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All Journal Jurnal Anestesiologi Indonesia Jurnal Kesehatan Masyarakat Jurnal Anestesi Perioperatif Jurnal Kesehatan Andalas Jurnal Berita Ilmu Keperawatan Indonesian Journal of Anesthesiology and Reanimation (IJAR) Jurnal Anestesi Obstetri Indonesia Solo Journal of Anesthesi, Pain and Critical Care Journal of Anesthesiology and Clinical Research Jurnal Berita Ilmu Keperawatan Academic Hospital Journal Jurnal Manajemen dan Pendidikan Agama Islam Jurnal Komplikasi Anestesi
Yunita Widyastuti
Department Of Anesthesiology And Intensive Care, Faculty Of Medicine, Public Health, And Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
Religion Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Decision Sciences, Operations Research & Management Dentistry Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Determinan Prolonged Length Of Stay (PLOS) ICU pada Pasien Pediatrik yang Menjalani Pembiusan Di Masa Pandemi Covid-19 Hernawan, Agung Diky; Sari, Djayanti; Widyastuti, Yunita
Jurnal Komplikasi Anestesi Vol 10 No 2 (2023): Volume 10 Number 2 (2023)
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.v10i2.8300

Abstract

Background: In Indonesia, the utilization of ICU is not balanced, due to the limited ICU space or the length of time ICU patient care. ICU services include patients with organ dysfunction or post-anesthesia patients, especially pediatrics. Period 1 March 2020 Indonesia was hit by the COVID-19 pandemic. The need for ICU space increases, most of the infected patients fall into respiratory failure conditions both adults and pediatrics. Problems that are interconnected and become the basis for researchers in determining the determinants of PLOS ICU are post-anesthesia pediatric patients who need ICU care, limited ICU space and the problem of the COVID-19 pandemic. Objective: To identify the determinant factors of ICU Prolonged Length of Stay (PLOS) in pediatric patients undergoing anesthesia during the COVID-19 pandemic. Method: This research is a retrospective cohort observational study. The study sample was 173 pediatric patients undergoing anesthesia and postoperative care in the ICU at Dr Sardjito General Hospital for the period April 2020 - March 2021. The variables were tested using Student's t-test for numerical data, Chi square test for categorical/dichotomous data. The results of p <0.25 were followed by a logistic regression test. The results of p<0.05 were entered into the multivariate analysis and were considered significant. Results: The factors identified as the determinants of PLOS in the ICU Dr. Sardjito General Hospital were major surgery with a P value of 0.048 (OR 8.87), blood transfusions with a P value of 0.019 (OR 2.34) and mechanical ventilation with a P value of 0.010 (OR 3.44) ) is the most significant variable on PLOS in the ICU with a p<0.05. Conclusion: Major surgery, blood transfusions and mechanical ventilation/ventilators are the determinants of PLOS in the ICU of Dr. Sardjito General Hospital, pediatric patients undergoing anesthesia during the COVID-19 pandemic
Tatalaksana Nyeri Postoperatif pada Infant Widyastuti, Yunita; Sari, Djayanti; Hernandes, Crodia
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.v5i2.8311

Abstract

Postoperative acute pain is an unavoidable problem in postoperative conditions. Effective relief of pain is of the most importance to treating patients undergoing surgery. Effective pain management has significant physiological benefits. Manyways for pain management, althought opioid is general pain management and Regional block is a popular techniques in paediatric pain management recently, wether for surgery or need of adequate analgesic condition.
Hubungan Kadar Awal D-Dimer Terhadap Mortalitas pada Pasien COVID-19 Di RSUP Dr. Sardjito Alqustar, Adam; Kurniawaty, Juni; Widyastuti, Yunita
Jurnal Komplikasi Anestesi Vol 10 No 1 (2022): Volume 10 Number 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.v10i1.8325

Abstract

In severe COVID-19 infection, the immune response can be exaggerated andcause a systemic cytokine storm that triggers systemic inflammatory responsesyndrome (SIRS). Excessive systemic inflammatory response can lead to systemicendothelial injury (endotheliopathy) and a hypercoagulable state that increasesthe risk of systemic macrothrombosis and microthrombosis. D-dimers arereleased when plasmin, a fibrinolytic enzyme, breaks down fibrin and is areflection of the endovascular thrombosis process. Assessment of circulating Ddimer concentrations is a sensitive test for diagnosing thrombotic status(including pulmonary embolism and DIC) and predicting mortality event inpatient contracted with COVID- 19
Hubungan Neutrophil-Lymphocyte Ratio (NLR) Terhadap Mortalitas dan Lama Rawat Inap Pasien COVID-19 Di RSUP Dr. Sardjito Khoeri, Fatkhur Roofi; Sari, Djayanti; Widyastuti, Yunita
Jurnal Komplikasi Anestesi Vol 10 No 1 (2022): Volume 10 Number 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.v10i1.8326

