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All Journal Jurnal Anestesiologi Indonesia Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Jurnal Prima Medika Sains Indonesian Journal of Anesthesiology and Reanimation (IJAR) Journal SAGO Gizi dan Kesehatan Jurnal Neuroanestesi Indonesia Majalah Anestesia & Critical Care (MACC) Jurnal PADE: Pengabdian & Edukasi The Journal of Society Medicine (JSOCMED)
Lubis, Andriamuri Primaputra
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Biochemistry, Genetics & Molecular Biology Dentistry Education Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Veterinary

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Hubungan Nyeri dengan Delirium pada Pasien yang Terintubasi di ICU RSUP Haji Adam Malik Medan Nurchotijah, Nurchotijah; Lubis, Andriamuri Primaputra; Hamdi, Tasrif
Majalah Kedokteran Indonesia Vol 74 No 5 (2024): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.74.5-2024-1494

Abstract

Introduction: Pain can sometimes trigger a stress response and stimulate adrenergic-sympathetic activity. Delirium, a serious disruption of consciousness, is characterized by fluctuating perceptions, confused thinking, and varying levels of attention. Undiagnosed pain and delirium can lead to increased infection rates, prolonged mechanical ventilation, hemodynamic instability, and delirium. This study utilizes the Critical-Care Pain Observation Tool (CPOT) to measure pain and the Confusion Assessment Method (CAM) ICU to evaluate delirium in intubated patients in the ICU of RSUP HAM to explore the connection between pain and delirium. Method: The research employed a quantitative, cross-sectional observational analytical method. It investigated the association between pain and delirium in patients who were intubated at H. Adam Malik General Hospital Medan between January and February 2023, using the CPOT and CAM ICU scales. The chi-square test was used to analyze the relationship between pain and delirium, as well as the relationship between confounding factors and both pain and delirium. Results: The association between pain and delirium had a P-value of 0.001. The association between fentanyl dosage and pain in intubated patients also had a P-value of 0.001. Confounding factors included the length of stay with pain (P-value less than 0.001) and delirium with age (P-value = 0.026), gender (P-value = 0.013), and length of stay (P-value = 0.001). However, the doses of fentanyl and midazolam showed no significant association between patients with and without delirium (P-value = 0.5). Conclusion: There is a significant associations between pain and delirium.
Hubungan Ketebalan Dinding Diafragma Dengan Keberhasilan Weaning pada Pasien Kritis di ICU RSUP Haji Adam Malik Medan Soleh, Muhamad; Lubis, Andriamuri Primaputra; Hanafie, Achsanuddin
Majalah Kedokteran Indonesia Vol 74 No 5 (2024): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.74.5-2024-1508

Abstract

Introduction: Critically ill patients are at risk of developing persistent organ dysfunction that can deteriorate the patient's clinical outcome. This leads to patients in life-threatening conditions that require intensive care. Patients in the Intensive Care Unit (ICU) mostly require mechanical ventilation. Prolonged mechanical ventilation can cause a decrease in the contractile ability of the diaphragm along with diaphragmatic muscle atrophy. This is known as Ventilator Induced Diaphragm Dysfunction (VIDD). Diaphragm dysfunction remained a major cause of weaning difficulty or failure. Ultrasonography measurement of diaphragm function can be used to predict the outcome of weaning from mechanical ventilation. Methods: This study used a prospective observational study with a cross-sectional method. The total sample consisted of 36 critical patients on mechanical ventilators in the ICU who were planned for weaning. Patients were measured for diaphragm wall thickness fraction using ultrasonography. Result: In the diaphragm thickness fraction less than 30%, the successful weaning group was 3 people (8.3%), and failed weaning as many as seven people (27.8%); in the diaphragm thickness fraction greater than 30%, the successful weaning group was 24 people (66.7%) and failed weaning as many as two people (5.6%). The mean diaphragm thickness fraction in the successful weaning group was 40.77 ± 10.12, while in the weaning failure group, it was 24.50 ± 6.89. There is a relationship between diaphragm wall thickness as a predictor of successful weaning in critical patients in the ICU with a p-value = 0.001. Conclusion: Measurement of diaphragm wall thickness using ultrasonography can be used to predict weaning success in critically ill patients on ventilators in the ICU.
Hubungan Intra-abdominal Pressure Terhadap Gastric Residual Volume pada Pasien Sepsis Aulia, Miftah Furqon; Lubis, Bastian; Lubis, Andriamuri Primaputra
Majalah Anestesia & Critical Care Vol 43 No 1 (2025): Februari
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif (PERDATIN) / The Indonesian Society of Anesthesiology and Intensive Care (INSAIC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55497/majanestcricar.v43i1.375

