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All Journal E-Jurnal Medika Udayana Syntax Literate: Jurnal Ilmiah Indonesia
Mas Shintya Dewi, Dewa Ayu
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Humanities Education Environmental Science Health Professions Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Social Sciences Other

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PROFILE OF HEMOSTASIS PHYSICAL DISORDERS IN CONFIRMED COVID-19 PATIENTS TREATED IN THE ISOLATION ICU UDAYANA UNIVERSITY HOSPITAL PERIOD OF 2020-2021 Indrastuti, Putu Shintadewi; Aryabiantara, I Wayan; Mas Shintya Dewi, Dewa Ayu; Utara Hartawan, I Gusti Agung Gede
E-Jurnal Medika Udayana Vol 13 No 6 (2024): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2024.V13.i06.P07

Abstract

COVID 19 is contagious disease cause by the Coronavirus which is a type of RNA virus that causes symptoms. In some cases, coagulation disorders have been found as a hemostatic dysfunction that occurs due to a decrease patient's immune system. This condition causes patients to experience coagulopathy, endothelial dysfunction, excessive platelet activation and blood flow stasis. This research used descriptive methods and cross-sectional approach. The population of this study was the Isolation ICU patients at Udayana University Hospital in 2020-2021. Data collection uses PT, aPTT, INR, D-dimer and platelet count data. The results of this study found that out of 169 subjects, the most common cases occurred in the male group at 69.2%, the age group most often occurred in the age > 60 years at 42.6%, based on comorbid group, the most common cases occurred in those with no comorbidities at 37.9% with the most common clinical symptom in the form of shortness breath at 77.5%. The most common picture of coagulation parameters was normal PT values in 55%, a normal INR in 81.1%, an increased APTT in 53.3%, an increased D-Dimer in 91.9%, and normal platelets counts in 69.2%. Coagulation parameters in hypertensive and diabetic mellitus type II patients increased on aPTT sequentially by 50% and 52%, respectively. D-dimer increased in 93% and 98% meanwhile PT, INR and Platelets are normal.
Anesthetic Approach In A Patient With A Left Submandibular Colli Abscess and Multiple Comorbidities Richard, Richard; Mas Shintya Dewi, Dewa Ayu; Gede Widnyana, I Made
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36418/syntax-literate.v10i7.60694

Abstract

Submandibular–colli abscess accompanied by comorbidities such as diabetic ketoacidosis (DKA), airway obstruction, and chronic heart failure (CHF) presents a complex anesthetic challenge. Patients with maxillofacial abscesses and comorbidities such as impending airway obstruction, diabetic ketoacidosis (DKA), and chronic heart failure pose significant challenges to anesthetic management. Each comorbidity significantly influences perioperative management and increases the risk of morbidity and mortality. The goal of preoperative management is to stabilize the patient prior to surgery and reduce the risk of perioperative complications. Preoperative management includes ensuring adequate oxygenation, optimizing and monitoring hydration status, and controlling blood glucose levels. Objectives: To describe the perioperative anesthetic approach in a patient with a left submandibular abscess and multiple comorbidities, emphasizing the importance of a holistic strategy in managing complex surgical cases. Case Report: A 51-year-old female presented with progressive swelling of the left face and neck for two weeks. Examination revealed a submandibular abscess, DKA, and a known history of CHF. The patient reported trismus and odynophagia with marked hyperglycemia. Imaging showed tracheal deviation and abscess extension to the retropharyngeal space. Preoperative management focused on metabolic stabilization and cardiovascular optimization. Awake fiberoptic intubation (AFOI) with dexmedetomidine sedation was performed due to the anticipated difficult airway. Surgery proceeded uneventfully for 2 hours and 10 minutes, followed by intensive postoperative monitoring. Discussion: Anesthetic management in patients with deep neck abscesses and comorbid DKA and CHF requires comprehensive perioperative planning. Metabolic and hemodynamic stability must be achieved prior to induction. Careful airway planning, the use of cardiovascularly stable anesthetic agents, and vigilant glucose and fluid monitoring are essential to prevent complications. Conclusion: Successful anesthetic care in patients with submandibular abscess and complex comorbidities demands coordinated, individualized perioperative strategies to minimize risk and optimize outcomes.
Co-Authors I Gusti Agung Gede Utara Hartawan I Made Gede Widnyana I Wayan Aryabiantara, I Wayan Indrastuti, Putu Shintadewi Richard Richard