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All Journal SAINS MEDIKA : JURNAL KEDOKTERAN DAN KESEHATAN Jurnal Anestesiologi Indonesia Jurnal Anestesi Perioperatif Indonesian Journal of Anesthesiology and Reanimation (IJAR) Journal of Anaesthesia and Pain Jurnal Kesehatan Tambusai Solo Journal of Anesthesi, Pain and Critical Care Ahmad Dahlan Medical Journal The International Journal of Medical Science and Health Research Jurnal Komplikasi Anestesi
Akhmad Yun Jufan
Department Of Anesthesiology And Intensive Therapy, Faculty Of Medicine, Public Health, And Nursing, Universitas Gadjah Mada, Yogyakarta
Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Dentistry Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Veterinary

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Manajemen pada Pasien Sindroma Guillain-Barré Di ICU RSUP Dr. Sardjito Jufan, Akhmad Yun; Sudadi; Sunantara, I Gusti Ngurah Putu Mandela
Jurnal Komplikasi Anestesi Vol 9 No 2 (2022): Volume 9 Number 2 (2022)
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.v9i2.8347

Abstract

Guillain-Barré syndrome (GBS) is an autoimmune disorder that affects the peripheral nervous system. Most patients with GBS are clinically characterized by tetraplegia with or without sensory disturbances. In GBS this is due to a hyperreactive immune response including release of antiganglioside antibodies, formation of antibody-dependent immune complexes, and increased macrophages leading to axonal demyelination and degeneration. Severe cases of GBS may present with progressive clinical signs involving respiratory muscle and requiring mechanical ventilation and treatment in an intensive care unit (ICU). We reported a 26-year-old woman with type 2 respiratory failure with suspicion of GBS who was being treated in the ICU of RSUP Dr. Sardjito and undergone plasma exchange as immunomodulator therapy. The patient was treated for 9 days in the ICU of RSUP Dr. Sardjito with the outcome of the patient discharged from ICU to the ward.
Manajemen Intraoperative Nausea and Vomiting (IONV) pada Pasien Seksio Sesarea dengan Anestesi Spinal Apsari, Ratih Kumala Fajar; Jufan, Akhmad Yun; Sari, Dhanty Dwita
Jurnal Komplikasi Anestesi Vol 9 No 2 (2022): Volume 9 Number 2 (2022)
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.v9i2.8350

Abstract

Background: Spinal anesthesia is the most commonly used anesthesia for caesarean section with it being safely, quickly and easy to administer. Current literature indicates a high incidence of intraoperative nausea and vomiting (IONV) during caesarean section under spinal anesthesia up to 80% likely to suffer from nausea and vomiting because of the pregnancy itself. This is applicable not only to the first 3 months of pregnancy but also to the last trimester due to the reduced tone of the esophagogastric junction and an increased intraabdominal pressure. During abdominal surgery under regional anesthesia, nausea may happen due to several contributing factors such as sympathetic blocks followed by parasympathetic dominance with hypotension which is the most important cause of nausea after spinal anesthesia, decreased perfusion of central nervous system, anxiety, and sudden abdominal movements during surgery
Korelasi Kadar Prokalsitonin dengan Angka Leukosit pada Pasien Sepsis Bakterial di Ruang Rawat Intensif RSUP Dr. Sardjito Yogyakarta Utami, Vengky; Wisudarti, Calcarina Fitriani Retno; Jufan, Akhmad Yun
Jurnal Komplikasi Anestesi Vol 8 No 2 (2021): Volume 8 Number 2 (2021)
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.v8i2.8361

Abstract

Background: The Surviving Sepsis Campaign recommends using procalcitonin to help diagnose acute systemic infections, infection resolution, escalation, and discontinue antibiotic therapy on sepsis patients. Unfortunately, procalcitonin testing is very expensive and not yet available in all hospitals. Alternative biological markers are needed besides procalcitonin. The component of differentiated leukocyte count is known to be correlated with procalcitonin. Methods: This is a cross-sectional retrospective study and includes all bacterial sepsis patients that have been treated in the Dr. Sardjito General Hospital ICU between 1 January - 31 December 2019. Data of 436 laboratory examinations have been collected from 104 patients’ medical records, then processed with SPSS version 26 to look for correlations between procalcitonin with each component of leukocyte count value, followed by regression analysis between procalcitonin and leukocyte count values. Results: We found very strong positive correlation (R2 = 0.823, p <0.05) in multivariate analysis between procalcitonin levels and differential leucocyte count. There was moderate positive correlation in bivariate correlation between procalcitonin and leucocytes (r = 0.279, p <0.05) and absolute monocytes (r = 0.254, p> 0.05). There was also very weak positive correlation between procalcitonin and absolute neutrophils (r = 0.239, p <0.05), percentage neutrophils (r = 0.078, p <0.05), absolute eosinophils (r = 0.148, p<0.05), percentage eosinophils (r = 0.104, p<0.05), absolute basophils (r = 0.029, p>0.05), percentage basophils (r = 0.011, p> 0.05), absolute lymphocytes (r = 0.121, p>0.05), lymphocyte percentage (r = 0.074, p> 0.05), monocyte percentage (r = 0.208, p>0.05), absolute immature granulocytes (r = 0.064, p <0.05) , and percentage immature granulocytes (r = 0.029, p> 0.05). Conclusion: There was a strong positive correlation between procalcitonin levels and leukocyte count in bacterial sepsis patients treated in Dr. Sardjito General Hospital, Yogyakarta intensive care unit
Diagnosis dan Tatalaksana Sepsis Maternal Jufan, Akhmad Yun; Wisudarti, Calcarina Fitriani Retno; Atmanagara, Dikho
Jurnal Komplikasi Anestesi Vol 8 No 2 (2021): Volume 8 Number 2 (2021)
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.v8i2.8366

