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All Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research Bioscientia Medicina : Journal of Biomedicine and Translational Research Jurnal Kesehatan Komunitas Indonesia Frontiers on Healthcare Research
Johannas
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Biochemistry, Genetics & Molecular Biology Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Effectiveness of Airway Management Strategies in Critically Ill Patients: A Meta-Analysis Putra, Ricko Yorinda; Novita Anggraeni; Johannas
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 11 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i11.1113

Abstract

Background: Airway management is a cornerstone of critical care, but the optimal strategies for critically ill patients remain debated. This meta-analysis aimed to evaluate the effectiveness of various airway management techniques in critically ill patients. Methods: A systematic search of PubMed, Embase, Cochrane Library, and Web of Science was conducted from January 2018 to December 2023. Studies comparing different airway management strategies (e.g., endotracheal intubation, laryngeal mask airway, video laryngoscopy) in critically ill adults were included. Primary outcomes were successful airway establishment, time to airway securement, and complications (e.g., hypoxia, aspiration). Meta-analyses were performed using random-effects models, and the risk of bias was assessed. Results: Twenty-three studies (n=5,894 patients) were included. Video laryngoscopy was associated with a higher success rate of first-pass intubation compared to direct laryngoscopy (OR 1.85, 95% CI 1.43-2.40, p<0.001). No significant differences were found in overall complications between video laryngoscopy and direct laryngoscopy (OR 0.92, 95% CI 0.68-1.24, p=0.59). In patients with difficult airways, video laryngoscopy demonstrated a reduced risk of complications compared to direct laryngoscopy (OR 0.63, 95% CI 0.41-0.97, p=0.04). Conclusion: Video laryngoscopy is a safe and effective alternative to direct laryngoscopy, particularly in critically ill patients with predicted difficult airways. Further research is needed to determine the optimal airway management strategy in specific subgroups of critically ill patients.
Effectiveness of Airway Management Strategies in Critically Ill Patients: A Meta-Analysis Putra, Ricko Yorinda; Novita Anggraeni; Johannas
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 11 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i11.1113

Abstract

Background: Airway management is a cornerstone of critical care, but the optimal strategies for critically ill patients remain debated. This meta-analysis aimed to evaluate the effectiveness of various airway management techniques in critically ill patients. Methods: A systematic search of PubMed, Embase, Cochrane Library, and Web of Science was conducted from January 2018 to December 2023. Studies comparing different airway management strategies (e.g., endotracheal intubation, laryngeal mask airway, video laryngoscopy) in critically ill adults were included. Primary outcomes were successful airway establishment, time to airway securement, and complications (e.g., hypoxia, aspiration). Meta-analyses were performed using random-effects models, and the risk of bias was assessed. Results: Twenty-three studies (n=5,894 patients) were included. Video laryngoscopy was associated with a higher success rate of first-pass intubation compared to direct laryngoscopy (OR 1.85, 95% CI 1.43-2.40, p<0.001). No significant differences were found in overall complications between video laryngoscopy and direct laryngoscopy (OR 0.92, 95% CI 0.68-1.24, p=0.59). In patients with difficult airways, video laryngoscopy demonstrated a reduced risk of complications compared to direct laryngoscopy (OR 0.63, 95% CI 0.41-0.97, p=0.04). Conclusion: Video laryngoscopy is a safe and effective alternative to direct laryngoscopy, particularly in critically ill patients with predicted difficult airways. Further research is needed to determine the optimal airway management strategy in specific subgroups of critically ill patients.
Comparing Postoperative Fentanyl Use: Ibuprofen VS Ibuprofen-Dexamethasone as Preemptive Analgesia Herman, Awanda; Hidayat, Nopian; Sukiandra, Riki; Johannas
Frontiers on Healthcare Research Vol. 2 No. 2 (2025)
Publisher : Rumah Sakit Umum Pusat (RSUP) Dr. M. Djamil

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.63918/fhr.v2.n2.p45-50.2025

Abstract

Background: Fentanyl is the most frequently used opioid analgesic for managing postoperative pain. While effective, it is associated with various side effects. Postoperative pain is mainly due to acute tissue damage. Several studies have shown that administering preemptive analgesia before anesthesia can help reduce postoperative pain, thus decreasing the need for fentanyl and its side effects. Methods: This research employed a randomized controlled trial (RCT) with a double-blind design. Postoperative pain was measured using the Numeric Rating Scale (NRS). Patients with an NRS score above 6 received fentanyl. Statistical analysis was conducted to compare the impact of preemptive analgesia with Ibuprofen 800 mg alone versus Ibuprofen 800 mg combined with Dexamethasone 10 mg in patients undergoing postoperative gynecological abdominal surgery. Results: The findings revealed a significant difference in NRS pain scores between the groups. The group receiving the combination of Ibuprofen 800 mg and Dexamethasone 10 mg had a 69% reduction in the need for postoperative fentanyl compared to the group that received only Ibuprofen. Conclusion: Patients who received preemptive analgesia with Ibuprofen and Dexamethasone had lower pain scores and a reduced need for fentanyl in the postoperative period compared to those receiving Ibuprofen alone.
The Effect of Anesthesia on TGF-β Levels in Lung Tumor Patients Undergoing Bronchoscopy: A Literature Review Johannas; Efrida; Basyar, Masrul; Darwin, Eryati
Jurnal Kesehatan Komunitas Indonesia Vol 6 No 1: April 2026
Publisher : Al-Hijrah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58545/jkki.v6i1.713

Abstract

Lung cancer remains the leading cause of cancer-related mortality worldwide, with persistently low survival rates. Bronchoscopy is an essential diagnostic procedure in patients with lung tumors and often requires anesthesia to improve comfort and procedural success. Emerging evidence suggests that anesthetic agents and techniques may influence tumor biology through modulation of immune responses and inflammatory mediators. Transforming Growth Factor-Beta (TGF-β) is a multifunctional cytokine involved in cell proliferation, differentiation, immune regulation, and extracellular matrix remodeling, and plays a critical role in cancer progression. This literature review aims to evaluate current evidence regarding the effects of anesthetic agents and techniques on TGF-β levels and their implications for tumor biology in patients with lung tumors undergoing bronchoscopy. A narrative literature review approach was used to analyze scientific publications exploring the relationship between anesthesia, immune modulation, cytokine alterations, and cancer progression, particularly focusing on inhalational and intravenous anesthetics. Surgical stress and anesthetic exposure can alter immune responses through activation of neuroendocrine pathways, leading to cytokine imbalance and immunosuppression. TGF-β exhibits dual roles in cancer, acting as a tumor suppressor in early stages and a tumor promoter in advanced stages. Inhalational anesthetics may enhance tumor progression, whereas intravenous anesthetics such as propofol may have immunomodulatory effects. Anesthetic techniques may influence tumor-related pathways, including TGF-β; however, evidence remains limited and inconsistent, requiring further well-designed studies.
Co-Authors Awanda Herman Efrida Eryati Darwin Hidayat, Nopian Masrul Basyar Novita Anggraeni Putra, Ricko Yorinda Riki Sukiandra