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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
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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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Perbandingan Luaran Pasien Level Of Care 3 yang Menggunakan Ventilator Sebelum dan Sesudah Operasional Ruang High Care Unit Di RSUP Dr. Sardjito Yogyakarta Suryaman, Rifandi; Widodo, Untung; Sari, Djayanti
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.v8i1.7493

Abstract

Background: Mortality rate in emergency department (ED) of Dr. Sardjito General Hospital did not achieve national target. Result of evaluation and analysis of this condition was established of High Care Unit for critical care management of patient in ED with the goal to decrease morbidity and mortality rate. Objective: To compare outcome such as mortality rate, MSOFA exit score, Length of Stay(LOS) in IMC, HCU, hospital and ventilator day at patients 3rd level of care (LOC) using ventilator before and after the implementation of HCU at the Dr. Sardjito General Hospital. Method: This research was an observational study using retrospective cohort analysis. Subjects had been collected from medical record included 198 meet the inclusion criteria; aged ≥18 years who were treated with critical illness with 3rd level of care (LOC) who used a ventilator in the HCU or IMC of RSUP dr.Sardjito. Exclusion criteria were patients with end-stage malignancies, patients with HIV / AIDS infections, patients with end-stage chronic disease and incomplete medical record. Result: Mortality rate in HCU (40.4%) and IMC (73.3%) with p = 0.000. MSOFA exit score in HCU (5.5) and IMC (7.4) with p= 0.001. HCU and IMC length of stay (LOS) showed no statistically signifcant difference. Hospital LOS in HCU (314.7) hours and IMC (210.6) hours with p = 0.000. Ventilator day in HCU (5.1) days and IMC (4.8) days and showed no statistically signifcant difference. Conclusion: Mortality rate and MSOFA exit score in HCU was lower than IMC. There was no significant difference between LOS in HCU and IMC. Hospital LOS in HCU group 314.7 hours and IMC group was 192.6 hours. Ventilator day in HCU group was 5.1 days and IMC group 4.8 days.
Pengendalian Hemodinamik Intraoperatif pada Pasien Tumor Adrenal Fungsional yang Menjalani Adrenalektomi Adiyanto, Bowo; Widodo, Untung; Sutiyoso, Noor Aditya
Jurnal Komplikasi Anestesi Vol 10 No 2 (2022)
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.v10i2.8291

Abstract

Adrenal gland surgery needs a multidisciplinary team including endocrinologist, radiologist, anesthesiologist, and surgeon. The indications for adrenal gland surgery include hormonal secreting and non-hormonal secreting tumors. Adrenal hormonal secreting tumors present to the anesthesiologist unique challenges requiring good preoperative evaluation, perioperative hemodynamic control, corrections of all electrolytes and metabolic abnormalities, a detailed and careful anesthetic strategy, overall knowledge about the specific diseases, control and maintaining of postoperative adrenal function, and finally a good collaboration with other involved colleagues.
Manajemen Nutrisi pada Pasien ICU yang Menjalani Prosedur Esofagektomi Widodo, Untung; Jufan, Akhmad Yun; Adrin, Olga Elenska
Jurnal Komplikasi Anestesi Vol 10 No 2 (2022)
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.v10i2.8297

Abstract

Patients in intensive care are generally exposed to catabolic stress with complications that increase morbidity and mortality, and affect the length of stay in the intensive care unit. Optimal nutritional management can help enhance the metabolic response to stress, prevent oxidative cellular injury, and modulate the immune response. We reported a 30 years old male underwent an esophagectomy procedure due to esophageal tumor. After the third day of surgery the patient was given enteral nutrition, there was a brownish residue in the nasogastric tube, in exchange of this condition, parenteral nutrition was given until the tenth day of intensive care. Enteral nutrition was continued on the tenth day of care until the patient transferred to the ward on the thirteenth day in the intensive care unit.
Faktor Risiko Mortalitas Pasien Geriatri yang Dirawat Di ICU RSUP Dr. Sardjito Yogyakarta Hendra, Maijoni; Akhmad Yun; Widodo, Untung
Jurnal Komplikasi Anestesi Vol 10 No 2 (2022)
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.v10i2.8306