Abstract

Background: COVID-19 is a viral-caused disease which has become pandemic disease with broad clinical manifestation. Neutrophyl Lymphocyte Ratio (NLR) may represent immune system dysregulation, a warning sign in mild COVID-19 patient and was predicted to have relation to mortality and length of stay. NLR is a simple blood test and applicable in daily clinical practice. Method: This study is an observational, cohort retrospective by taking secondary data from confirmed COVID-19 patient’s medical record during April 2020 – Maret 2021. NLR cut-off point was concluded using ROC and Youden’s Index. Survival Kaplan Meier analysis was used to determine the relation between NLR, mortality, and length of stay (LOS). This relation was analyzed using univariat and Cox regression multivariat analysis Method: This study is an observational, cohort retrospective by taking secondary data from confirmed COVID-19 patient’s medical record during April 2020 – Maret 2021. NLR cut-off point was concluded using ROC and Youden’s Index. Survival Kaplan Meier analysis was used to determine the relation between NLR, mortality, and length of stay (LOS). This relation was analyzed using univariat and Cox regression multivariat analysis. Result: 273 samples was included in the study. With 7,62 cut-off point, it was found that 190 samples had NLR <7,62 and 83 samples had NLR >7,623. Multivariat analysis shown that samples with higher NLR independently and significantly had higher mortality risk (HR 3,345, p<0,001). Samples with NLR > 7,62 significantly had longer LOS (23 vs 19 days, respectively). However, multivariat analysis shown that NLR did not correlate with LOS (p=0,090). Summary: High NLR >7,62 independently and significantly correlate with higher mortality risk. Univariat analysis shown that higher NLR correlate with LOS in COVID-19 patients, but did not affect LOS.
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 (2022): Volume 9 Number 3 (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.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.
Rotasi Opioid dan Manajemen Nyeri pada Pasien Cancer Pain Akibat Kanker Serviks Stadium 4 dan Fistula Rectovagina Mahmud; Widyastuti, Yunita; Atmanagara, Dikho
Jurnal Komplikasi Anestesi Vol 9 No 3 (2022): Volume 9 Number 3 (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.v9i3.8337

Abstract

Pain is an unpleasant experience that will be felt by almost all cancer patients, which can result in reduced quality of life for cancer patients. Administration of opioid analgesics by increasing the dose to achieve the expected analgesia potentially followed by harmful side effects to the patient. In this situation, it is necessary to rotate the opioid to obtain an adequate dose of analgesia without increasing the risk of using the opioid. We present a case report of severe cervical cancer pain not controlled by oral opioid administration. The patient was assessed for the degree of pain and opioid rotation to control the cancer pain. After the rotation of opioids, it was found that pain was controlled by giving the new type and route of the opioid.
Identifikasi Faktor Risiko Kematian di ICU RSUP Dr. Sardjito Ardiansyah, Firman; Widyastuti, Yunita; Jufan, Akhmad Yun
Jurnal Komplikasi Anestesi Vol 9 No 2 (2022): Volume 9 Number 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.v9i2.8345

Abstract

Background: ICU is one of patients care unit that is costly and have limited capacity. Thus, time spending, man resources and tools should be allocated wisely based on the needs of the patients that would be admitted to ICU. One of the means that can be used to increase care quality of the ICU is creating a risk prediction system to assess and analyze risk factors that associated with mortality in ICU. This system makes comparative assessment and intensive care evaluation can be done. For the first step, we need to identify risk factors that affect mortality in ICU, that can be used as a new scoring models. Methods: This study based on 356 patients that admitted to ICU RSUP dr. Sardjito from 1 January to 31 December 2019. In this cohort retrospective study, variables will be tested with regression logistics test, with univariable and multivariable approach. From this test, we achieved variables that identified as risk factors of mortality in ICU. Those identified variable undergo assessment of strength as a predictor with Area Under The Curve (AUC) method. If we find that, the discrimination strength is quite strong, we continue the test with calibration test using Hosmer-Lemeshow to achieve compoarative value within observed and expected mortality. The whole statistic process use SPSS application version 26.0. Results: Factors that identified as risk factors for mortality in the ICU Dr.Sardjito Hospital were intraoperative use of vasopressor/inotropic drugs drugs, respiratory failure, GCS (Glasgow Coma Scale) decrease, kidney failure and intraoperative PRC transfusion with p < 0.005 in both univariable and multivariable tests. The AUC for mortality prediction in this study was 0.896 (95% CI; 85,3-94%). This value is classified as strong as a predictor factors, so it is continued to the calibration test with Hosmer-Lemeshow test and showed a p value of 0.53 (p > 0.05) which means that this risk prediction factors has a good fit between the observed and the expected. Conclusion: The intraoperative use of vasopressor/inotropic drugs, respiratory failure, GCS decrease, kidney failure and intraoperative PRC transfusion are predictive factors for mortality in the ICU Dr.Sardjito Hospital. The discrimination ability of these factors is strong and also have a good fit in predicting the incidence of mortality in the ICU Dr.Sardjito Hospital.
Efek Pemberian Priming Fentanil 1 Μg/Kgbb Terhadap Insidensi Batuk Pasca-Preemptif Analgesia Fentanil 2μg/KgBB di RSUP Dr. Sardjito Prakosa, Nur Hamam; Uyun, Yusmein; Widyastuti, Yunita
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.v8i2.8360