Abstract

Latar Belakang: Sepsis merupakan salah satu penyebab terjadinya Abdominal Compartment Syndrome (ACS). ACS muncul apabila disfungsi organ terjadi sebagai hasil dari hipertensi intra-abdominal lebih dari 20 mmHg atau tekanan perfusi abdomen kurang dari 60 mmHg. Hipertensi intra-abdominal (IAH) dan ACS telah menjadi penyebab serius terhadap morbiditas dan mortalitas pada pasien bedah dan medis kritis dalam 10 tahun terakhir. Peningkatan intra-abdominal pressure (IAP) menjadi salah satu elemen pengukuran parameter fisiologis rutin pada pasien kritis dan dapat menunjukkan prognosis. Metode: Penelitian ini merupakan penelitian analitik dengan desain cross-sectional untuk mencari hubungan antara IAP terhadap Gastric Residual Volume (GRV) pada pasien sepsis di Intensive Care Unit (ICU). Subjek penelitian diambil dengan teknik consecutive sampling hingga jumlah subjek penelitian terpenuhi. Hasil: Hubungan IAP terhadap GRV menunjukkan bahwa rerata IAP pada T0 sebesar 17,7 ± 1,62 berkorelasi dengan rerata GRV T0 sebesar 263,75 ± 11,34. Sementara itu, rerata IAP pada T1 sebesar 15,7 ± 1,26 berkorelasi dengan rerata GRV T1 sebesar 243,75 ± 12,79. Analisis statistik menunjukkan nilai p <0,05, yang mengindikasikan hubungan yang signifikan antara IAP dan GRV dengan nilai r=0,625. Korelasi ini bersifat positif, yang berarti semakin tinggi nilai IAP, maka semakin tinggi pula nilai GRV. Simpulan: Terdapat hubungan IAP terhadap GRV pada pasien sepsis di ICU RSUP H. Adam Malik Medan di mana dapat disimpulkan bahwa peningkatan IAP berkorelasi dengan peningkatan GRV.
Antisialogogue Effect of Atropine Sulfate at Dosages of 0.25 Mg and 0.5 Mg Under General Anesthesia with Ketamin Hasibuan, Muhammad Ramadhan; Lubis, Andriamuri Primaputra; Wijaya, Dadik Wahyu
Journal of Society Medicine Vol. 1 No. 3 (2022): December
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (374.362 KB) | DOI: 10.47353/jsocmed.v1i3.14

