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All Journal Jurnal Anestesiologi Indonesia Jurnal Anestesi Perioperatif Majalah Kesehatan FKUB Jurnal Respirologi Indonesia Journal of Anaesthesia and Pain Journal of Anesthesiology and Clinical Research Majalah Anestesia & Critical Care (MACC)
Arie Zainul Fatoni
Universitas Brawijaya- RSUD Dr. Saiful Anwar, Malang
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Acute Respiratory Distress Syndrome (ARDS) pada Pneumonia COVID-19 Arie Zainul Fatoni; Ramacandra Rakhmatullah
Journal of Anaesthesia and Pain Vol 2, No 1 (2021): January
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2021.002.01.02

Abstract

Coronavirus disease 2019 (COVID-19) merupakan penyakit pernafasan akut yang ditandai dengan pneumonia dan gagal paru-paru. Agen penyebab COVID-19 telah dikonfirmasi sebagai virus korona baru, yang sekarang dikenal sebagai severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Acute respiratory distress syndrome (ARDS) adalah salah satu komplikasi COVID-19 yang paling sering dengan angka kematian yang cukup tinggi. ARDS muncul sebagai salah satu gambaran disfungsi organ pada fase hiperinflamasi COVID-19. Patofisiologi dan manifestasi klinis ARDS yang disebabkan COVID-19 memiliki perbedaan dengan ARDS pada umumnya. Oleh sebab itu, kami merekomendasikan manajemen ARDS pada COVID-19 disesuaikan dengan tipe ARDS yang terjadi sehingga dapat memperoleh luaran yang baik
Effective Enteral Treatment of Antibiotic for Patient with Respiratory Failure and Septic Shock in the Intensive Care Unit Maya sari; Wiwi Jaya; Arie Zainul Fatoni
Journal of Anaesthesia and Pain Vol 2, No 3 (2021): September
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2021.002.03.03

Abstract

Background: Pneumonia is a lung infection involving pulmonary alveoli caused by microbes, including bacteria, viruses, and fungi. It is a major infection that causes hospitalization and death worldwide and exacts an enormous cost in economic and human terms. The study to assess clinical outcomes for a critically ill patient treated with an enteral antibiotic for bacterial pneumonia is still limited.Case: We reported a case of pneumonia from 68 years old patient that caused respiratory failure and septic shock in the intensive care unit treated by enteral antibiotic and had a good outcome.Conclusion: Pneumonia can cause respiratory failure and septic conditions. Optimum antibiotic management is one of the methods to solve this problem. The benefit of utilizing enteral antibiotics is substantial and probably appropriate in certain patients.
Hubungan Faktor Sosiodemografi dengan Angka Kejadian Nyeri Kronik pada Pasien Pasca Operasi Bedah Mayor di Rumah Sakit Dr. Saiful Anwar Malang Trianna Mailawati; Ristiawan Muji Laksono; Arie Zainul Fatoni
Journal of Anaesthesia and Pain Vol 1, No 1 (2020): January
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2020.001.01.01

Abstract

Latar belakang: Nyeri kronik pasca bedah mayor merupakan komplikasi bermakna pada sebagian besar pasien.  Faktor sosiodemografi menjadi salah satu perhatian dalam prevalensi kejadian nyeri kronik pasca bedah mayor dan belum ada data mengenai angka kejadian nyeri kronik dan faktor yang mempengaruhinya di Indonesia, khususnya di Malang. Penelitian ini bertujuan untuk mengetahui hubungan faktor sosiodemografi seperti usia, jenis kelamin, pendidikan, dan tingkat pendapatan terhadap angka kejadian nyeri pasca bedah.Metode: Penelitian ini tergolong penelitian epidemiologi analitik dengan metode cross sectional pada 123 pasien yang menjalani operasi elektif bedah mayor di RS Dr. Saiful Anwar Malang periode Juli-Desember 2018. Penelitian dilaksanakan dengan metode wawancara pada responden. Variabel penelitian ini yaitu usia, jenis kelamin, tingkat pendidikan dan  tingkat pendapatan. Data yang diperoleh dianalisa dengan menggunakan uji korelasi Spearman pada SPSS 25.0.Hasil: Sebanyak 66 subjek tidak mengalami nyeri kronik dan 57 subjek mengalami nyeri kronik pasca bedah mayor. Tingkat pendidikan memiliki hubungan yang signifikan dengan dengan angka kejadian nyeri kronik (p=0,038). Akan tetapi hubungan yang terjadi bersifat lemah  (koefisien korelasi Spearman =0,187). Faktor sosiodemografi di antaranya usia, jenis kelamin dan pendapatan tidak berhubungan dengan angka kejadian nyeri kronik pasca bedah mayor (p>0,05).Kesimpulan: Faktor tingkat pendidikan memiliki hubungan yang bersifat lemah dengan angka kejadian nyeri kronik pasca operasi bedah mayor. Akan tetapi, faktor sosiodemografi seperti usia, jenis kelamin, dan pendapatan tidak berhubungan dengan angka kejadian nyeri kronik pasca operasi bedah mayor.
Manajemen Nyeri Akut Pasca-Kraniotomi Razi Ageng Pratama; Buyung Hartiyo Laksono; Arie Zainul Fatoni
Journal of Anaesthesia and Pain Vol 1, No 3 (2020): September
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2020.001.03.04

