+other) (p=0,019 OR 7,7 CI 95% 1,39-42,66) while ICU mortality increased with value of APACHE II (p=0,015 OR 1,69 CI 95% 1,11-2,58). Conclusion: There were no correlation of CPB and AOX time against ICU LOS and in mortality ICU, but preoperative factor (CHF+other) and postoperative factor (APACHE II score) respectively have a factor correlation.
Manajemen Perawatan Pasien Kritis dengan Ketoasidosis Diabetikum di ICU Jufan, Ahmad Yun; Widodo, Untung; Gafar, Wiramas Ikhsan
Jurnal Komplikasi Anestesi Vol 6 No 2 (2019): Volume 6 Number 2 (2019)
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.v6i2.7351

Abstract

Diabetic ketoacidosis (DKA) is a syndrome of insulin deficiency and counterregulatory hormone excessthat causes excessive production of glucose and ketones, but their use is reduced, causing ketoacidosis and hyperglycemia. The purpose of this case report is to review the pathophysiology of DKA and the current management of DKA relevant to anesthesiologists, especially in intensive care unit (ICU) settings. DKA therapy includes adequate fluid requirements, restoration of metabolic consequences of insulin insufficiency, correction of electrolyte and acid-base imbalances, introduction of causes or triggers and treatment; and avoid complications. A better understanding of the pathophysiology of DKA and its aggressive and uniform approach to diagnosis and management has reduced mortality.
Manajemen Anestesi pada Anak dengan Sindrom Mowat-Wilson Sari, Djayanti; Widodo, Untung; Wicaksono, Galih Sahid
Jurnal Komplikasi Anestesi Vol 6 No 2 (2019): Volume 6 Number 2 (2019)
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.v6i2.7352

Abstract

Sindromaa Mowat-Wilson adalah penyakit genetik yang disebabkan oleh mutasi heterozigot atau delesi dari gen ZEB2 dan ditandai oleh ciri-ciri klinis yang khas. Malformasi kongenital yang khas dari sindroma ini memerlukan prosedur diagnostik dan pembedahan dini yang memerlukan anestesi umum, tetapi sedikit informasi tentang manajemen anestesi pada pasien dengan sindroma tersebut. Sindromaa Mowat-Wilson melibatkan kelainan sistem ganda. Kelainan yang paling sering ditemukan adalah deformitas wajah, keterbelakangan mental, dan penyakit Hisprung. Kami melaporkan manajemen anestesi pada kasussindroma Mowat-Wilson dengan jalan nafas yang sulit yang menjalani prosedur biopsi rectum et causa penyakit hisprung.
Tatalaksana Perawatan Intensif Pasien PPOK Eksaserbasi Akut dengan Gagal Napas Tipe II Widodo, Untung; Adiyanto, Bowo; Aprianti, Tutut
Jurnal Komplikasi Anestesi Vol 6 No 2 (2019): Volume 6 Number 2 (2019)
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.v6i2.7354

Abstract

A fifty-two years old male was diagnosed COPD with acute exacerbation had care in intensive care unit for 7 days. Patient hospitalized for dyspneu, decreased consciousness and was diagnosed with acute exacerbation of obstructive pulmonary disease with mix type of respiratory failure. Patient was intubated, mechanically ventilated, and given COPD medical therapy during ICU treatment. Routine blood gas analysis and chest X-rays evaluation has been done to determine the improvement of ventilation. Ventilator weaning was performed so that the patient can breathe adequately and blood gas analysis showed improve.
Tablet Gabapentin sebagai Analgesia Multimodal Perioperatif dalam Anestesi Umum Widodo, Untung; Sarosa, Pandit; Gentong, Metia Gledis Gilang
Jurnal Komplikasi Anestesi Vol 6 No 2 (2019): Volume 6 Number 2 (2019)
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.v6i2.7355

Abstract

Multimodal analgesia is a combination of different drugs with different actions and targets in the nervoussystem, producing addictive effects or synergistic analgesia by reducing the side effects of single drug. The response of the humoral and neuronal complexes that occur due to surgery requires balanced perioperative pain management. Multimodal use can reduce the dose of each drug and reduce the incidence of side effects of drugs used for the treatment of perioperative pain, which can shorten hospitalization time, speed-up recovery and function of the body, and reduce health costs. Today, the American Society of Anesthesiologists Task Force on Acute Pain Management advocates the use of multimodal analgesia.
Hubungan Antara Mikroalbuminuria dan Skor SOFA pada Pasien Sepsis yang Dirawat di ICU RSUP Dr Sardjito Sulistiyantoro, Antonius Catur; Widodo, Untung; Jufan, Akhmad Yun
Jurnal Komplikasi Anestesi Vol 7 No 1 (2019): Volume 7 Number 1 (2019)
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.v7i1.7382