Abstract

Maternal sepsis is a common and potentially preventable cause of direct maternal death globally. A barrier to further progress has been the lack of consensus on the definition of maternal sepsis. Recognition and treatment of maternal sepsis are often delayed due to the physiological adaptations of pregnancy and vague or absent signs and symptoms during its initial presentation. Over the past decade, our understanding of sepsis has evolved and maternal early warning systems have been developed to help providers promptly identify and stratify parturients who are at risk. In addition, new consensus definitions and care bundles have recently been published by the World Health Organization and the Surviving Sepsis Campaign to facilitate earlier recognition and timely management of sepsis. Standardizing the criteria for maternal sepsis optimizes clinical findings. It may facilitate the evaluation of the role of different clinical parameters and biomarkers in the diagnosis, earlier recognition, and management of maternal infection and sepsis. Further work is required to develop an international consensus on the criteria for diagnosing maternal sepsis and any associated organ dysfunction.
Terapi Opioid pada Kasus COVID-19 Jufan, Akhmad Yun; Kurniawaty, Juni; Dewi, Baiq Dessy Resmana
Jurnal Komplikasi Anestesi Vol 9 No 1 (2021): Volume 9 Number 1 (2021)
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.v9i1.8515

Abstract

One-third of COVID-19 patients experience a variety of neurological symptoms involving the central and peripheral nervous systems. These symptoms include headache, dizziness, loss of consciousness, impaired smell, neuralgia, and skeletal muscle damage. Myalgia is the most common symptom in cases of COVID-19. Therefore, adequate pain management isneeded, one of the choices is using opioids. Opioid receptor agonists are a group of drugs that stimulate opioid receptors and produce their effects by mimicking endogenous opioid peptides known as endorphins.
Hubungan Fungsi Absorbsi Gastrointestinal dengan Lama Rawat Inap dan Mortalitas pada Pasien Pascaoperasi Kraniotomi di ICU RSUP Dr. Sardjito Yogyakarta Setiadi, Teguh; Widodo, Untung; Jufan, Akhmad Yun
Jurnal Komplikasi Anestesi Vol 9 No 1 (2021): Volume 9 Number 1 (2021)
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.v9i1.8516

Abstract

Background: Nutrition is an important part of patient management in the intensive care unit. Nutritional factors need to be known, whether there is a relationship between nutrition and ICU outcome in post craniotomy patients in ICU. Objective: The aim of this study is to know the relationship between gastrointestinal absorption function with the length of stay (LOS) and mortality in post-operative craniotomy patients in ICU RSUP Dr. Sardjito. Methods: Prospective cohort observational study design with the number of the sample was 60 post craniotomy surgery patients older than 18 years old hospitalized in ICU RSUP Dr. Sardjito. The gastrointestinal absorption function was assessed from the parameters of blood sugar examination before and after the administration of enteral nutrition. The association of gastrointestinal absorption function related to the LOS and mortality in ICU RSUP Dr. Sardjito Yogyakarta was analyzed. Results: There were 60 patients enrolled in this study. GCS values 13-15 were 45 patients (75%), GCS values 9-12 were 6 patients (10%), GCS values 3-8 were 9 patients (15%). The average LOS in the ICU was 3.4±5.13 days. The outcome was 58 patients (96.7%) survived and 2 patients (3.3%) died. The 2002 NRS average score was 3.2 ± 0.4, average APACHE II score was 6.53±4.7. There were 47 patients (78.3%) with good absorption and 13 patients (21.7%) with poor absorption. Vomiting occurred in 14 patients (23.35%), diarrhea 6 patients (10%), constipation 10 patients (16,7%). Spearman's correlation test showed a significant correlation of GCS and APACHE II score with LOS (p<0.05). While age, gender, weight, height, and BMI were not significant (p>0.05). A significant variable in multivariate analysis was the gastrointestinal absorption function(p<0.05) with a regression coefficient of -9.3. Conclusion: There was a significant relationship between gastrointestinal absorption function with length of stay and mortality, If the gastrointestinal absorption function was good the length of stay and mortality were decreased in post craniotomy patients in the ICU RSUP DR. Sardjito. > <0.05) with a regression coefficient of -9.3. Conclusion: There was a significant relationship between gastrointestinal absorption function with length of stay and mortality, If the gastrointestinal absorption function was good the length of stay and mortality were decreased in post craniotomy patients in the ICU RSUP DR. Sardjito.
Identifikasi Faktor Risiko Prediktif Prolonged Length of Stay (PLOS) di ICU RSUP Dr. Sardjito Yogyakarta Fauzi, Rizqi Ahmad; Jufan, Akhmad Yun; Widyastuti, Yunita
Jurnal Komplikasi Anestesi Vol 9 No 1 (2021): Volume 9 Number 1 (2021)
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.v9i1.8517