Abstract

Background: Fentanyl is an opioid analgesic that is almost always used in patients undergoing general anesthesia. The use of intravenous fentanyl can cause a cough effect known as fentanyl-induced cough (FIC). Although there have been many studies conducted to reduce the incidence of cough after injection of fentanyl intravenously both pharmacologically and nonpharmacologically, standard therapy has not been established to prevent coughing. Method: Randomized clinical trial with double blindness. The sample was chosen using the non-probability sampling method in a consecutive manner until the sample was fulfilled. Age range 18-65 years, with ASA III physical status, non-active smokers undergoing elective surgery with general anesthesia at Dr. Sardjito General Hospital will be grouped into 2 groups, one group of a priming dose of fentanyl 1 μg/kgbb and the control group without priming dose of fentanyl. Both groups received total fentanyl 2 μg/kgbb with an injection speed of 0.5 cc per second. Data analysis to determine differences in the incidence of cough between the two treatment groups with outcomes in the form of mild cough, severe cough, or not coughing, then the chi-square test is used when the requirements are met. Secondary outcomes and side effects of fentanyl administration were also assessed.is performed Result. Incidence of fentanyl-induced cough (FIC) in the treatment group using priming dose of fentanyl 1 μg/kgbb was 2 patients (2.7%), while the incidence of cough in the group without priming dose of fentanyl was 11 patients (15.1%) with p = 0.009 meaning that there was a statistically significant difference. All patients with cough incidence were in the mild cough category, both in the priming dose of fentanyl group as many as 2 patients and 11 patients in group without priming dose of fentanyl. There is no statistically significant difference in the incidence of apnea, and bradycardia Conclusion. The use of 1 μg/kgbb priming dose of fentanyl can reduce the incidence of cough after fentanyl 2 μg/kgbb analgesia at an injection rate of 0.5 cc per second
Manajemen Jalan Nafas pada Pasien dengan Sindroma Crouzon Sari, Djayanti; Widyastuti, Yunita; Hidayat, Fachsyar
Jurnal Komplikasi Anestesi Vol 8 No 3 (2021): Volume 8 Number 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.v8i3.8369

Abstract

Crouzon syndrome is a congenital disorder that prevents premature closure of the coronal suture (synostosis), or, less commonly, the sagittal or lambdoidal suture of the cranium. This results in a skull dysmorphic appearance of the skull and face, with a high forehead, flattened occiput, and brachycephaly. Inaddition to craniosynostosis, affected children may also experience an abnormal fusion of the skull base and central bones, resulting in maxillary hypoplasia, high arched palate, and shallow orbits, causing protruding exophthalmos. These abnormalities in facial features can have implications for managing a difficult airway. A 4-year-old woman with a head complaint from the age of 1 year. The patient has a history of being diagnosed with Crouzon syndrome
Enhanced Recovery After Surgery (ERAS) pada Pediatrik yang Menjalani Operasi Kolorektal Pratomo, Bhirowo Yudo; Widyastuti, Yunita; Ilman, Pesiar
Jurnal Komplikasi Anestesi Vol 8 No 3 (2021): Volume 8 Number 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.v8i3.8376

Abstract

Enhanced recovery after surgery (ERAS) was first described by Henrik Kehlet as a tool for optimizing perioperative care. The general scope of ERAS includes perioperative counseling, limiting the fasting hours before surgery, postoperative enteral intake, early mobilization, use of non-opioid pain medications, and restriction of intravenous fluids, drainage, and catheters. Colorectal surgery in pediatrics has a higher infection rate in the surgical area than in adults, thereby the implementation of ERAS in this operation canhave a big impact. There are few studies on the implementation of ERAS in pediatrics. Despite that, the available data shows the implementation of ERAS in pediatrics undergoing colorectal surgery is positive.
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