Abstract

Background: Sepsis causes release of inflammatory mediator to circulation. The inflammatory molecules and oxidative stress increase the capilar permeability include the glomerular renalis. An early event is the loss of barrier integrity leading to systemic capillary leakage. The glomerular manifestation of this increased permeability is increased excretion of albumin in the urine. Microalbuminuria, defined as 30–300 mg/day of albumin excretion in the urine, occurs rapidly after an acute inflammatory insult such as sepsis. SOFA scoreis one of parameter to asses the degree of organ dysfunction severity.Purpose: The purpose of this study was to determine the correlation between microalbuminuria and SOFA score in patient with sepsis in ICU Dr. Sardjito Government General Hospital.Methods: This observational study was conducted in ICU Dr. Sardjito Government General Hospital between January-July 2019. Inclusion criteria were all patients with sepsis admited to ICU (≥18 years old), exclusion criteria were patient with diabetic mellitus, anuria, chronic kidney disease, pregnant, urological trauma, nephrotic syndrome, urinary tract infection. urine samples were collected per 24 hour (Day-1st), 48 hour (Day-2nd) and 72 hour (Day-3st). The microalbuminuria was measured in hospital laboratory. The SOFA score evaluated every day. The correlation between SOFA score with microalbuminuria was analyzed with SPSS.Result: Total 35 subject included, 20 subject excluded, 1 subject dropout. The study included 57,1% male and 42,9% female, mean of SOFA score were 9,4 ± 3,4, mean of microalbuminuria were 132 ± 75,2 mg/l. Subject with septic shock were 42,9% and all of subject required mechanical ventilation. Mortality rate were 50%, the major infection sourced was respiratory tract (42,9%), and the major bacteria was Acinebacter baumanii. The mean of SOFA score in survivor subject were 6,43 ± 2,80 and not survivor were 10,34 ± 3,00, the microalbuminuria in survivor subject were 82,10 ± 70,73 mg/l and not survivor were 167,71 ± 46,81 mg/l. There was positive correlation between microalbuminuria and SOFA score with strength correlation r: 0,627, p: 0,016. SOFA score >7 had risk 16 times to die, and microalbuminuria >156,35 had prognostic risk 36 times to die.Conclusion: There was positive correlation between microalbuminuria level and SOFA score in septic patients in ICU Dr. Sardjito Government General Hospital.
Perbandingan Chlorhexidine 0,5% dan Povidone Iodine 10% dalam Mencegah Kolonisasi Bakteri pada Kateter Epidural Harianto, Widi Yuli; Mahmud; Widodo, Untung
Jurnal Komplikasi Anestesi Vol 7 No 3 (2020): Volume 7 Number 3 (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.v7i3.7468

Abstract

Background: Infection in the epidural space is rare but if it occurs it is a serious complication of epidural catheter placement. Aromaa et al reported 8 cases of bacterial infection in the spinal or central nervous system (CNS) after 170,000 epidurals and 550.00 spinal anesthesia, with an overall frequency of 1.1 per 100,000 blocks. The purpose of this study was to compare chlorhexidine 0.5% with 10% povidone iodine in preventing bacterial colonization of epidural catheters in patients treated at the Central General Hospital (RSUP) Dr. Sardjito. Methods: The study design was a single-blind randomized controlled trial in 52 patients who had epidural anesthesia or a combination of general and epidural anesthesia at RSUP Dr. Sardjito Yogyakarta in JanuaryApril 2019. The research subjects were divided into two groups, namely clorhexidine 0.5% in 70% alcohol and povidone iodine 10%. Examination of the epidural catheter (3-4 cm) tip culture on the 3rd day after installation. The research data was tested using the Chi-Square test. Results: This study found positive bacterial cultures on chlorhexidine 0.5% and povidone iodine 10% each in 13% of 23 epidural catheters (p> 0.05). Risk factors for the incidence of spinal needle bacterial colonization which include age, sex, history of diabetes, autoimmune diseases, cytostatica therapy, HIV / AIDS infection, steroid use more than 2 weeks and type of surgery, antibiotic use and irritation events, and complications between the two groups there was no significant difference (p.0,05). Conclusion: The effectiveness of chlorhexidine 0.5% in 70% alcohol compared to povidone iodine 10% did not differ significantly in preventing bacterial colonization in epidural catheters, there was a growth of 13% (3/23) in the chlorhexidine 0.5% group in 70% alcohol and 13 % (3/23) in the povidone iodine 10% group
Perbandingan Antara Nilai Indeks Variasi Gelombang Plethysmography dengan Nilai Variasi Tekanan Pulsasi Arteri pada Pasien dengan Ventilasi Tekanan Positif di ICU RSUP Dr. Sardjito Bhaktiyar, Agung; Widodo, Untung; Jufan, Akhmad Yun
Jurnal Komplikasi Anestesi Vol 7 No 3 (2020): Volume 7 Number 3 (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.v7i3.7470