Abstract

Background: One method to improve the service quality in the Intensive Care Unit (ICU) is to develop a risk prediction system to assess and analyze associated risk factors that cause the prolonged length of stay (PLOS) at the ICU. In Indonesia, there is no risk prediction system developed from the population of Indonesians themselves who have different disease characteristics and patterns from European countries that have developed risk prediction such as APACHE IV and SAPS II. Objective: This study aims to identify the predictive factors of PLOS in ICU RSUP Dr. Sardjito. The long-term goal of this research is to develop a PLOS risk prediction model in the ICU based on the patient population treated at RSUP Dr. Sardjito. Methods: A retrospective cohort study was conducted on 451 patients in the ICU RSUP Dr. Sardjito. Variables that are thought to have a relationship with PLOS were tested using bivariate and multivariable logistic regression tests. After that, an assessment of the power of discrimination and calibration of the new PLOS predictive risk scoring system was carried out using the Area Under the Curve (AUC) method. A calibration test with Hosmer-Lameshow was done to get a comparison value between the observed and expected PLOS. Results: Factors identified as risk factors for PLOS in the ICU RSUP Dr.Sardjito were the medical cases, GCS value <8, use of vasoactive or inotropic drugs, sepsis, respiratory failure, and renal failure in both univariate and multivariate tests. Factors that have passed the multivariable test were used as predictors of PLOS in the ICU and a discrimination test was performed with the AUC. The discriminatory ability of the PLOS predictive model was 0,878 (95% CI). This value is classified as strong as a predictor model. The calibration test with Hosmer-Lameshow obtained a p-value of 0.547 (p>0.05) which means that this model was good. Conclusion: The medical cases, GCS value <8, use of vasoactive or inotropic drugs, sepsis, respiratory failure, and renal failure are predictive factors for PLOS in the ICU RSUP Dr. Sardjito. The discriminatory ability of these factors is strong and is able to predict the incidence of PLOS in the ICU RSUP Dr.Sardjito.
Hubungan Thoracic Fluid Content Cardiometry dengan Lung Ultrasound Score untuk Menilai Lung Water pada Pasien Pascaoperasi Mayor di ICU Pradana, Gilar Rizki Aji; Jufan, Akhmad Yun; Wisudarti, Calcarina Fitriani Retno
Jurnal Komplikasi Anestesi Vol 9 No 1 (2021): Volume 9 Number 1 (2021)
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.v9i1.8519

Abstract

Background: Perioperative fluid management in patients undergoing major surgery is important. Excessive administration of fluid can cause atrial natriuretic peptide release and iatrogenic glycocalyx/vascular endothelial junction dysfunction which can cause intravascular fluid shifting to the extravascular space. This fluid shifting can occur in the pulmonary interstitial space. Lung Ultrasound Score (LUS) score and Thoracic Fluid Content (TFC) examination with ICON is considered suitable to assess Extravascular Lung Water (EVLW). Objective: To determine the correlation between the LUS score with TFC using ICON in post-operative major patients in the ICU. Methods: A prospective observational research design with a cross-sectional study design. The sample size was 30 adult post-major surgery patients who were treated in the ICU of Dr. Sardjito. The LUS score was obtained from an ultrasound examination of the lungs and TFC was assessed with the ICON device. LUS examination was performed at 3-4 and 7-8 intercostal space between the parasternal-mid clavicular line, and on the lateral side at the level of the mid-axillary line. Correlation analysis was conducted to determine the degree of correlation between LUS score and TFC. Results: The sample of this study was 30 patients. Mean age 46.40±12.30 years, P/F ratio 411,21±77,64, AaDO2 121,20±53,4, LUS score 3.30±2.58, and TFC 24.56±10.30. Fluid balance during operation 194,2±756,65. The Spearman correlation test between LUS score and TFC showed a positive and significant correlation between LUS score and TFC, p<0.001 and r=0.703. The Spearman correlation test for LUS score and P/F ratios, LUS score and AaDO2, LUS score and fluid balance in the operating room showed no significant relationship (p>0.05). Conclusions: The correlation between LUS score and TFC values in postmajor surgery patients treated in the ICU was statistically significant (p<0.001) and the correlation was positive (r=0.703).
Konsiderasi Anestesi pada Pasien Seksio Sesarea dengan COVID-19 Wisudarti, Calcarina Fitriani Retno; Jufan, Akhmad Yun; Trijayanti, Christiana
Jurnal Komplikasi Anestesi Vol 9 No 1 (2021): Volume 9 Number 1 (2021)
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.v9i1.8522