Abstract

Kraniotomi adalah sebuah prosedur operasi umum divisi bedah saraf yang melibatkan pembuatan lubang yang cukup pada tempurung kepala atau tengkorak (cranium) untuk akses optimal ke intrakranial. Nyeri pasca kraniotomi adalah komplikasi berulang dari prosedur bedah saraf dan sulit untuk dikelola. Manajemen nyeri akut sangat penting untuk menghindari terjadinya nyeri kronik serta komplikasi seperti hipertensi dan muntah, yang dapat menyebabkan peningkatan tekanan intrakranial maupun perdarahan intrakranial, outcome pasien yang tidak baik, dan perpanjangan masa rawat inap. Pemilihan obat dalam manajemen nyeri akut pasien pasca kraniotomi merupakan hal yang sangat penting dikarenakan dapat menentukan morbiditas dan mortalitas pasien.
Emboli Paru pada COVID-19 Arie Zainul Fatoni; Nasywa Florean Dzakiyyah; Christian Ambrosius Soeiono
Majalah Anestesia & Critical Care Vol 39 No 3 (2021): Oktober
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif (PERDATIN) / The Indonesian Society of Anesthesiology and Intensive Care (INSAIC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1317.659 KB) | DOI: 10.55497/majanestcricar.v39i3.212

Abstract

COVID-19 adalah sebuah penyakit menular yang disebabkan oleh severe acute respiratory syndrome coronavirus-2 (SARS-CoV- 2) dan telah dinyatakan sebagai pandemi oleh WHO. Spektrum klinis penyakit ini begitu luas, mulai dari asimtomatik hingga Acute Respiratory Distress Syndrome (ARDS). Pada penyakit COVID-19, terdapat keadaan gangguan hiperkoagulabulitas dan hiperinflamasi/ cytokine storm, yang dapat menimbulkan komplikasi berupa emboli paru (EP). Gejala yang muncul biasanya berupa sesak, batuk, dan nyeri pleuritic; dengan tanda berupa takipneu, takikardi, dan sianosis pada keadaan yang parah. Penegakkan diagnosis emboli paru dilakukan berdasarkan temuan klinis dan pemeriksaan penunjang. Sampai sekarang belum ada bukti yang cukup terkait penggunaan marker tertentu sebagai acuan diagnosis klinis dari EP. Berbagai ssistem skoring pun dibuat sebagai panduan untuk diagnosis dan juga sebagai upaya dalam melakukan stratifikasi risiko. Manajemen emboli paru pada COVID-19 dibagi menjadi dua, yaitu terapi profilaksis dan terapeutik, baik secara farmakologis maupun non farmakologis. Prognosis EP COVID-19 lebih baik apabila dilakukan diagnosis dini dan tatalaksana dini berhasil dilakukan.
Management of Respiratory Failure in Patients with COVID-19 and Multiple Myeloma Slamet Hadi Santoso; Arie Zainul Fatoni
Journal of Anaesthesia and Pain Vol 3, No 3 (2022): September
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2022.003.03.03