Abstract

Background: Pulse pressure variations (PPV) provide a good assessment of fluid status but require the installation of arterial line with high cost, difficult installation, and the risk of complications in the form of tissue death as well as infection. Meanwhile, the plethysmography variation index which has similarities to the pulse pressure variation that arises due to arteriolar pulses and is influenced by the breathing cycle, but is non-invasive, easy to apply, cheaper material, and without the risk of tissue death or infection. Methods: This study uses a prospective observational study design. We measured pulse pressure variation and plethysmography variability index (PVi) in 22 patients mechanically ventilated with preexisting radial artery catheter in intensive care unit (ICU). PPV was obtained by installing radial arterial line connected to Mostcare®. PVi was obtained by installing an oximetry probe on fourth finger and connected to the Masimo® monitor. We compared PPV and PVi using Mann-whitney test and looked for correlations with the spearman coefficient. Result: Twenty-two patients (SAPS II = 1.74 (0.4-75) had PPV values of 11.7 (7.03) and PVi 13.29 (7.76) different but were not statistically significant p = 0.405 (p> 0.05). There was a moderate correlation between PPV and PVi (r = 0.55). Four of the 22 patients receiving noreepinephiren (dose = 0.125 mcg / kg / min (0.1- 0.15)) showed no correlation between PPV and PVi (r = 0.40 p = 0.60). Conclusion: There was no significant difference between the value of the pulse pressure variation and the plethysmography variability index (PVi). There was a moderate correlation between the pulse pressure variation with the plethysmography variability index. There was no correlation between PVi and PPV in patients receiving norepinephrine.
Manajemen Pasien Leptospirosis di ICU Jufan, Akhmad Yun; Widodo, Untung; Bahrun, Nugraha Septian
Jurnal Komplikasi Anestesi Vol 8 No 1 (2021): Volume 8 Number 1 (2021)
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.v8i1.7490

Abstract

We reported a 54-year-old male patient with leptospirosis, septic shock, and MODS. Patient is referred from RSUD Prambanan with chief complaint of high fever accompanied by yellow eyes and body, headache, calf pain, body aches rheumatic pain, nausea, vomiting, shortness of breath, and tea colored urine. From history taking, it was found that there was a possibility of a history of contact with animals that were the source of transmission of leptospirosis, namely rats. The patient was treated in the ICU for several days. During treatment, hemodialysis was performed several times due to an increase in blood urea. After being treated for several days, the patient’s condition improved and treatment was carried out on the ward by internist.
Co-Authors Abu Tholib Aman Adi Nugroho Adrin, Olga Elenska Agustina, Ayu Yesi Ainiyah, Ghonimah Zumroatun Aji, Bambang Hantoro Sarti Akbar, Shonnif Akhmad Yun Akhmad Yun Jufan Al-Hilal, Said Rival Andriani, Ika Jati Setya Anggraini, Diana Anisa Fadhila Farid Aprianti, Tutut Arif Setyo Wibowo Artika, I Gusti Ngurah Rai Bahrun, Nugraha Septian Baskoro, Windu Adi Bayu, Timor Krisna Bernadeta M Wara Kushartanti Bhaktiyar, Agung Bhirowo Yudo Pratomo Bowo Adiyanto Burhanuddin, Muhammad Fuad Calcarina Fitriani Retno Wisudarti Castro, Toto Damayanti Damayanti Dewi, Wahyu Jati Paramita Djayanti Sari Farizi, Sulaiman Al Ferdiansyah, David FRW, Calcarina Gafar, Wiramas Ikhsan Gautama, Raditsya Mada Gentong, Metia Gledis Gilang Hamam Hadi Harianto, Widi Yuli Hendra, Maijoni Hernawan, Agung Diky Heru Susilo Hihayat, Ibnu Hijriyatunnisa, Hijriyatunnisa Ikhwandi, Arif Indra Wijaya, Adi Irawati, Tri Endang Jaelani, M Jufan, Ahmad Yun Krispratama, Avian Kusumasari, Nur Hesti Lies Indriyatni Loru, Martha Yuanita Lumbantoruan, Mitra Maduretno Widowati Marthysal, Audhiaz Mi’raj, Geza Getar Mulyono, Arif Hei Muniroh Almunawar, Nira Naomi, Diah Anis Ningtias, Devi Rosita Noegroho, Wahyu Permatasari, Kartika Dewi Perwira, Rendra Prabowo, Janitra Prasamya, Erlangga Puspita, Mia Qurrotuaini, Dhiya Nisrina Rakhmatjati, Pradana Bayu Ramsi, Irhash Faisal Ratih Kumala Fajar Apsari Rudika Harminingtyas Sari, Ayu Rosema Sarosa, Pandit Satrya, Rafi Nanda Septiyono, Dwi Rahmat Gandhi Setiawan, Yosy Budi Shila Suryani, Shila Siti Helmyati Sudadi Sulistiyantoro, Antonius Catur Suryaman, Rifandi Suryono S, Bambang Susanti Wahyuningsih, Susanti Susetyowati Sutiyoso, Noor Aditya Tasriastuti, Nurohmi Ambar Taufik Eko Nugroho Teguh Setiadi Toruan, Joner Lumban Trifiana, May Lisa Triongko, Budi Ummi, Riadatul Wahyunigsih, Susanti Wicaksono, Galih Sahid Widowati, Madu Retno Widowati, Madurento Wijayanti, Maria Setya Yuliati - Yunita Widyastuti Yusmein Uyun Zulkarnaini, Zukarnaini