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Djajantisari
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Medicine & Pharmacology

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Faktor Risiko yang Mempengaruhi Terjadinya Komplikasi Kardiovaskular Pasca Pembiusan/Sedasi Prosedural pada Pasien Pediatri hendra, hendra hermawan; Widyastuti, Yunita; Djajantisari
Jurnal Komplikasi Anestesi Vol 11 No 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.v11i2.12446

Abstract

Background: The morphology and physiology of neonates and children differ from those of adults. The most common complications encountered involve respiratory issues followed by cardiovascular problems. The predominant cardiovascular complications in the field of pediatric anesthesia are hemodynamic instability followed by cardiac arrest. Perioperative cardiovascular complications are closely related to a history of prematurity under the age of 1 year, ASA physical status ≥3, concomitant cardiovascular or metabolic diseases, emergency surgeries, and surgical procedures. To date, few risk factors related to the cardiovascular system have been identified in pediatric anesthesia. Objective: To identify risk factors influencing the occurrence of post-anesthesia/sedation cardiovascular complications in pediatric patients at Dr. Sardjito Hospital, Yogyakarta. Method: The research design employed in this study was a prospective cohort observation of pediatric patients undergoing anesthesia or procedural sedation at Dr. Sardjito Hospital. Research subject data included demographic characteristics, ASA status, history of concomitant diseases, type of surgery, urgency level, and post-anesthesia complication occurrences. Data normality was tested using the Kolmogorov-Smirnov test, bivariate analysis was conducted using the Fisher test, variables with p-value <0.25 underwent multivariate analysis using logistic regression for categorical data. The results were processed using SPSS version 23.00. Results: A total of 181 subjects were predominantly male patients aged >5 years. Factors influencing post-anesthetic cardiovascular complications included ASA physical status ≥3 (p=0.033) OR 8.96 (95% CI 2.07 – 38.89), emergency procedures (p=0.043) OR 12.63 (95% CI 1.08 – 147.15), age >5 years (p=0.033) OR 5.67 (95% CI 1.15 – 28.1), female gender (p=0.001) OR 7.85 (95% CI 2.23 – 27.71), and type of surgical procedure (p=0.017) OR 16.64 (95% CI 1.63 – 169.05). Conclusion: Age >5 years, female gender, ASA physical status ≥3, emergency procedures, and surgical procedures are risk factors associated with the occurrence of post-anesthetic/sedation cardiovascular complications in pediatric patients.
Faktor-Faktor yang Berhubungan dengan Mortalitas pada Pasien Pediatrik yang Menjalani Pembiusan di Masa Pandemi Covid-19 di RSUP DR Sardjito Getar M, Geza Getar M; Djajantisari; Widyastuti, Yunita
Jurnal Komplikasi Anestesi Vol 11 No 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.v11i2.12975

Abstract

Background: Anesthesia has the potential to cause physiological changes that lead to morbidity and mortality. Perioperative mortality alone is higher in children than in adults. During this time, the COVID-19 pandemic has affected anesthesia care around the world. The practice of pediatric surgery shows a significant decrease in the frequency of elective surgeries during the pandemic compared to the last three months before the pandemic. Surgical delays that occur, especially in "time-sensitive" surgeries and urgent illnesses in children, can affect the child's growth, development, and quality of life. There are several risk factors associated with mortality and morbidity in pediatric patients, namely age, ASA III-V physical status, emergency surgery, use of ventilators, oxygen support, inotropic drug support, preoperative sepsis, and patients refusing resuscitation. Objective: Identifying factors that influence mortality in pediatric patients undergoing anesthesia during the COVID-19 pandemic. Method: This study is a retrospective cohort observational study. This study included all pediatric patients who underwent anesthesia at Dr. Sardjito General Hospital between April 1, 2020 - March 31, 2021. Variables suspected of having a relationship with mortality will be tested bivariately in this study, and if p<0.25 is considered significant, they will be included in the multivariate analysis. They will be excluded from the multivariate analysis if p<0.05 is considered significant. Result: Factors that influence the incidence of mortality in pediatric patients undergoing anesthesia at Dr. Sardjito General Hospital are ASA III-V physical status with a value of p = 0.004 (OR 3.47), and the use of mechanical ventilation postoperative with a value of p=<0.001 (OR 9.46), both factors that have a significant effect with a p<0.05. Conclusion: ASA III-V physical status and the use of mechanical ventilation postoperative are factors that significantly influence the mortality of pediatric patients undergoing anesthesia at Dr. Sardjito General Hospital.
Co-Authors Getar M, Geza Getar M hendra, hendra hermawan Yunita Widyastuti