Abstract

Background: Cancer patients have higher risk of getting COVID-19. Individuals with malignancy who infected COVID-19 often underwent prolonged hospitalization or death. Here, we report respiratory failure management of of COVID-19 patient with multiple myeloma (MM).Case: A 66-year-old man came with complaints of shortness of breath. The patient was intubated and treated in the intensive care COVID. Patients with a history of multiple myeloma and who have chemotherapy cycle. The laboratory results showed an increase in markers of inflammation, hypoalbuminemia, and bicytopenia. The results of the polymerase chain reaction swab were positive.  There are 4 managements in this patient, airway management: intubation and ventilator settings using the Lung Protective Strategy principle. Management Breathing: administration of antibiotics according to sputum culture results. Circulation Management: Fluid management using a non-invasive Contractility Index (ICON) monitor. Management of Disability: Spontaneous Awakening Trial (SAT) and Spontaneous Breathing Trial (SBT) when the aggravating disease has been handled.Conclusion: Management of respiratory failure in patients with multiple myeloma and COVID-19 infection is primarily focused on supportive care such as airway management, breathing management, fluid management and disability management.
Laporan Kasus: MAKROADENOMA HIPOFISIS FUNGSIONAL DENGAN MANIFESTASI AKROMEGALI DAN DIABETES MELITUS TIPE LAIN YANG TIDAK TERKONTROL Della Fitricana; Ardianto Ardianto; Alwi Shahab; Yuliato Kusnadi; Ratna Maila Dewi; Anugrah Onie; Yoan Levia Magdi; Arie Zainul Fatoni
Majalah Kesehatan Vol. 9 No. 4 (2022): Majalah Kesehatan
Publisher : Faculty of Medicine Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/majalahkesehatan.2022.009.04.6

Abstract

Akromegali merupakan penyakit yang sangat jarang dan sering tidak disadari, sehingga menimbulkan keterlambatan diagnosis serta munculnya komplikasi sistemik. Peningkatan kadar growth hormone pada pasien akromegali menyebabkan munculnya penyakit diabetes mellitus (DM). Laporan kasus ini bertujuan untuk  membahas makroadenoma hipofisis fungsional dengan manifestasi akromegali dan diabetes melitus tipe lain yang tidak terkontrol. Laki-laki berusia 39 tahun dirujuk ke RS Dr. Mohammad Hoesin karena DM yang tidak terkontrol, sering sakit kepala, nyeri di tangan dan kaki serta pandangan mata kabur. Pasien merasakan perubahan pada tubuh yang bertambah besar sejak tahun 2004. Pada tahun 2018 pasien mulai menderita DM dengan terapi insulin yang dosisnya meningkat bertahap. Pada pemeriksaan fisik dijumpai gambaran khas akromegali mulai dari muka serta jari tangan dan kaki. Pemeriksaan mata dengan tes Humprey didapatkan gangguan lapangan pandang pada kedua mata. Pemeriksaan penunjang didapatkan kadar insulin-like growth factor-1 (IGF-1) yang sangat tinggi dan gambaran massa di hipofisis yang berukuran 32 x 22 x 28 mm. Pasien menjalani operasi transpheonidal (TSS) dengan hasil pemeriksaan patalogi didapatkan suatu adenoma hipofisis. Pasien didiagnosis dengan akromegali oleh karena makroadenoma hipofisis fungsional dengan DM tipe lain. Lima hari setelah operasi pasien didapatkan kebocoran liquor cerebro spinal (LCS) dan kembali dilakukan operasi untuk mengatasi kebocoran LCS. Pasien menderita DI permanen setelah 2 minggu setelah operasi. Setelah TSS didapatkan ukuran tumor berkurang sekitar 54% dan pasien mendapat terapi lanjutan somatostatin analogs (SSA) octretide long-acting release (LAR). Kondisi post TSS terjadi perbaikan klinis dan kadar gula darah.  
Intravenous Immunoglobulin (IVIG) Therapy for COVID-19 Omicron (B.1.1.529) Variant with Acute Respiratory Distress Syndrome Dewi Arum Sawitri; Arie Zainul Fatoni
Journal of Anaesthesia and Pain Vol 4, No 1 (2023): January
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2023.004.01.04

Abstract

Background: COVID-19 become the pandemic and infect more than million people. The World health organization and other clinical institutions have not yet established a definitive therapy to treat this disease due to a rapid virus mutation and anomaly.Case: A 78-year-old man who had previously confirmed COVID-19 was referred to the COVID-19 intensive care unit (ICU), the patient had geriatrics comorbid, cerebrovascular accident (CVA) infarction, and hypertension. The patient came with unresponsive awareness, and complaints of right hemiparesis and dysarthria. Other symptoms included cough, shortness of breath, and fever. Shortness of breath aggravates, blood pressure increases, and SpO2 was 86%. We decide intubated the patient because have a sign of respiratory distress. Patients receive standard therapy for COVID-19. On the second day, patient receive intravenous immunoglobulin (IVIG) gamaras 20 g. IVIG therapy perform for five days. On the fifth day of treatment in the ICU, the patient’s complaints had decreased and the patient breathed spontaneously with high flow nasal cannula (HFNC).Conclusion: Intravenous immunoglobulin (IVIG) therapy on the COVID-19 Omicron variant patient with ARDS produce a positive outcome. Patients treat with IVIG for 5 days show an improvement in breathing, laboratory result and chest x-ray. 
Convalescent Plasma Therapy in COVID-19 Patients with Acute Respiratory Distress Syndrome (ARDS) Dewi Arum Sawitri; Arie Zainul Fatoni
Jurnal Respirologi Indonesia Vol 43, No 2 (2023)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v43i2.413

