Claim Missing Document
Check
Articles

Perbandingan Insidensi Hipotensi Saat Induksi Intravena Propofol 2 Mg/Kg Bb Pada Posisi Supine dengan Perlakuan dan Tanpa Perlakuan Elevasi Tungkai Beni Indra; Untung Widodo; Yunita Widyastuti
Jurnal Kesehatan Andalas Vol 5, No 1 (2016)
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v5i1.476

Abstract

Abstrak          Penggunaan Propofol untuk induksi pada general anestesi dapat menyebabkan  hipotensi akibat vasodilatasi arteri dan vena terutama vena kapasitan ditungkai. Manuver elevasi tungkai dapat mempertahankan stabilitas hemodinamik dengan meningkatkan aliran balik vena ke jantung dan mengurangi penumpukan darah di vena kapasitan tungkai. Penelitian ini dirancang dengan menggunakan cara Open Randomized Control Trial. Subyek penelitian adalah 184 sampel pasien dewasa ASA I-II yang menjalani operasi elektif dengan menggunakan general anestesi dengan induksi propofol. Kelompok sampel penelitian dibagi dalam dua kelompok masing-masing berjumlah 92 orang. Setelah prabeban cairan RL 10 cc/kgbb dan pemberian fentanyl 2 mcg/kgbb dan midazolam 0,05 mg/kgbb maka kelompok A dilakukan elevasi tungkai 45º satu menit sebelum induksi propofol dan dipertahankan sampai penelitian selesai. Sedangkan kelompok B tidak dilakukan elevasi tungkai. Data yang dikumpulkan dianalisa dengan uji t tes. Untuk data proporsi dilakukan analisa dengan tes chi-square. Dari data demografi tidak didapatkan perbedaan yang bermakna secara statistik (p>0,05) antara kedua kelompok penelitian kecuali untuk BMI (p<0,05). Insidensi hipotensi  menit pertama pasca induksi propofol pada kelompok A (elevasi tungkai) secara signifikan lebih rendah (12%) dibanding kelompok kontrol B  (27,2%) (p=0,016; p < 0,05). Pada menit ketiga pasca induksi juga didapatkan insidensi hipotensi kelompok A  (15,2%) signifikan lebih rendah dibanding kelompok B (23,9%) (p= 0,014; p < 0,05). Elevasi tungkai 45 derajat efektif dalam menurunkan insidensi hipotensi pasca induksi propofol.  Kata kunci: propofol, hipotensi, elevasi tungkai AbstractThe induction of general anaesthesia with propofol may induce of considerable degree of hypotension that has been atributed to decrease in systemic vascular resistance  caused by combination of venous and arterial vasodilatation. It will produce a shifting  of blood to venous reservoir, especially capacitance venule of legs. Leg elevation can provide hemodynamic stability by increases cardiac preload and recruits blood contained in the venous reservoir. This is Open Randomized Control Trial include 184 elective surgery patients with American Society of Anaesthesiologist (ASA) physical status I and II. Anesthesia  was induced with propofol. Patients were randomly allocated into two groups with 92 patients in each. All the patients received Ringer’s Lactate (10 ml/kg) and premedicated with fentanyl (2 mcg/kg) and midazolam (0,05 mg/kg) before induction of anesthesia. Group A was performed passive leg raising 45 degree 1 minute before injection of propofol until  the end of study and group B (control) did not receive any maneuver. Parametric data were analyzed with t-test and categorical data was done by using Chi-square test. A p value of less than 0,05 was consider significant. Demografic characteristics (age, sex, body weight and height) and  baseline haemodynamic parameters of the patients were similar in two groups (p > 0.05) except for BMI (p < 0.05) . The incidence of hypotension was significantly lower in group A (12 %, ) than group  B (27,2%) at the first minute after propofol  injection, p value = 0.016 (p < 0,05). In the third minute, incidence of hypotension was also significantly lower in group A (15,2%) than group B (23,9%), p value = 0,014 (p < 0,05). Leg elevation maneuver 45º significantly decrease incidence of hypotension after propofol induction. Keywords: Propofol, hypotension, leg elevation
Proporsi Kejadian Awareness selama Anestesi Umum pada Pasien Pediatrik dengan Monitored Anesthesia Care (MAC) Yunita Widyastuti; Fadhilah Zulfa; Djayanti Sari
JAI (Jurnal Anestesiologi Indonesia) Vol 13, No 1 (2021): Jurnal Anestesiologi Indonesia
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v13i1.25264