Abstract

Background: Nowadays, many geriatric patients need intensive care. In intensive care geriatric patients will show geriatric syndromes such as delirium, sensory disturbances and frailty which are closely related to morbidity and mortality. Until now in Indonesia there has been no specific study that examines the risk of death in geriatric patients treated in the ICU. Objective: To identify the risk factors that influence the mortality of geriatric patients in the ICU, as a reference material in the management of geriatric patients in the ICU. Method: This study is a retrospective cohort observational study. The study sample consisted of 162 patients who were treated at ICU Dr. Sardjito General Hospital from 1 January 2020 to 31 December 2020. The identified risk factors were then analyzed and tested using the student's t-test for numerical data and the chi square test for categorical data. The results of the analysis with p <0.25 were then carried out with a logistic regression test. Variables with p <0.05 in multivariate analysis were considered significant. Data were analyzed statistically with the SPSS 25.0 application. Results: Factors identified as risk factors for mortality in geriatric patients in the ICU Dr. Sardjito General Hospital were kidney comorbidities in the form of acute kidney injury and chronic kidney disease (p=0.019, OR 0.364), the use of inotropic vasopressor drugs such as dopamine, dobutamine, norepinephrine, epinephrine, vasopressin (p=0.003, OR 0.277) and the use of mechanical ventilation (p=0.004, OR 0.890) were the variables that had the most significant effect simultaneously on the mortality of geriatric patients in the ICU. Conclusion: The identified risk factors for geriatric patients’ mortality in the ICU of Dr. Sardjito General Hospital are renal comorbidities, the use of invasive mechanical ventilation and the use of inotropic and vasopressor drugs.
Hubungan Indeks ROX dengan Mortalitas Pasien COVID-19 di RSUP Dr. Sardjito Naomi, Diah Anis; Wisudarti, Calcarina Fitriani Retno; Widodo, Untung
Jurnal Komplikasi Anestesi Vol 10 No 1 (2022)
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.v10i1.8327

Abstract

Background: In December 2019, a new infectious disease caused by a corona virus named SARS-CoV-2 emerged. COVID-19 disease causes multi-organ failure that occurs in the lungs and extra-pulmonary, sepsis, and even death. Pulmonary disorders that often occur in COVID-19 patients are ARDS. Early recognition of ARDS can be done by assessing the clinical condition of the patient and the parameters of RR and SpO2. ROX is a calculation of Index (SpO2/FiO2)/RR. The ROX index may be one of the predictors of mortality in COVID-19 patients. Methods: An observational study with a retrospective cohort approach to COVID19 patients who were hospitalized at Sardjito General Hospital in July 2020 to June 2021. Patients with COVID-19 without oxygen therapy or with nasal cannula oxygen therapy, NRM, or HFNC who were hospitalized, the ROX Index were calculated on the first day of treatment and then assessed for patient mortality and length of stay. The data was taken from medical records at the Medical Records Installation at Sardjito General Hospital. Results: There were 953 research subjects with average age of 51 (± 15.5) years old, 479 women (50.3%) and 474 men (49.7%). There was a significant relationship between the ROX index 15.06 and the mortality of COVID-19 patients (p < 0.001, HR = 2.15, 95% CI 1.57-2.94). Other factors related to mortality in COVID-19 patients were age, oxygen therapy with HFNC, hypertension, diabetes mellitus, chronic kidney failure, and cardiovascular disease. The survival time of subjects with an ROX index of 15.06 was 24 days, shorter than the index group > 15.06, which was 31 days (p < 0.001). The ROX index did not have a significant relationship with the length of stay in the hospital. The average length of stay in the ROX 15.06 index group was 17 days, longer than the > 15.06 index group, which was 14 days (p=0.002). Factors related to length of stay were age ³ 65 years, history of hypertension and diabetes mellitus. Conclusion: There was a significant association of ROX index and mortality of COVID-19 patients at Sardjito General Hospital.
Manajemen Preoperatif pada Pasien dengan Hipertiroid Pratomo, Bhirowo Yudo; Widodo, Untung; Ferdiansyah, David
Jurnal Komplikasi Anestesi Vol 9 No 3 (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.v9i3.8332

Abstract

Gangguan tiroid adalah kelainan endokrin yang paling sering ditemukan setelah diabetes melitus. Prevalensi kelainan tiroid di wilayah dengan defisiensi iodin lebih tinggi, salah satunya wilayah Asia Tenggara. Hormon tiroid memiliki banyak efek pada beberapa organ di dalam tubuh seperti meningkatkan pertumbuhan, sistem saraf pusat, kardiovaskuler, dan laju metabolisme. Stres, yang salah satunya diakibatkan oleh prosedur operatif, dapat mengeksaserbasi kelainan tiroid sehingga dapat menyebabkan dekompensasi atau bahkan mortalitas. Semua prosedur operasi elektif harus ditunda hingga pasien berada pada kondisi eutiroid dengan terapi medikamentosa. Pasien harus memiliki kadar T3 dan T4 yang normal dan tidak mengalami takikardi pada kondisi istirahat.
Hubungan Antara C-Reactive Protein dengan Mortalitas dan Lama Rawat Pasien COVID-19 di RSUP Dr. Sardjito Ramsi, Irhash Faisal; Widyastuti, Yunita; Widodo, Untung
Jurnal Komplikasi Anestesi Vol 9 No 3 (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.v9i3.8333