Abstract

Introduction: Excessive saliva production can becomes an airway problem in conditions of decreased consciousness where there is impaired swallowing function. It increases the risk of aspiration of saliva into the airways that can result in choking. The use of premedication drugs to reduce the incidence of drug-induced hypersalivation can be done as a prevention. The anticholinergic drug class is the drug of choice for the management of hypersalivation in general anesthesia patients who have been given ketamine and ether. Ketamine as a sedating agent will provide a side effect of hypersalivation, where hypersalivation can cause laryngospasm or aspiration, as a form of prevention, anticholinergic drugs such as atropine can be given. The aim of this research was to compare the effect of antisialagogue on the administration of atropine sulfate at a dose of 0.25 mg and 0.5 mg in intravenous general anesthesia patients without ETT with ketamine at Haji Adam Malik General Hospital Medan and Putri Hijau Hospital Medan. Method: This study used a double blind RCT design. A total of 60 patients with intravenous general anesthesia without ETT with ketamine (1-2 mg/kg BW) were divided into 2 groups of Atropine Sulfas doses (0.25 and 0.5 mg) then the total salivary volume of each patient was measured and analyzed. Results: There was a significant difference between the treatment groups of 0.25 mg and 0.5 mg in the volume of saliva that had been collected (P-value = 0.008). Conclusion: There was a significant comparison between the use of 0.25 mg and 0.5 mg atropine in patients at Haji Adam Malik Hospital and Putri Hijau Hospital Medan.
The Relationship Between The Characteristics of COVID-19 Patients To Predict Mortality in The COVID-19 ICU Special Care Taufik, Maulana; Wijaya, Dadik Wahyu; Lubis, Andriamuri Primaputra
Journal of Society Medicine Vol. 1 No. 1 (2022): October
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (425.36 KB) | DOI: 10.47353/jsocmed.v1i3.18

Abstract

Introduction: The SARS-CoV-2 epidemic is sweeping the world with several waves of infections continuing. In some COVID-19 patients, this condition can develop into ARDS (acute respiratory distress syndrome) which requires ICU care with a mortality rate of 50-65 and the need for mechanical ventilation reaches 97%. The aim of this research was to know characteristics of COVID-19 patients to predict mortality in the Negative Pressure Isolation Room COVID 19 ICU at H. Adam Malik General Hospital Method: Retrospective research method with secondary data sources of COVID-19 Negative Pressure Isolation Room ICU (RITN) patients at RSUP H. Adam Malik Medan for the period May 2021 – July 2021.The data collected was in the form of patient data including name, gender, age, medical record number, comorbidities, NLR, D-Dimer, Fibrinogen, PF ratio, use of oxygen supplementation, and length of ICU stay. Chi Square statistical analysis was used for categorical data, while the T-test or Mann Whitney was used for numerical data. Then between the variables an ANOVA test was carried out to assess the comparison of clinical characteristics with mortality. Results: The results of this study indicate a higher mortality rate in women41 people (57.7%), 56-65 years age group 26 people (36.6%), patients using ventilators 51 people (71.8%), comorbid hypertension 33 people (46.5%) ), Moderate PF Ratio were 44 people (62%) and Length of stay <10 days were 55 people (77.5%). The mean fibrinogen value in COVID-19 patients who died was 658.96 ± 674.98, as well as the D-dimer value of 658.96 ± 674.98 and NLR of 11.06 ± 3.23 which showed a significant increase compared to patients Survivors of COVID-19 (p<0.05). Conclusion: A significant relationship was found between gender, age, breathing apparatus, D-dimer, Fibrinogen, NLR and length of stay with mortality of COVID-19 patients treated in the COVID Negative Pressure Room (RITN) ICU
Prophylactic Effectiveness of Phenylephrine 100 mcg and Ephedrine 10 mg on the Incidence of Spinal Anesthesia Induced Hypotension in Patients Undergoing Cesarean Section Etania, Cassandra; Hanafie, Achsanuddin; Lubis, Andriamuri Primaputra
Indonesian Journal of Anesthesiology and Reanimation Vol. 7 No. 2 (2025): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V7I22025.85-92