Abstract

Latar Belakang: Selama anestesi berlangsung, awareness intraoperatif dapat terjadi. Kejadian awareness intraoperatif pada pasien dewasa dengan anestesi umum dilaporkan sebesar 0,1%, sedangkan pada pasien pediatrik sebesar 2,7% dan 5%. Penelitian mengenai awareness intraoperatif pada pasien pediatrik dengan monitored anesthesia care (MAC) belum pernah dilakukan di RSUP Dr. Sardjito Yogyakarta.Tujuan: Mengetahui angka kejadian awareness selama anestesi umum pada pasien pediatrik dengan MACMetode: Studi observasional dilakukan pada 30 pasien pediatrik (usia 1-18 tahun) yang direncanakan akan dilakukan MAC. Kedalaman anestesi dimonitor dengan menggunakan index of consciousness (IoC) dan skor pressure, heart rate, sweating, tears (PRST)/Skor Evan. Proporsi awareness dianalisis dan dikelompokkan dalam kriteria-kriteria seperti usia, jenis kelamin, status fisik, indikasi tindakan yang dilakukan, serta medikasi yang digunakan untuk anestesi.Hasil: Pasien dengan nilai IoC positif awareness sebesar 63,3%, sedangkan pasien dengan skor PRST positif awareness sebanyak 3,33%. Penjelasan mengapa hasil dari IoC lebih besar adalah karena nilai pada IoC dapat dipengaruhi oleh nistagmus yang terjadi pada pasien-pasien yang menggunakan ketamin (15/30 (50%)).Kesimpulan: Kejadian awareness intraoperatif pada pasien pediatrik dengan prosedur MAC di RSUP Dr. Sardjito sebanyak 3,33%. Pencegahan awareness diperlukan agar awareness tidak terjadi lagi di kemudian hari.
FAKTOR KARAKTERISTIK YANG BERHUBUNGAN DENGAN KEPUASAN PASIEN PADA LAYANAN PERSALINAN DI PUSKESMAS KABUPATEN GROBOGAN Yunita Widyastuti; Priyadi Nugraha Prabamukti; Zahroh Shaluhiyah
Jurnal Kesehatan Masyarakat (Undip) Vol 6, No 5 (2018): SEPTEMBER
Publisher : Fakultas Kesehatan Masyarakat Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (203.525 KB) | DOI: 10.14710/jkm.v6i5.22145

Abstract

Customer service and customer satisfaction are the core of a business, as well as services to patients provided by hospitals or other healthcare organizations. Therefore the motion of healthcare business should lead to customer satisfaction. Patient is a customer who has the right to specify requirements for products or services provided by the organization. Customer satisfaction will be achieved if the product or service provided is a response to customer needs. The purpose of this study is to determine the characteristic factors associated with patient satisfaction in delivery services at Grobogan healthcare. This research used descriptive analytic method with cross sectional design. The sample of this research was 100 respondents. Data analysis included univariate analysis with presentation of frequency distribution table and bivariate analysis using Slovin. The univariate result showed that the satisfaction of customer / patient of delivery health service at healthcare in Grobogan Regency tended not to be satisfied (77%). Most respondents were dominated by patients of adult age group 26-45 years old (74%) and low-educated (77%). The result of bivariate analysis showed that there was a significant correlation on service type variables (p = 0,040) and disease history factor (p = 0,043). Suggestion writer in this research that healthcare had to improve supervision both internal and external, giving sanction for officer who was not perform task according to SOP.
The Voice of the Qur'an's Potential in Pain Management : Review Study Iwan Purnawan; Yunita Widyastuti; Sri Setiyarini; Probosuseno Probosuseno
Jurnal Berita Ilmu Keperawatan Vol 15, No 2 (2022): July 2022
Publisher : Universitas Muhammadiyah Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23917/bik.v15i2.16990

