Pertiwi, Previasari Zahra
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Succesful Continuous Renal Replacement Therapy (CRRT) for Acute Kidney Injury (AKI) with Septic Shock Underwent Long Coronary Artery Bypass Graft Procedure (CABG) Pertiwi, Previasari Zahra; Fatoni, Arie Zainul; Agustina, Ayu Yesi; Jaya, Wiwi
Journal of Anaesthesia and Pain Vol 5, No 1 (2024): January
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2024.005.01.05

Abstract

Background :AKI occurs in significant numbers of patients undergoing cardiopulmonary bypass surgery for coronary artery disease. Patient with AKI requiring renal replacement therapy (RRT) after cardiac surgery were at a higher risk of postoperative mortality. One of mode of RRT is CRRT. CRRT can keep hemodynamic of the patient stable, excellent control of azotemia, sypport beneficial immunomodulation,increase clearance of inflammatory mediators and potentially less ongoing or repeated renal ischaemia. As an alternative to traditional intermittent hemodialysis, CRRT has now emerged as the leading form of RRT for patients with AKI post CABG because the CRRT can keep hemodynamic still stable.Case: We report a case report of patient who had long aorta cross clamp in CABG procedure. He got AKI with shock condition during hospitalization in ICU, had been done with CRRT and had good response after the procedure.Discussion: The  incidence  of AKI  after  cardiac  surgery in this patient  may  increase  with several risk factors, such as surgical bleeding, diabetes mellitus, pre operative renal dysfunction, low  LVEF,  the use of CPB machine and infection. An  imbalance  between  renal oxygen  supply  and  oxygen demand will induce AKI. This patient had done CRRT and showed good clinical and laboratory condition after that. Conclusion : CRRT is a good choice for AKI patient post CABG procedure with shock condition.
Characteristic Outline of Head Trauma Patients at Dr. Saiful Anwar General Hospital Laksono, Buyung Hartiyo; Pertiwi, Previasari Zahra; Siswagama, Taufiq Agus; Isngadi, Isngadi
Journal of Anaesthesia and Pain Vol. 6 No. 3 (2025): In Press
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/

Abstract

Background: Traumatic brain injury is defined as a decline in brain function characterized by a decreased level of consciousness, seizures, and focal sensory and motor neurologic deficits caused by blunt force or penetration by a sharp object into the intracranial space. This reseracrh aims to determine the characteristics of head trauma patients at Dr. Saiful Anwar General Hospital, Malang.Methods: This descriptive observational study sampled all head trauma patients at Dr. Saiful Anwar General Hospital, Malang, from March to August 2023. The study variables included patient demographics, cause of trauma, clinical data, pre-and postoperative procedures, outcomes of trauma patients undergoing treatment, and length of stay. Data were analyzed using Microsoft Excel.Results: A total of 227 head trauma patients were identified, most of whom were men aged 20-39 (71). Students (72) were the most common victims of head trauma, most often due to accidents. There were 156 patients with mild head injuries. 208 patients had normal oxygen saturation. 157 patients had normal hemoglobin, 181 patients had normal sodium, and 196 patients had normal blood glucose levels. 102 patients experienced hypocarbia. A normal CT scan of 141 patients was performed. 206 patients underwent surgery, while 214 patients did not undergo tracheostomy. 149 patients underwent surgery with early emergence. The highest number of patients were patients with a hospital stay of more than 14 days (140 patients). The most common outcome was mild disability (84 patients).Conclusion: Most patients were male, aged 20-39. The most common cause was accidents involving students. Most patients with mild head injuries had normal oxygen saturation, hemoglobin,sodium, and blood glucose levels. Most patients with hypocarbia had no bleeding, and CT scans showed no bleeding. Most patients underwent surgery and early emergence, with a hospital stay of more than 14 days, and the most common outcome was mild disability.
Succesful Continuous Renal Replacement Therapy (CRRT) for Acute Kidney Injury (AKI) with Septic Shock Underwent Long Coronary Artery Bypass Graft Procedure (CABG) Pertiwi, Previasari Zahra; Fatoni, Arie Zainul; Agustina, Ayu Yesi; Jaya, Wiwi
Journal of Anaesthesia and Pain Vol. 5 No. 1 (2024): January
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jap.2024.005.01.05

Abstract

Background :AKI occurs in significant numbers of patients undergoing cardiopulmonary bypass surgery for coronary artery disease. Patient with AKI requiring renal replacement therapy (RRT) after cardiac surgery were at a higher risk of postoperative mortality. One of mode of RRT is CRRT. CRRT can keep hemodynamic of the patient stable, excellent control of azotemia, sypport beneficial immunomodulation,increase clearance of inflammatory mediators and potentially less ongoing or repeated renal ischaemia. As an alternative to traditional intermittent hemodialysis, CRRT has now emerged as the leading form of RRT for patients with AKI post CABG because the CRRT can keep hemodynamic still stable.Case: We report a case report of patient who had long aorta cross clamp in CABG procedure. He got AKI with shock condition during hospitalization in ICU, had been done with CRRT and had good response after the procedure.Discussion: The  incidence  of AKI  after  cardiac  surgery in this patient  may  increase  with several risk factors, such as surgical bleeding, diabetes mellitus, pre operative renal dysfunction, low  LVEF,  the use of CPB machine and infection. An  imbalance  between  renal oxygen  supply  and  oxygen demand will induce AKI. This patient had done CRRT and showed good clinical and laboratory condition after that. Conclusion : CRRT is a good choice for AKI patient post CABG procedure with shock condition.