Abstract

Introduction: Birth by cesarean section (C-section) has increased significantly, with a high risk of maternal hypotension due to spinal anesthesia. Objective: This study aims to compare the prophylactic effectiveness of phenylephrine 100 mcg and ephedrine 10 mg in preventing spinal anaesthesia induced hypotension in C-section patients. With a focus on safety and reducing the incidence of fetal acidosis, the results of the study are expected to provide clinical insights that can improve the safety and quality of care for pregnant women undergoing this procedure. Methods: This study compared the effectiveness of phenylephrine 100 mcg and ephedrine 10 mg in preventing hypotension due to spinal anesthesia in cesarean section patients in four hospitals in Medan, Indonesia. Using a double-blind design, 40 patients aged 18-40 years were randomly selected, and blood pressure and heart rate were measured before and after anesthesia. Data were analyzed using SPSS, and ethical aspects were taken care of through informed consent. Results: This study found that phenylephrine 100 mcg was more effective than ephedrine 10 mg in preventing spinal anaesthesia induced hypotension in cesarean section, with more stable blood pressure and mean arterial pressure (MAP) at the 5th, 10th, and 15th minutes (p-value < 0.05). Although ephedrine remained above 100 mmHg for systolic blood pressure (SBP), the incidence of nausea and vomiting was slightly higher in the ephedrine group. Results support phenylephrine as the primary choice for hypotensive management. Conclusion: Phenylephrine 100 mcg is more effective than ephedrine 10 mg in preventing hypotension due to spinal anesthesia, without increasing heart rate. Despite causing nausea, ephedrine has a higher incidence of vomiting. Ephedrine is recommended if phenylephrine is not available, with further studies needed for lower doses of phenylephrine.
Tingkat pengetahuan tentang bantuan hidup dasar (BHD) pada pengemudi kendaraan umum Kota Medan: Studi kuasi-eksperimental Lubis, Andriamuri Primaputra; Irina, Rr Sinta; Akbar, Hera Zein; Elfazi, Tazzya Shailla
Jurnal SAGO Gizi dan Kesehatan Vol 6, No 2 (2025): Agustus
Publisher : Poltekkes Kemenkes Aceh

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30867/gikes.v6i2.2643

Abstract

Background: Basic Life Support (BLS) knowledge is essential, particularly for public transport drivers who frequently encounter medical emergencies. Adequate education on BLS can enhance their preparedness in responding to such situations.Objectives: This study aims to assess the level of knowledge among public transport drivers in Medan City regarding BLS before and after an educational interventionMethods: This study employed a quasi-experimental design using a one-group pretest-posttest approach. The sample consisted of 521 public transportation drivers in Medan City, divided into four groups: angkot drivers (125), online motorcycle taxi drivers (201), motorized rickshaw drivers (125), and rental car drivers (50). Data were collected using a structured questionnaire containing items assessing basic knowledge of Basic Life Support (BLS), administered both before and after an educational intervention. Data were analyzed descriptively to summarize respondent characteristics, and paired t-tests and Chi-Square tests were used to assess statistical differences in knowledge scores before and after the intervention and between driver groups.Results: The majority of participants were male (n = 451, 86.56%), with the most common age range being 31–40 years (n = 250, 47.98%). Most respondents had completed junior high school (n = 251, 47.98%), and the largest driver category was online motorcycle taxi drivers (n = 201, 38.57%). The initial assessment indicated that most participants had a limited understanding of BLS. However, post-intervention analysis demonstrated a statistically significant improvement, with the majority achieving higher knowledge scores in the posttest.Conclusion: Educational interventions on Basic Life Support significantly enhance the knowledge levels of public transport drivers in Medan City, as evidenced by the substantial difference between pretest and posttest scores. 
The relationship between pain intensity and sleep quality in various type of elective postoperative patients at Prof. Dr. Chairuddin P. Lubis USU Medan Hospital Tarigan, Randi Joel Oktavianus; Lubis, Andriamuri Primaputra; Ardinata, Dedi; Ketaren, Aga Shahri Putera
Jurnal SAGO Gizi dan Kesehatan Vol 6, No 2 (2025): Agustus
Publisher : Poltekkes Kemenkes Aceh