Abstract

Pain is multidimensional. Pharmacological therapy is still not optimal and has unwanted side effects. Therefore, a safe, effective, and comprehensive non-pharmacological therapy is needed to compensate for the lack of pharmacological therapy. Listening to the recitation of the Quran in several studies has been shown to have a relaxing effect in various situations. The study aims to see whether listening to the Quran as a type of non-pharmacological therapy will help people overcome pain. Method used is comprehensive search on multiple databases (Clinical Key, Cochrane Lab, Medline, Host EBSCO, ProQuest, Science Direct, and Springer Link) using the term "Quran, Holy Quran, Koran, Quran, Pain, Pain Management, and endorphins.". There were 209 articles found, and after several screening stages, 9 articles met the inclusion and exclusion criteria. The level of evidence and the Cochrane Collaboration's tool for assessing the risk of bias was used to assess the article's quality.  The result is listening to The Qur'an has been shown to reduce pain in post-surgery, blood sampling, wound care, dysmenorrhea, and childbirth. Some studies are still lacking evidence and are biased. Listening to the Quran is highly recommended for use as a health service.
Outcome Comparison Between Insulin-Dependent and Non Insulin-Dependent Patients after Open Adult Cardiac Surgery Juni Kurniawaty; Budi Yuli Setianto; Supomo Supomo; Yunita Widyastuti; Cornelia Ancilla; Cindy Elfira Boom
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 3, No 1 (2023): April 2023
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v3i1.66306

Abstract

Background: Insulin-dependent diabetic patients usually have poor glycemic control and higher risk of complications than non-insulin-dependent diabetic patients. However, the difference in clinical outcomes between these two groups of patients who underwent open cardiac surgery was not established. Therefore, this study compares the short-term outcome of insulin vs non-insulin-dependent diabetic patients after open cardiac surgery in a large-scale study.Methods: The study design was a retrospective cohort. All adults who underwent open cardiac surgery between January 1st 2016-December 31st 2020 in 4 tertiary hospitals in Indonesia were included in the study. From a total of 4.931 samples included in the study, 3.753 patients were non-diabetic (Group I) and 1.178 were diabetic (Group II). Group II was divided into subgroup IIA (930 non-insulin-dependent) and subgroup IIB (248 insulin-dependent). The main outcome was in-hospital mortality of open cardiac surgery patients.Result: In-hospital mortality between group I and II had no significant difference (6.8% vs 5.7%; p = 0.188), as well as IIA and IIB (5.6% vs 6%; p = 0.782). Multivariate analysis demonstrated that diabetes did not increase mortality of open cardiac surgery (OR 0.665; p = 0.021). In-hospital mortality of subgroup IIB was higher than subgroup IIA, but insulin therapy did not increase the risk of in-hospital mortality (OR 1.259; p = 0.464).Conclusion: Both insulin-dependent and non-insulin-dependent diabetes mellitus were not the predictors of poor short-term outcomes for open adult cardiac surgery patients.
Validation of the APACHE IV Score for ICU Mortality Prediction in Dr. Sardjito Hospital During the Pandemic Era Rayhandika; Akhmad Yun Jufan; Yunita Widyastuti; Juni Kurniawaty
Indonesian Journal of Anesthesiology and Reanimation Vol. 5 No. 2 (2023): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V5I22023.72-80