Abstract

COVID-19 infection in pregnant patients can lead to premature labor. The most common method of delivery is by caesarean section. There are many aspects that must be considered in carrying out anesthesia for COVID-19 patients, including physiological changes that occur due to pregnancy and the effects of COVID-19 infection which can aggravate the condition of pregnant patients. Maintaining adequate oxygenation in the blood, choosing the right anesthetic agent, considering its effect on the fetus, and mechanical ventilation management related to ARDS caused by COVID-19 infection are the main things that should be of concern in anesthesia management
Penyakit Paru Obstruktif Kronis (PPOK) dengan Multipel Komorbid Maryani, Nova; Akhmad Yun Jufan; Bowo Adiyanto
Jurnal Komplikasi Anestesi Vol 11 No 1 (2023): Volume 11 Number 1 (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.v11i1.12862

Abstract

Background: COPD is a common disease, can prevent and cure, but sometimes its difficult to diagnose and misdiagnose. Hence, patient couldn’t have the correct treatment. Case: A man 76 years old transfer from district hospital with diagnose COPD with multiple comorbid such as CAP, AKI, and CHF cf III needs to hemodialysis. One month before hospitalization, patient complaint dyspnea and become worst in last 1 week. The quality of dyspnea increasing by activity and cough. Cough with white sputum. He has intubated and give treatment for COPD and other comorbids. Patient hospitalize in ICU for 12 days and after that transfer to HCU for further treatment. Discussion: Intubation and weaning process for COPD patient was very challenging. Patient has treatment 12 days in ICU have COPD medical support based on diagnosa and management ventilation with NIV and NRM after autoextubate on day 5. Clinical and imaging evaluation shows us the recovery of pneumonia and pulmo edema that’s help patient to breathing easily even COPD needs more times to resolve. Results: COPD with multiple comorbid disease make the intesivist more difficult to wean and manage the treatment. Keywords: COPD, Cor Pulmonale, ICU
Co-Authors Adi Wibowo Adiyatma, Krisna Hario Adrin, Olga Elenska Al-Munawar, Nira Muniroh Anwar, Yusuf ‘Alim Musthofa Apriyanto Arifin, Achmad Reza Atmanagara, Dikho Bahrun, Nugraha Septian Bhaktiyar, Agung Bhirowo Yudo Pratomo Bowo Adiyanto Calcarina Fitriani Retno Wisudarti Dewi, Baiq Dessy Resmana Dian Ayu Listiarini Djayanti Sari Fauzi, Rizqi Ahmad Febrianti, Skolastika Rani Firman Ardiansyah FRW, Calcarina Hanafi, Irham Hanafia, Mochamad Fauzi Hartono, Pinter helen yudi irianto Helen Yudi Irianto Indra Wijaya, Adi Juni Kurniawaty Muhdar Abubakar Djayanti Sari Kuncoro, Kusuma Edhi Kusuma, Danur Adi Kusumawardani, Dwi Indriati Mahardieni, Karlina Maryani, Nova Nova Maryani Pradana, Gilar Rizki Aji Prasamya, Erlangga Pratama, Andhika Marthsyal Ratih Kumala Fajar Apsari Rayhandika Sari, Dhanty Dwita Sarosa, Pandit Sudadi Sulistiyantoro, Antonius Catur Sunantara, I Gusti Ngurah Putu Mandela Teguh Setiadi Trijayanti, Christiana Untung Widodo Untung Widodo Untung Widodo, Untung Utami, Vengky Wibowo, Catur Prasetyo Wibowo, Erry Alamsyah Asjhuri Wijaya, Andryadi Yuliani, Irma Yunita Widyastuti Yusmein Uyun Zulfakhri, Zulfakhri