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All Journal Journal of Anesthesiology and Clinical Research Jurnal Anestesi dan Terapi Intensif Udayana
I Putu Fajar Narakusuma
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Physics

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Successful Post-Resuscitation Care in End-Stage Renal Disease Patients: A Case Report Merry; Made Septyana Parama Adi; I Gusti Agung Gede Utara Hartawan; I Gusti Ngurah Mahaalit Aribawa; I Putu Fajar Narakusuma; I Gusti Agung Made Wibisana Kurniajaya
Journal of Anesthesiology and Clinical Research Vol. 6 No. 1 (2025): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jacr.v6i1.673

Abstract

Introduction: Cardiac arrest in end-stage renal disease (ESRD) patients presents unique challenges due to their complex medical conditions. Post-resuscitation care for these patients requires careful management of various factors, including hemodynamic instability, electrolyte imbalances, and fluid overload. This case report describes the successful post-resuscitation care of an ESRD patient who experienced cardiac arrest and achieved a return of spontaneous circulation (ROSC). Case presentation: A 50-year-old female with ESRD on hemodialysis (HD) presented with acute dyspnea and cardiac arrest. After 8 minutes of cardiopulmonary resuscitation (CPR), ROSC was achieved. The patient was managed with a comprehensive post-resuscitation care protocol, including brain resuscitation (targeted temperature management, ventilation optimization, and hemodynamic control) and sustained low-efficiency dialysis for fluid balance. Despite the severity of her condition, the patient showed significant neurological recovery and was successfully extubated after 7 days of mechanical ventilation. She was discharged after 12 days with follow-up for her chronic conditions. Conclusion: This case highlights the importance of individualized management strategies for ESRD patients post-cardiac arrest, including the need for prolonged resuscitation and careful monitoring to improve patient outcomes.
Awake Intubation in Patient with Superoanterior Mediastinal Mass and Superior Vena Cava Syndrome (SVCS): A Case Report Ery Oktadiputra; I Putu Fajar Narakusuma; Tjokorda Gde Agung Senapathi
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.p05

Abstract

Superior vena cava syndrome (SVCS) with airway compression is challenging in anesthesia management. We report the case of a 69-year-old man with a superoanterior mediastinal mass and grade 3 SVCS who underwent Video-Assisted Thoracoscopic Surgery (VATS) with awake intubation using a double lumen tube (DLT) and videolaryngoscope. Awake intubation was chosen as the safest anesthesia technique where patients still breathe spontaneously without experiencing the effects of deep sedation. The combination of 4% lidocaine nebulization, oropharyngeal lidocaine spray, and dexmedetomidine infusion (0.5 μg/kg bolus over 10 minutes followed by 0.3-0.6 μg/kg/hour during surgery) in this patient, successfully maintained spontaneous ventilation without hemodynamic complications. The use of nebulized lidocaine, lidocaine spray, and dexmedetomidine as intubation facilities showed excellent effectiveness by maintaining the patient's spontaneous breathing, increasing the pain threshold, suppressing the nausea-vomiting reflex, and providing comfort in the form of mild sedation during awake intubation. This approach emphasizes the importance of topical anesthesia and selective sedation in high-risk patients with airway difficulties.
Co-Authors Ery Oktadiputra I Gusti Agung Gede Utara Hartawan I Gusti Agung Made Wibisana Kurniajaya I Gusti Ngurah Mahaalit Aribawa Made Septyana Parama Adi Merry Tjokorda Gde Agung Senapathi