Abstract

Introduction: ICU service quality must continuously improve to provide better patient service. One of these improvement efforts is the use of a risk prediction system to predict mortality rates in the ICU by utilizing risk factors. This system helps healthcare services perform evaluations and comparative audits of intensive services, which can also aid with more targeted planning. APACHE IV is considered to have good validity. However, its predictive capabilities may change over time due to various factors, such as the pandemic, where changes in the case mix may affect its predictive abilities. Therefore, this research tests the validity of APACHE IV on the Indonesian population through Dr. Sardjito Hospital patients. The findings can be utilized for future use and risk stratification, and ICU quality benchmarking. Objective: This study aims to assess the validity of the APACHE IV score in ICU Mortality prediction in Dr. Sardjito Hospital for medical patients, surgical patients, and patients with both cases during the pandemic. Methods: This study used retrospective data from 336 patients at Dr. Sardjito Hospital Yogyakarta from the 1st of January 2020 to the 31st of December 2021. All data required for calculating the APACHE IV score was collected, and the patient's observed ICU Mortality was used. The model's predictive validity is measured by finding the discrimination and calibration of the APACHE IV score and comparing it to the observed ICU mortality. Validation was also conducted separately for medical and surgical cases. Results: APACHE IV shows good discrimination ability in all cases (AUC-ROC 95% CI: 0.819 [0.772-0.866]) but poor calibration (p = 0.023) for mortality prediction in the ICU. For medical cases, the discrimination ability is poor but still acceptable (AUC-ROC 95% CI: 0.698 [0.614-0.782]), and in surgical cases, the discrimination ability is good (AUC-ROC 95% CI: 0.848 [0.776-0.921]). Both cases showed good calibration (p: medical = 0.569, surgical = 0.579) in predicting mortality during the pandemic. Conclusion: APACHE IV showed good discrimination but poor calibration ability for predicting mortality for all ICU patients during the pandemic era. Mortality prediction for surgical cases showed good discrimination and calibration. However, medical cases showed poor discrimination but good calibration.
Faktor-faktor yang Mempengaruhi Pemanjangan Lama Rawat Intensif Pasien Atresia Bilier Pediatrik yang Menjalani Operasi Kasai di RSUP Dr Sardjito Muhammad Brian Ristianto; Yunita Widyastuti; Djayanti Sari
Jurnal Anestesi Perioperatif Vol 12, No 1 (2024)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v12n1.3411

Abstract

Atresia bilier merupakan kelainan pada neonatus yang menyebabkan gagal hepar progresif dan kematian bila tidak ditangani. Operasi Kasai merupakan penanganan atresia bilier melalui pembuatan anastomosis untuk drainase empedu. Pemanjangan lama rawat pascaoperasi Kasai meningkatkan morbiditas dan mortalitas. Penelitian ini bertujuan menemukan faktor-faktor yang memengaruhi pemanjangan lama rawat intensif pascaoperasi Kasai. Penelitian ini merupakan studi observasional kohort retrospektif pada pemanjangan lama rawat intensif pasien atresia bilier pediatrik yang menjalani operasi Kasai di RSUP Dr. Sardjito dari 1 Januari 2017 hingga 31 Desember 2021. Terdapat 33 dari 52 sampel (64%) mengalami pemanjangan lama rawat intensif. Uji statistik dilakukan dengan uji regresi logistik univariat dan uji regresi logistik multivariat bagi parameter yang signifikan pada uji sebelumnya (p<0,25). Didapatkan sepsis (OR=39,2) dan malnutrisi (OR=7,55) signifikan memengaruhi pemanjangan lama rawat intensif pascaoperasi Kasai. Simpulan, Sepsis dan malnutrisi signifikan memengaruhi pemanjangan lama rawat intensif pasien atresia bilier pediatrik yang menjalani operasi Kasai masing-masing sebanyak 39 dan 7,5 kali. 
Hubungan Kegawatdaruratan dengan Teknik Anestesi pada Plasenta Akreta di RSUP H. Adam Malik Medan Fadinie, Wulan; Fajar Apsari, Ratih Kumala; Uyun, Yusmein; Widyastuti, Yunita; Kurniawaty, Juni
Jurnal Anestesi Obstetri Indonesia Vol 7 No 1 (2024): Maret
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v7i1.172

