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All Journal Narra J Majalah Anestesia & Critical Care (MACC) Jurnal Pengabdian Pada Masyarakat METHABDI
Lubis, Andriamuri P.
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Religion Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Computer Science & IT Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Education Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Physics Public Health

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Role of pediatric risk of mortality (PRISM IV) score at 24 and 72 hours of hospitalization in predicting mortality among critically ill pediatric patients treated in PICU Lubis, Aridamuriany D.; Nasution, Badai B.; Lubis, Andriamuri P.; Supriami, Kelvin
Narra J Vol. 4 No. 2 (2024): August 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i2.780

Abstract

Pediatric patients with multiple organ failures in the pediatric intensive care unit (PICU) are at a higher risk of mortality. Assessing the mortality risk when patients are admitted to PICU is important to allocate treatment and care properly. The aim of this study was to compare the performance of the PRISM IV score within the first 24 and 72 hours to predict mortality in the PICU. Demographic, clinical, and laboratory data were collected to compute the PRISM IV in the first 24 and 72 hours among critically ill pediatric patients in the PICU at H. Adam Malik General Hospital, Medan, Indonesia, from April 2021 to February 2022. The comparison of the PRISM IV scores and its components within the first 24 and 72 hours was analyzed using the Wilcoxon test, Student’s independent t-test or McNemar test.  The role of PRISM IV score in predicting mortality was assessed using the receiver operating characteristic (ROC) curve. Out of 35 pediatric patients, 17 (48.6%) of them died. Platelet count (p=0.022), pCO2 (p=0.026), HCO3 (p=0.009), total CO2 (p=0.015), and base excess (p=0.001) were statistically different between 24 and 72 hours groups. The area under curve (AUC) for the first 24 hours using PRISM IV scores was 47.4% with p=0.792 (95%CI, 27.7%–67.1%). Meanwhile, the AUC of 72 hours group was 65.4%, p=0.121 (95%CI, 47.1%–83.6%). This study suggested that PRISM IV scores in the first 24 and 72 hours may not be a reliable screening tool for predicting mortality. However, further studies are suggested to validate these findings.
Effectiveness and safety of thoracic segmental spinal anesthesia for breast surgery: A systematic review and meta-analysis Hamdi, Tasrif; Mastari, Ekawaty S.; Lubis, Andriamuri P.; Ghozali, Imam; Kemalasari, Nadia; Harahap, Awi TM.
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.1630

Abstract

General anesthesia is the standard approach for thoracic and abdominal procedures; however, it has notable limitations, particularly in high-risk patients. Regional anesthesia techniques, such as thoracic segmental spinal anesthesia, have gained popularity due to their potential to reduce these associated risks. The aim of this study was to assess the effectiveness and safety of thoracic segmental spinal anesthesia in breast cancer surgery using systematic review and meta-analysis. This study adhered to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 guidelines, conducting a comprehensive literature search across ScienceDirect, Cochrane Library, and PubMed databases up to July 4, 2024. The inclusion criteria focused on studies that provided specific information on the effectiveness (postoperative pain reduction) and safety (incidence of adverse events and complications) of thoracic segmental spinal anesthesia, as well as satisfaction among patients and surgeons. Out of 4,060 articles, six studies were included for qualitative assessment, with four further analyzed quantitatively. Meta-analysis findings indicated that thoracic segmental spinal anesthesia provided significantly better pain control at 12 hours postoperatively (SMD: -1.25; 95%CI: -1.54 to -0.96; p<0.0001), although no significant difference was noted at 0 hours (SMD: -1.07; 95%CI: -2.33 to 0.18; p=0.09). Thoracic segmental spinal anesthesia was associated with a lower incidence of postoperative vomiting (RR: 0.46; 95%CI: 0.22–0.95; p=0.04), but it presented a higher risk of hypotension (RR: 2.57; 95%CI: 1.41–4.71; p=0.002). Importantly, no anesthesia-related mortalities were reported. The technique resulted in higher satisfaction levels among both patients (SMD: 0.63; 95%CI: 0.33–0.92; p<0.0001) and surgeons (SMD: 0.81; 95%CI: 0.51–1.11; p<0.0001) compared to general anesthesia. The study highlights that thoracic segmental spinal anesthesia is a safe and effective alternative to general anesthesia for breast cancer surgery, offering superior postoperative pain control, enhanced patient and surgeon satisfaction, and a reduced incidence of postoperative vomiting.
Co-Authors Chalil, M. Jalaluddin A. Diani Nazma Endy Juli Anto Fadinie, Wulan Hadyanto Lim Hamdi, Tasrif Harahap, Awi TM. Hutasoit, Eka Samuel P. Imam Ghozali Irfan Hamdani, Irfan Irina, Sinta Kemalasari, Nadia Lubis, Aridamuriany D. Mastari, Ekawaty S. Nasution, Badai B. Natalie S., Karen Rimbun, Surjadi Rr Sinta Irina Siahaan, Dwi Lunarta D. S. Siahaan, Jekson Martiar Silaen, Ester L. R. Simbolon, Boyke M. Sinatra, Jadeny Siregar, Ahmad Solihin Sitepu, John Frans Stephanie S., Kezia Supriami, Kelvin Tambunan, Ronald T. H. Tanjung, Qodri F. Tarigan, Juliyanti Tobing, Paul S. M. L. YUNAFRI, ANDRI Zainumi, Cut M.