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All Journal Jurnal Biomedika dan Kesehatan JUARA: JURNAL WAHANA ABDIMAS SEJAHTERA AMMA : Jurnal Pengabdian Masyarakat Sanus Medical Journal
Trilaksmi, Antin
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Humanities Biochemistry, Genetics & Molecular Biology Chemistry Education Engineering Environmental Science Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Materials Science & Nanotechnology Medicine & Pharmacology Nursing Public Health Social Sciences

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Journal : Sanus Medical Journal

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D-Dimer Sebagai Salah Satu Parameter Perbaikan Klinis pada Kasus Covid-19 Gejala Berat Trilaksmi, Antin; Martin
Sanus Medical Journal Vol. 4 No. 2 (2022)
Publisher : Universitas Muhammadiyah Prof. Dr. Hamka (UHAMKA Press)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22236/sanus.v4i2.10039

Abstract

Background. Coronavirus Disease 2019 (COVID-19) has been a global pandemic since March 2020. The number of patients is massive and clinical symptoms vary from mild to severe symptoms. Several laboratory results showed abnormal values in Covid-19 patients, including an increase in the value of D-dimer. Elevated levels of D-dimer in COVID-19 patients are strongly associated with severity and increased mortality. We report a case of a severe symptomatic COVID-19 patient with high D dimer levels at the start of treatment and showing clinical improvement according to a decrease in D dimer levels. Methods. We treat and follow the clinical and laboratory developments of COVID-19 patients with severe symptoms from the time they enter the Intensive Care Unit (ICU) until they move to a regular ward. Results. A 53-year-old male patient diagnosed with viral pneumonia et causa covid-19 was admitted to the ICU with severe symptoms and high initial d-dimer levels (1,413 ug/ml). The patient received ventilator assistance and standard therapy according to the Covid 19 management protocol of the Ministry of Health of the Republic of Indonesia. Anticoagulation using heparin intravenously with a dose adjusted to the level of d dimer, aPTT, and clinical condition of the patient who is monitored regularly. The trend of d dimers decreased parallel to the decrease in C reactive protein (CRP) levels, increased lung gas exchange function was evaluated from the PaO2/Fio2 ratio (PF ratio) and the clinical improvement of the patients. Conclusion. D-dimer is closely related to the severity of covid 19 patients. D dimer can be used as one of the parameters of patient clinical improvement.
Emfisema Subkutis sebagai Komplikasi pada Pasien Covid-19 dengan Penggunaan Ventilasi Mekanik Panduwaty, Lira; Trilaksmi, Antin; Cipta, Ferdy
Sanus Medical Journal Vol. 4 No. 2 (2022)
Publisher : Universitas Muhammadiyah Prof. Dr. Hamka (UHAMKA Press)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22236/sanus.v4i2.10388

Abstract

Background. The incidence of subcutaneous emphysema in patients with severe pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus infection has been in the spotlight recently. Subcutaneous emphysema is a rare complication. With the increasing prevalence of subcutaneous emphysema in patients with confirmed coronavirus disease (COVID-19), it is necessary to know what factors can cause this and how to treat it. Case Description. Two patients, a man and a woman aged 50 and 70 years, diagnosed with COVID-19, came to the Emergency Room (IGD) of Bunda Menteng General Hospital, Jakarta, with symptoms of acute respiratory distress syndrome (ARDS). Both patients experienced severe shortness of breath with a respiratory rate above 30 times per minute. Then the two patients were treated in the intensive care Unit (ICU) isolation room and required mechanical ventilation assistance. After 3-4 days of mechanical ventilation treatment, subcutaneous emphysema develops, characterized by subcutaneous crepitus. After chest x-rays were carried out in both patients, the results were subcutaneous emphysema and pneumomediastinum. Several invasive procedures have been performed, such as subcutaneous insertion of an intravenous cannula, mediastinoscopy, and chest tube insertion. Conclusion. Complications of subcutaneous emphysema in COVID-19 patients are rare and require further research to determine the cause, where the infection is still the focus. With this case report, it is hoped that clinicians will pay more attention to the initial clinical findings of subcutaneous emphysema to reduce even more severe complications such as pneumothorax.
Co-Authors Christian Cipta, Ferdy Devantoro, M Ridho Diani Nazma Husnun Amalia Lira Panduwaty Mahardieni, Karlina Martin Meiriani Sari Panduwati, Lira Prasetyaningsih, Noviani Rachmiyani, Irmiya Soesilo, Christian