Abstract

Latar Belakang: Plasenta akreta dapat terjadi selama kehamilan karena implantasi plasenta yang tidak normal, dengan anestesi neuraksial saat ini lebih umum digunakan dalam persalinan seksio sesarea untuk kasus ini.Tujuan: Penelitian bertujuan untuk menilai hubungan antara kegawatdaruratan dan teknik anestesi pada kasus plasenta akreta di RSUP H. Adam Malik Medan.Subjek dan Metode:Melibatkan analisis deskriptif kohort retrospektif menggunakan data sekunder dari rekam medis pasien plasenta akreta di RSUP H. Adam Malik Medan dari 2020 hingga 2023.Hasil: Hasil dari 200 sampel terungkap adanya hubungan antara kegawatdaruratan dan teknik anestesi. Ditemukan bahwa kasus emergensi terjadi pada 70,6% dari pasien yang menggunakan anestesi umum dan 44,9% dari pasien yang menggunakan anestesi neuraksial. Sedangkan kasus elektif terjadi pada 29,4% dari pasien yang menggunakan anestesi umum dan 55,1% dari pasien yang menggunakan anestesi neuraksial.Simpulan: Pemilihan teknik anestesi, baik anestesi umum maupun neuraksial, dipengaruhi oleh kegawatdaruratan dalam persalinan seksio sesarea pada kasus plasenta akreta.
Peran Mahasiswa Muslim Dalam Mengembangkan Edukasi Agama Denaldi Rananda Saputra; Romeo Putra Dirama; Fauzan Imani Ardanto; Yunita Widyastuti; Amelia Ananda Putri Lestari; Erwin Kusumastuti
Jurnal Manajemen dan Pendidikan Agama Islam Vol. 2 No. 5 (2024): September : Jurnal Manajemen dan Pendidikan Agama Islam
Publisher : Asosiasi Riset Pendidikan Agama dan Filsafat Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61132/jmpai.v2i5.481

Abstract

Edukasi agama adalah bagian integral dari pendidikan yang bertujuan untuk mengembangkan dan meningkatkan pemahaman, kesadaran, dan praktik spiritual dalam kehidupan dunia. Mahasiswa merupakan salah satu bagian yang berpengaruh dalam mengembangkan edukasi agama. Peran mahasiswa dalam mengembangkan edukasi agama sangat penting karena mereka merupakan agen perubahan sosial yang memiliki potensi besar untuk dapat mempengaruhi masyarakat di lingkungannya. Penelitian ini bertujuan untuk mengkaji peran mahasiswa dalam mengembangkan edukasi agama dalam konteks masyarakat modern. Di zaman sekarang, nilai-nilai keagamaan sering dihadapkan pada tantangan dan perubahan, di mana era yang semakin modern, banyak generasi muda tidak tertarik dengan meningkatkan kapasitas pengetahuan dalam ilmu agama. mahasiswa dianggap sebagai agen perubahan sosial yang memiliki potensi besar untuk memengaruhi masyarakat sekitarnya agar dapat meningkatkan pemahaman dan kesadaran pentingnya ilmu agama. Studi ini mencermati berbagai peran yang dapat dimainkan oleh mahasiswa dalam konteks pengembangan edukasi agama. Melalui pendekatan deskriptif kualitatif, penelitian ini mengidentifikasi peran-peran kunci yang dimainkan oleh mahasiswa dalam pengembangan edukasi agama.
Validity of Acute Physiology and Chronic Health Evaluation (APACHE) IV for the Prediction of Prolonged Intensive Care Unit (ICU) Length of Stay in Dr. Sardjito General Hospital in the COVID Era Muhammad Mufti Sofyanoor; Widyastuti, Yunita; Juni Kurniawaty; Djayanti Sari
Journal of Anesthesiology and Clinical Research Vol. 4 No. 2 (2023): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jacr.v4i2.302

