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All Journal Jurnal Anestesiologi Indonesia Indonesian Journal of Anesthesiology and Reanimation (IJAR) Journal of Anaesthesia and Pain Majalah Anestesia & Critical Care (MACC) Jurnal Medika Nusantara The International Journal of Medical Science and Health Research Jurnal Komplikasi Anestesi Cermin Dunia Kedokteran
Bowo Adiyanto
Departemen Anestesiologi Dan Terapi Intensif, Fakultas Kedokteran, Kesehatan Masyarakat Dan Keperawatan, Universitas Gadjah Mada, Yogyakarta, Indonesia
Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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Penyakit Paru Obstruktif Kronis (PPOK) dengan Multipel Komorbid Maryani, Nova; Akhmad Yun Jufan; Bowo Adiyanto
Jurnal Komplikasi Anestesi Vol 11 No 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
Management of Tetanus Patients in the Intensive Care Unit : A Case Report Hanafia, Mochamad Fauzi; Adiyanto, Bowo
The International Journal of Medical Science and Health Research Vol. 4 No. 3 (2024): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/afhb4p29

Abstract

We report a case of a 41-year-old male patient with a history of a nail puncture wound who presented to the Emergency Department (ED) with complaints of generalized body stiffness. The patient experienced worsening stiffness, particularly in the neck, jaw, back, and abdomen. He was diagnosed with tetanus and received initial treatment with human tetanus immunoglobulin (HTIG) and antibiotics. The patient was admitted to the intensive care unit (ICU) due to the risk of recurrent seizures and airway obstruction. During the treatment, he developed several complications, including pneumonia and hematemesis. Supportive care was provided, including adequate nutrition, prevention of pressure sores, and physiotherapy. The patient showed improvement after the administration of magnesium sulfate (MgSO4) to control spasms and autonomic dysfunction. He was successfully weaned off the ventilator and discharged after 40 days of intensive care.
Modern Intensive Care Unit Design : A Literature Review Wijaya, Andryadi; Jufan, Akhmad Yun; Adiyanto, Bowo
The International Journal of Medical Science and Health Research Vol. 4 No. 4 (2024): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/h3b92933

Abstract

The need for Intensive Care Units (ICUs) continues to increase over time. In Canada, 11% of hospitalized patients are referred to the ICU, while in the United States, up to half of the population receives ICU care in their last year of life. Standardization of ICU design and operations is considered essential for efficiency and high-quality patient care. The ICU is a clinical care unit to monitor and support the vital functions of potentially life-threatening critical patients. The organization and management of critical care services are key components that contribute to ICU performance and can impact patient outcomes and healthcare costs. Modern ICU design should consider various elements such as layout, isolation rooms, staff areas, and family rooms. Technological developments such as Smart ICU and the ICU Without Walls concept demonstrate innovation in efficiency improvement and patient safety. The continuity of care activities in the ICU requires skilled human resources, adequate facilities, effective management, and a deep understanding of good ICU design. Technology integration and multidisciplinary approaches are essential to optimize critical patient care and improve clinical outcomes.
Perbandingan Angka Keberhasilan Pemasangan Laryngeal Mask Airway (Lma) Klasik pada Usaha Pertama Antara Teknik Standar dengan Modifikasi Teknik Menggunakan Rigid Stylet Bowo Adiyanto; IG Ngurah Rai Artika; Sudadi
Jurnal Komplikasi Anestesi Vol 1 No 1 (2013): Volume 1 Number 1 (2013)
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.v1i1.5522