Abstract

COVID-19 is caused by SARS-CoV-1, an RNA virus of the betacoronavirus genus, making it the seventh coronavirus infecting humans. Because particular therapies are still in the research stage, no confirmed treatment for this illness has been agreed upon by the World Health Organization (WHO) or other clinical institutes. The reason is that there are many different potential remedies. Antiviral treatments like favipiravir, oseltamivir, and remdesivir have been investigated and tested. On the other hand, the outcomes of the replies of patients who were given these medications are still quite inconsistent. Furthermore, the COVID-19 mortality rate has remained at a level of less than 5.21 percent of cases that have been documented. Patients suffering from COVID-19 may be treated with convalescent plasma, a therapeutic option that utilizes a mix of neutralizing antibodies and other immunological components. Activation of body-dependent cellular cytotoxicity (ADCC) and phagocytic activity against COVID-19 will occur due to this immunological component. This medication also has the potential to reduce the systemic inflammatory response brought on by COVID-19. Clinical improvement was different after 28 days when convalescent plasma was used as a treatment for patients with severe COVID-19 symptoms and emergency conditions compared to patients treated with conventional therapy alone. However, it is not very significant.
Percutaneous Dilatational Tracheostomy; Diagnosis and Mortality Rate in Intensive Care Saiful Anwar Hospital Ariady, Randika Rea; Wiwi Jaya; Arie Zainul Fatoni; Isngadi; Aswoco Andyk Asmoro
Journal of Anesthesiology and Clinical Research Vol. 5 No. 1 (2024): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jacr.v5i1.457

Abstract

Introduction: Tracheostomy is a common surgical procedure performed on critically ill intensive care patients. Reports have documented considerable associated morbidity, with complication rates varying from 6 to 66%. The reports on mortality associated with tracheostomy range from 0 to 5%. Since its introduction, percutaneous dilatational tracheostomies (PDT) have gained increasing popularity. The most commonly cited advantages are the ease of the familiar technique and the ability to perform the procedure at the bedside.7 This paper aims to study the mortality rate and diagnosis of patients who performed the percutaneous dilatational tracheostomy procedure in the ICU of Saiful Anwar Malang Hospital. Methods: Observational analytical research is carried out cross-sectionally. Data was collected from the medical records of patients undergoing PDT for the period July 2022 – October 2022. Statistical analysis using the Chi-square test. Results: From 39 subjects, 34 (87.2%) subjects experienced respiratory failure. The most common cause was HAP pneumonia (61.5%), followed by CVA (17.9%) and CAP pneumonia (12.8%); the rest were EDH, SAH, and ASD secundum, as much as 2.6%. The outcome was that 13 (33.3%) subjects died, and the rest survived and were transported to a care ward. Correlation between patient outcomes with respiratory failure p=0.735, with diagnosis p=0.309. Conclusion: The most common diagnosis of PDT is HAP pneumonia. There was no significant correlation between diagnosis and mortality of patients performed by PDT.
Co-Authors Ahmad Feza Fadhlurrahman Alwi Shahab Anugrah Onie Ardianto Ardianto Ariady, Randika Rea Aswoco Andyk Asmoro Aswoco Andyk Asmoro Aulia Martyana Achsar Buyung Hartiyo Laksono Christian Ambrosius Soeiono Della Fitricana denny prasetyo Devi Ariani Dewi Arum Sawitri Dewi Arum Sawitri Harri Kurnia Chandra Isngadi Isngadi Isngadi Karmini Yupono Kinanti Narulita Dewi Laksono, Buyung Hartiyo Maya sari Muhammad Priangga Akbar Nasywa Florean Dzakiyyah Ramacandra Rakhmatullah Ratna Maila Dewi Razi Ageng Pratama Resa Putra Adipurna Riska Yulinta Viandini Ristiawan Muji Laksono Ristiawan Muji Laksono Ruddi Hartono Rudy Vitraludyono Slamet Hadi Santoso Taufiq Agus Siswagama Trianna Mailawati Ulil Abshor Viandini, Riska Yulinta Vilda Prasastri Yuwono Wiwi Jaya Wiwi Jaya Wiyogo Yana Agung Satriasa Yoan Levia Magdi Yuliato Kusnadi