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All Journal Jurnal Ilmiah Keperawatan (Scientific Journal of Nursing) Open Access Indonesian Journal of Medical Reviews Journal of Anesthesiology and Clinical Research
Andy Nugroho
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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GAMBARAN PERSEPSI PASIEN GAGAL JANTUNG KONGESTIF TENTANG PEMBATASAN CAIRAN DI POLIKLINIK JANTUNG DI RUMAH SAKIT SWASTA YOGYAKARTA: An Overview Patient’s Perception of Congestive Heart Failure About Fluid Restriction at The Cardiac Clinic in Non-Government Hospital Andy Nugroho; Diah Pujiastuti
Jurnal Ilmiah Keperawatan (Scientific Journal of Nursing) Vol. 9 No. 2 (2023): JIKep | Juni 2023
Publisher : LPPM STIKES Pemkab Jombang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33023/jikep.v9i1.1383

Abstract

Pendahuluan : Kematian akibat penyakit jantung menduduki peringkat nomer satu. Gagal jantung kongestif merupakan tahap akhir dari penyakit jantung. Pasien akan merasakan keluhan seperti sesak nafas, batuk dan kaki bengkak. Pasien gagal jantung kongestif perlu membatasi asupan cairan guna mengurangi kelebihan cairan. Tindakan pembatasan cairan dipengaruhi oleh persepsi. Tujuan: Mengetahui gambaran persepsi pasien Gagal Jantung Kongestif tentang tindakan pembatasan cairan di poliklinik jantung sakit swasta di Yogyakarta Tahun 2022. Metode: Desain penelitian kuantitatif deskriptif dengan pendekatan cross sectional. Teknik sampling menggunakan teknik purposive sampling sehingga didapatkan sampel sebanyak 52 pasien gagal jantung kongestif di poliklinik jantung di salah satu rumah sakit swasta di Yogyakarta. Alat ukurnya adalah kuesioner. Hasil: Responden berjumlah 52 pasien gagal jantung kongestif. Responden yang mempunyai persepsi positif sebanyak 44 responden (84,6%) dan responden yang mempunyai persepsi negatif sebanyak 8 responden (15,4%). Kesimpulan: Hampir seluruh pasien gagal jantung kongestif memiliki persespi positif tentang pembatasan cairan yaitu 44 responden dari 52 responden. Dalam penelitian terkait persepsi pasien Gagal Jantung Kongesti tentang pembatasan cairan bisa menggunakan metode kualitatif atau bisa menggunakan analisa bivariat jika ingin meneliti tentang hubungan salah satu karakteristik responden dengan persepsi pasien
Successful Management of Grade III Tetanus with Therapeutic Plasma Exchange: A Case Report Listyono Putro, Jati Febriyanto Adi; Andy Nugroho; Septian Adi Permana; Andi Hermawan
Journal of Anesthesiology and Clinical Research Vol. 5 No. 3 (2024): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jacr.v5i3.644

Abstract

Introduction: Tetanus, a severe neurologic disorder caused by Clostridium tetani neurotoxin, presents with progressive muscle rigidity and spasms. Grade III tetanus, characterized by generalized tetanus with severe spasms, carries a high mortality risk. Therapeutic plasma exchange (TPE) has emerged as an adjunctive therapy to remove circulating toxins and inflammatory mediators. Case presentation: We report a 50-year-old male with grade III tetanus following a minor injury. Despite standard treatment with tetanus immunoglobulin, antibiotics, and muscle relaxants, his condition deteriorated, necessitating intensive care unit (ICU) admission and mechanical ventilation. The patient underwent two sessions of TPE, demonstrating significant clinical improvement with reduced muscle spasms and successful ventilator weaning. Conclusion: This case highlights the potential benefit of TPE in managing severe tetanus, particularly in cases refractory to conventional therapy. Early recognition and aggressive management, including TPE, can improve outcomes in this life-threatening condition.
Navigating Pneumoperitoneum in Severe HFrEF: A Case Report on a Physiology-Based Anesthetic Strategy Setia Hilmi Mustajabah; Andy Nugroho; Muhammad Ridho Aditya
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 6 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i6.806

Abstract

Laparoscopic surgery in patients with severe heart failure with reduced ejection fraction (HFrEF) presents a formidable anesthetic challenge. The cardiovascular sequelae of pneumoperitoneum can precipitate acute hemodynamic collapse in a myocardium with minimal contractile reserve. This report details the anesthetic management of a high-risk patient with an extremely low ejection fraction undergoing laparoscopic cholecystectomy, focusing on a physiology-based approach. A 63-year-old, 72 kg male with severe HFrEF (ejection fraction 24%) and NYHA class III symptoms was scheduled for laparoscopic cholecystectomy. His ASA physical status was IV. Preoperative optimization ensured he was euvolemic and on guideline-directed medical therapy. Anesthetic induction was achieved with fentanyl (1.4 mcg/kg), atracurium (0.35 mg/kg), and ketamine (1 mg/kg). Following CO₂ insufflation, the patient developed profound bradycardia (42 bpm) and hypotension (MAP 58 mmHg). This anticipated crisis was managed with atropine and a supplemental ketamine bolus (0.3 mg/kg), successfully restoring hemodynamic stability. The procedure was completed uneventfully. In conclusion, this case demonstrates that a tailored anesthetic regimen, focused on intrinsic hemodynamic support and proactive crisis management, can be a safe and effective strategy in this high-risk cohort. The successful outcome hinged not on a single agent but on a comprehensive perioperative process encompassing meticulous optimization, a deliberate choice of anesthetic modality based on patient pathophysiology, goal-directed intraoperative therapy, and a structured transition to postoperative care.
Co-Authors Andi Hermawan Listyono Putro, Jati Febriyanto Adi Muhammad Ridho Aditya Pujiastuti, Diah Septian Adi Permana Setia Hilmi Mustajabah