Abstract

Introduction: APACHE IV was a good predictor of ICU length of stay in the USA and some countries outside the USA but poor in others. It is important to develop a scoring system for the Indonesian population, especially in this scope, Dr. Sardjito General Hospital. To develop such a scoring system, it is reasonable to study the validity of APACHE IV in ICU Dr. Sardjito General Hospital for predicting prolonged length of stay. Methods: A retrospective cohort observational study using data from January 1st, 2020, to December 31st, 2020, taken from the ICU of Dr. Sardjito General Hospital. The data are the patient's observed ICU LOS and data required in calculating APACHE IV score and ICU LOS prediction. Discrimination is calculated using the area under (AUC) the receiver operating characteristic curve (ROC) and calibration by the Hosmer-Lemeshow test. Results: Samples were 329 patients. APACHE IV ICU length of stay prediction showed moderate discriminatory ability (AUC-ROC: 0.74) and poor calibration (p <0.001) to predict prolonged ICU stay. The APACHE IV score has a strong discriminatory ability (AUC-ROC: 0.83). Using the DeLong method, the AUC from ROC APACHE IV score was greater than the AUC from ROC predicted length of stay in APACHE IV ICU (p <0.001). APACHE IV predicted ICU length of stay overestimated observed ICU length of stay. Conclusion: APACHE IV ICU length of stay prediction has moderate discrimination and poor calibration to predict prolonged ICU stay. The APACHE IV score has better discrimination than the APACHE IV ICU length of stay prediction in predicting prolonged ICU stay.
Co-Authors . Supomo Adhinugroho, Sudjati Adi, Danis Woro Kuncoro Akhmad Yun Jufan Alqustar, Adam Amelia Ananda Putri Lestari Anggraini, Diana Arifin, Achmad Reza Atmanagara, Dikho Atmojo, Danang Dwi Beni Indra, Beni Bhirowo Yudo Pratomo Budi Yuli Setianto Calcarina Fitriani Retno Wisudarti Cindy Elfira Boom Cornelia Ancilla Darwito, Darwito Denaldi Rananda Saputra Djajantisari Djayanti Sari Ekuarianto, Donny Erwin Kusumastuti Fadhilah Zulfa Fadinie, Wulan Fauzan Imani Ardanto Fauzi, Rizqi Ahmad Febrianti, Skolastika Rani Firman Ardiansyah Getar M, Geza Getar M Givano, Muhamad Randy Gunawan, Fanny Handayani, Donna Hartono, Dedy hendra, hendra hermawan Hernandes, Crodia Hernawan, Agung Diky Hidayat, Fachsyar Ika Puspitasari Ilman, Pesiar Iwan Purnawan Iwan Purnawan Juni Kurniawaty Muhdar Abubakar Djayanti Sari Khoeri, Fatkhur Roofi Krisdiyantoro, Nova Kurniawan, Novianto Mahmud Mahmud Muhammad Brian Ristianto Muhammad Mufti Sofyanoor Napitu, Annika Ngahu, Robby Mesakh Novianto Kurniawan Nugraha, Achmad Fauzani Nur Azza, Kamala Kan Prakosa, Nur Hamam Primastuti, Githa Rizki Priyadi Nugraha P Probosuseno Probosuseno Probosuseno, P Ramsi, Irhash Faisal Ratih Kumala Fajar Apsari Rayhandika Ridha, Ihsanur Rizki, Gilar Romeo Putra Dirama Rumpoko, Triaji Mudo Ruth Sally Sarosa, Pandit SATRIYAS ILYAS Siti Helmyati Sri Rahardjo Sri Setiyarini SRI SETIYARINI, SRI Sudadi Suhanda, Rellig Maret Susi Handayani Taneo, Desy Chery Marlyn Tjokronolo, Yudistira Tomo, Wahyu Kartiko Untung Widodo Untung Widodo, Untung Wardhana, Ardyan Prima Wikantama, Aswin Wisudarti, Calcarina Fitri Retno YP, Bhirowo Yusmein Uyun Zahroh Shaluhiyah