Abstract

Background: COVID 19 is an emerging viral infectious disease that is currently spreading around the world, and has become a pandemic. Diverse clinical manifestations also produce extensive morbidity and mortality. C reactive protein (CRP) is a new biomarker that describe the event of inflammation or infection. Serum CRP level reflects the relationship with disease severity and high mortality. Objective: The objective of this study is to analyze the relationship between CRP level and patient’s length of stay and mortality. Method: This study used retrospective observational cohort method at the Medical Records and Accounting Departement, Dr. Sardjito Hospital by reviewing confirmed COVID 19 patient’s medical records examined serum CRP level in the period of April until December 2020. To analyze the relationship between CRP level and mortality, logistic regression was used. And to analyze to relationship between CRP level and hospital length of stay, Kaplan-Meier was used. Result: Total sample population was 285 patients, and 178 patients met inclusion and exclusion criteria. The median of age of the patients was 54 years old (19-89) consist of 60,7% male patients and 39,3% female patients. Subjects with higher CRP level (>72 mg/L) were at higher risk of death (HR 4,726; p< 0,001) than those with lower CRP level. The difference in LOS was significantly different between groups of subjects, with the median LOS for subjects with CRP >72 mg/L was 20 days, while for subjects with CRP ≤72 mg/L was 16 days (p= 0.021). Conclusion: Increased serum CRP level >72 mg/L strongly related with increased risk of mortality and length of hospital stay in COVID-19 patients.
Faktor-Faktor Risiko Terjadinya Pneumonia pada Pasien Covid-19 Di RSUP Dr Sardjito Yogyakarta Perwira, Rendra; Uyun, Yusmein; Widodo, Untung
Jurnal Komplikasi Anestesi Vol 9 No 3 (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.v9i3.8334

Abstract

Background: Globally, more than three million confirmed cases of COVID-19 have been reported. According to the WHO report on May 6, 2020, the number of world cases that were confirmed positive was 3 588 773, and the death toll was 247 503 people. Pneumonia appears to be one of the serious manifestations of COVID-19 infection. It is necessary to know the risk factors for COVID-19 pneumonia Methods: The study used a retrospective cohort method, the research subjects were taken from March 2020 to March 2021 with the status of inpatients and confirmed Covid-19 at Dr Sardjito Hospital. Results: In this study, the total sample was 630 patients.The results of the multivariate analysis showed that the factors of age, type II DM, hypertension and male sex were significant for COVID-19 pneumonia. Age 60 years is at risk of pneumonia 1.6 times the risk of developing pneumonia (p=0.041 OR 1.6 95% CI=1.02-2.77), DM Ttype II has a risk of COVID-19 pneumonia 2.48 times (p=0.001 OR 2.48, 95%CI=1.44-4.29), hypertension risk of pneumonia 1.68 times (p=0.042 OR 1.68, 95%CI=1.01-2.77), male gender men were at risk of pneumonia 1.74 times (p=0.004, OR 1.74, 95%CI=1.2-2.57). Conclusion: Age 60 years, hypertension, type II DM and male are significant risk factors for pneumonia in patients with COVID-19 infection.
Manajemen Sulit Jalan Napas pada Pasien Pediatrik dengan Sindrom Bosman-Arhinia Mikroftalmia Mahmud; Widodo, Untung; Loru, Martha Yuanita
Jurnal Komplikasi Anestesi Vol 9 No 2 (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.v9i2.8348

Abstract

A 12-months-old boy with Bosman-Arhinia Microphthalmia Syndrome (BAMS) will undergo surgery to replace a nasopharyngeal duct catheter after nasal reconstruction. Patients with ASA physical status 2 with BAMS and prediction of difficult airway. Patient with a history of 2 months ago went on tracheostomy surgery, facilitated by general anesthesia using the Supraglotic Airway Device (SAD) or Laringeal Mask Airway (LMA). After 3 weeks, the tracheostomy cannula was removed and the tracheostomy wound was closed. We used crash induction but found difficulty in ventilation with a facemask or with the LMA so that management was immediately carried out according to the difficult airway algorithm and intubation was successful
Rapid Sequence Spinal pada Seksio Sesarea Emergensi Adiyanto, Bowo; Widodo, Untung; Wibowo, Arif Setyo
Jurnal Komplikasi Anestesi Vol 8 No 2 (2021): Volume 8 Number 2 (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.v8i2.8355

Abstract

Obstetric emergencies are a challenge both for the obstetrician and the anesthesiologist. The incidence of caesarean sections as per the National Family Health Survey published in 2015–16 was 17.2%. In 7.6% of cases, the decision to conduct a caesarean section was taken after the onset of labour pain. Caesarean sections are classified depending on the urgency into four categories. The target decision to delivery interval for category 1 caesarean section is less than 30 min. The management of these emergencies involves a rapid assessment with minimal investigations. Although general anaesthesia is considered to have higher morbidity and mortality, category 1 caesarean sections may still warrant this technique. Rapid sequence spinal anaesthesia is replacing general anaesthesia for category 1 SC emergency. In category 2 and 3 caesarean sections, spinal anaesthesia still remains the technique of choice
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