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All Journal BALI MEDICAL JOURNAL (BMJ) E-Jurnal Medika Udayana MNJ (Malang Neurology Journal) Bali Journal of Anesthesiology Syntax Literate: Jurnal Ilmiah Indonesia Bioscientia Medicina : Journal of Biomedicine and Translational Research PREPOTIF : Jurnal Kesehatan Masyarakat Neurologico Spinale Medico Chirurgico Journal of Anaesthesia and Pain Bioscientia Medicina : Journal of Biomedicine and Translational Research Journal of Anesthesiology and Clinical Research Sehat Rakyat: Jurnal Kesehatan Masyarakat Jurnal Anestesi dan Terapi Intensif Udayana Jurnal Anestesiologi dan Terapi Intensif
I Gusti Ngurah Mahaalit Aribawa
Department Of Anesthesiology, Pain Management, And Intensive Care, Faculty Of Medicine, Udayana University, Sanglah General Hospital, Denpasar-Bali, Indonesia
Humanities Biochemistry, Genetics & Molecular Biology Dentistry Education Environmental Science Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Physics Public Health Social Sciences Veterinary Other

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Journal : Jurnal Anestesiologi dan Terapi Intensif

 1 
Low-Flow Anesthesia Management in Pediatric Laparoscopic Choledochal Cyst Excision and Hepaticojejunostomy: A Case Report Togi Stanislaus Patrick; Aribawa, I Gusti Ngurah Mahaalit; Ra Ratumasa, Marilaeta Cindryani; Anak Agung Gde Adistaya
Jurnal Anestesiologi dan Terapi Intensif Vol. 1 No. 3 (2025): JATI Desember 2025
Publisher : Udayana University and Indonesian Society of Anesthesiologists (PERDATIN)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/xqsck350

Abstract

Laparoscopic surgery offers significant benefits in pediatric populations but presents anesthetic challenges, especially during prolonged procedures. This case report describes the anesthetic management of an 11-year-old boy who underwent nearly 12 hours of laparoscopic choledochal cyst excision, Roux-en-Y hepaticojejunostomy, and cholecystectomy. Low-flow anesthesia using sevoflurane was administered via a Dräger Perseus A500, enabling precise control of anesthetic delivery, oxygenation, and ventilation. Throughout the procedure, inspired oxygen fraction (FiO₂) was maintained above 30%, and end-tidal CO₂ (EtCO₂) remained stable around 35 mmHg. Volatile agent consumption was reduced, with age-adjusted MAC (xMAC) consistently between 0.85 and 0.90. Intraoperative hemodynamics and postoperative recovery were stable, with no immediate complications. This case highlights the safety, efficiency, and cost-effectiveness of low-flow anesthesia in complex pediatric laparoscopic surgery when guided by advanced monitoring systems and supports its broader adoption in resource-limited healthcare settings.
Fibrinolytic and Anticoagulant Therapy in COVID-19 Associated Pulmonary Embolism: A Case Report Eka Nantha Kusuma, Putu; I Made Prema Putra; I Gusti Ngurah Mahaalit Aribawa
Jurnal Anestesiologi dan Terapi Intensif Vol. 1 No. 2 (2025): JATI Agustus 2025
Publisher : Udayana University and Indonesian Society of Anesthesiologists (PERDATIN)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/JATI.2025.v01.i02.p04

Abstract

Pulmonary thromboembolism is a complication that can occur in coronavirus disease-2019 (COVID-19). Efforts to prevent and therapy for thromboembolism have been a challenge to this date. The side effects of fibrinolytic, anticoagulant, and platelet anti-aggregation therapies, such as hemorrhage, are some of the causes of morbidity and mortality that must be addressed immediately. In this case, the patient received prophylaxis with the anticoagulant enoxaparin and platelet anti-aggregation agents with aspirin and clopidogrel. The COVID-19 patient presented a complication of pulmonary thromboembolism that was established using a computed tomography pulmonary angiography (CTPA) performed on his third day of care (day 14 of onset treatment) due to the patient’s clinical aggravation of pulmonary manifestation. After fibrinolytic therapy had been given, the patient’s clinical condition improved. However, on the 7th day after the provision of recombinant tissue plasminogen activator (r-TPA), the patient experienced a side effect of hemorrhage, and management was undertaken to address these issues by transfusions of blood components, such as cryoprecipitates, thrombocyte concentrate, fresh frozen plasma, and packed red cell. Thromboembolism occurring in COVID-19 patients is based on the Virchow triad concept, comprising endothelial injury, static blood flow, and hypercoagulation. The principle of prevention and management of thromboembolism refers to this concept. Currently, further studies are required to treat thromboembolism and the side effects of fibrinolytic and anticoagulant therapies on COVID-19 patients.
Co-Authors Adi, Made Septyana Parama Adinda Putra Pradhana Anak Agung Gde Adistaya Christopher Ryalino Dewi, Dewa Ayu Mas Shintya Dewi, Putu Utami Doddy Setiawan Eka Nantha Kusuma, Putu Elisma Nainggolan, Elisma Emkel Perangin Angin, Emkel Faridatun Hasanah Gede Semarawima, Gede Gusti Agung Made Wibisana Kurniajaya Hengky Hengky, Hengky I Gede Budiarta I Gede Prima Julianto I Gusti Agung Gede Utara Hartawan I Gusti Agung Made Wibisana Kurniajaya I Ketut Sinardja I Ketut Wibawa Nada I Made Gede Widnyana I Made Prema Putra I Putu Agus Surya Panji I Putu Fajar Narakusuma I Wayan Aryabiantara, I Wayan I Wayan Suranadi Ida Ayu Sri Wijayanti Ida Bagus Krisna Jaya Sutawan IGNA Putra Arimbawa, IGNA Putra Indah, Carolin Tiara Lestari Kadek Agus Heryana Putra Kadek Agus Heryana Putra, Kadek Agus Kadek Agus Putra Udayana Ketut Semara Jaya, Ketut Semara Komang Ady Widayana Komang Alit Artha Wiguna Komang Alit Artha Wiguna Krisnawardhani Kumbara, Cokorda Istri Yuliandari Kurniajaya, I Gusti Agung Made Wibisana Leton, Yohanes PT Made Agus Kresna Sucandra, Made Agus Kresna Made Bagus Cahya Maha Putra Made Septyana Parama Adi Made Wiryana Mahadewi, Ni Putu Ayu Putri Merry Ni Made Ayu Candrayuni Pande Nyoman Kurniasari, Pande Parama Adi, Made Septyana Pontisomaya Parami Pramaswari, Anak Ayu Agung Putu Gede Ary Sanjaya Ra Ratumasa, Marilaeta Cindryani Riko Riko Saputra, Darmawan Jaya Sidemen, I Gusti Ayu Eka Para Santi Siska Permanasari Sinardja Sonni Soetjipto, Sonni Susilawathi, Ni Made Syamsuddin, Johanis Bosco Troy Tini, Kumara Tjokorda Gde Agung Senapathi Togi Stanislaus Patrick Wiranata, Jeremia Alvian Yuliana, Astrid