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30867/gikes.v6i2.2659

Abstract

Background: Postoperative pain arises after surgery and includes acute pain that needs to be treated immediately. The postoperative phase must always be observed because it relates to the patient's recovery process. The prevalence of postoperative pain varies widely around the world, with the United States at 86%, Europe at 70%, and China at 48.7%. The prevalence of postoperative pain in Indonesia has not been studied as a whole.Objectives: The research aims to analysed the relationship between pain intensity and sleep quality in elective postoperative patients at Prof. dr. Chairuddin P. Lubis USU Medan Hospital.Methods: The research used an analytical observation using a cross-sectional approach with a consecutive sampling design. Respondents' data was collected only once and simultaneously using the Numeric Pain Rating Scale (NRS) and Pittsburgh Sleep Quality Index (PSQI) questionnaires. The data will be analysed using the Statistical Package for the Social Sciences (SPSS), including Somers'd test.Results: Based on the analysis of 125 respondents' data, the highest experienced pain intensity by patients was moderate pain intensity with 49,6%, mild pain intensity with 38,4%, and severe pain intensity 12%. In the sleep quality, the poor sleep quality group was the highest, with 54,4% and the good sleep quality group 45,6%. Respondents in this research were majority aged 26–35 years with 37 respondents. This analysis shows a significant relationship and very strong correlation between pain intensity and sleep quality (p-value <0,001 and r = 0,789).Conclusion: There is a relationship between pain intensity and sleep quality in elective postoperative patients at Prof. dr. Chairuddin P. Lubis USU Medan Hospital.
Pengaruh pelatihan Early Warning Score (EWS) terhadap tingkat pengetahuan dokter dan perawat dalam penerapan EWS di Rumah Sakit Laras PT. Prima Medika Nusantara Simalungun Lubis, Andriamuri Primaputra; Rusda, Muhammad; Wahyuni, Arlinda Sari; Effendy, Elmeida; Amin, Mustafa Mahmud
Jurnal PADE: Pengabdian & Edukasi Vol 7, No 2 (2025): Oktober
Publisher : Politeknik Kesehatan Kemenkes Aceh

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30867/pade.v7i2.2739

Abstract

Background: The Early Warning Score (EWS) is a clinical monitoring system based on vital signs, designed to support early detection of patient deterioration. However, its implementation in hospitals is often hindered by limited knowledge and skills among healthcare professionals. Objective: To evaluate the impact of EWS training on improving doctors' and nurses' knowledge regarding the application of the system at Laras Hospital, PT. Prima Medika Nusantara. Methods: A quasi-experimental pre-post study without a control group was conducted involving 155 participants. The EWS training, delivered through lectures and simulations, was followed by pre- and post-intervention knowledge assessments using a structured questionnaire. Statistical analysis was performed using the Wilcoxon test. Results: The findings demonstrated a significant improvement in knowledge after training (p = 0.00), indicating the effectiveness of the intervention in enhancing clinical readiness among medical staff. Conclusion: EWS training plays a vital role in strengthening the clinical competencies of doctors and nurses. Its routine implementation can serve as a practical strategy to enhance early detection systems and improve patient safety and care quality in hospital settings.
Co-Authors Agus Pramono Akbar, Hera Zein Annisa Syifanurhati Ansari, Aulia Kamal Ardinata, Dedi - Aulia, Miftah Furqon Bastian Lubis Elfazi, Tazzya Shailla Elmeida Effendy Etania, Cassandra Hamdi, Tasrif Hanafie, Achsanuddin Harahap, Juliandi Hasibuan, Muhammad Ramadhan Irina, Rr Sinta Karim, T. Abdul Ketaren, Aga Shahri Putera Lubis, Adhika Syaputra Muhamad Soleh Muhammad Ihsan Mustafa Mahmud Amin Nadeak, Rommy Nadeak, Rommy Fransiscus Nasution, Afrida Aryani Nurchotijah, Nurchotijah Paramita, Deryne Anggia Pohan, Alfindy Maulana Rifani Masharto, Alegra Rusda, Muhammad Suherman, Jessen Syaputra, Adhika Tarigan, Randi Joel Oktavianus Taufik, Maulana Wahyuni, Arlinda Sari Wijaya, Dadik Wahyu Wijaya, Yudhi