Abstract

Pendahuluan. Angka keberhasilan pemasangan LMA klasik pada usaha pertama dengan teknik standar masih rendah dan bervariasi. Berbagai teknik dan modifikasi pemasangan LMA klasik telah dilakukan untuk meningkatkan keberhasilan dan mengurangi komplikasi. Salah satu modifikasi adalah dengan menggunakan rigid stylet. Kami berharap dengan teknik ini kelemahan pemasangan LMA klasik dengan teknik standar dapat teratasi, LMA menjadi lebih kaku, lengkung pipa lebih sesuai dengan anatomi jalan napas, dan tidak memerlukan ruang yang lebih di rongga mulut sehingga diharapkan dapat meningkatkan keberhasilan pemasangannya. Tujuan penelitian ini adalah untuk menguji hipotesis bahwa pemasangan LMA klasik pada usaha pertama dengan modifikasi teknik menggunakan rigid stylet lebih baik dibandingkan teknik standar. Metode Penelitian. Merupakan penelitian prospektif, uji klinis acak terkontrol yang dilakukan pada 88 pasien sehat (ASA I atau II) yang menjalani umum anestesi dilakukan randomisasi dan dialokasikan ke salah satu dari 2 dua kelompok yaitu teknik standar (kelompok S) dan kelompok modifikasi teknik menggunakan rigid stylet (Kelompok R). Waktu pemasangan LMA, dan komplikasi pemasangan berupa nyeri tenggorokan dan bercak darah pada LMA secara statistik dianalisa. Hasil. Keberhasilan pemasangan LMA klasik pada usaha pertama adalah terpasangnya LMA klasik yang dinilai efektif memberikan ventilasi pada usaha yang pertama. Angka keberhasilan pemasangan LMA Klasik pada usaha pertama dengan teknik modifikasi dengan rigid stylet (93,%) lebih tinggi dibandingkan dengan teknik standar (83,7%) secara statistik tidak bermakna (p>0,05). Waktu pemasangan secara signifikan lebih cepat pada teknik rigid stilet dibandingkan pada teknik standar. (15,52 ± 4,94 detik dibanding 7,12 ± 3,53 detik) (p<0.05). Kesimpulan. Angka keberhasilan pemasangan LMA Klasik pada usaha pertama dengan teknik modifikasi dengan rigid stylet (93,%) lebih besar dibandingkan dengan teknik standar (83,7%) secara statistik tidak bermakna (p>0,05).
Resusitasi pada Pasien Intoksikasi Methanol Jufan, Akhmad Yun; Adiyanto, Bowo; Hartono, Pinter
Jurnal Komplikasi Anestesi Vol 3 No 3 (2016): Volume 3 Number 3 (2016)
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.v3i3.7262

Abstract

Laki laki 24 tahun, pasien dengan rujukan keracunan alkohol. Pasien riwayat mengkonsumsi alcohol 1 hari yang lalu. 8 jam setelah konsumsi alkohol campuran pasien mengeluh kepala pusing dan pandangan menjadi kabur. Pasien mengalami muntah dan penurunan kesadaran, tekanan darah turun, sesak nafas, asidosis metabolik serta gagal ginjal. Pertolongan yang dilakukan intubasi, ventilasi mekanik, obat inotropik serta koreksi asidosis dengan bicarbonat, selanjutnya dilakukan hemodialisa di ICU. Pasien tidak mendapatkan penghambat metabolik untuk toksin methanol.
Manajemen Anestesi pada Neonatus Umur 3 Hari dengan Atresia Ani Tanpa Fistel dan Atresia Esofagus Tipe C Pro Gastrotomi Dekompresi, Jejunostomi Feeding dan Stoma Harianto, Widi Yuli; Sari, Djayanti; Adiyanto, Bowo
Jurnal Komplikasi Anestesi Vol 4 No 2 (2017): Volume 4 Number 2 (2017)
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.v4i2.7287

Abstract

Latar belakang : Tracheoesophageal fistula (TEF) dan esophageal atresia (EA) merupakan penyakit malformasi kongenital yang sering terjadi dengan rasio 1: 3000 – 4500 kelahiran hidup.Obyektif : Dapat melakukan intubasi dan penempatan ETT yang aman pada neonatus dengan TEF dan EA.Kasus : Dilaporkan kasus neonates usia 3 hari, dengan EA tipe C dan atresia anitanpafistel dilakukan gastrotomide kompresi, Jejunostomi dan stoma. Ibu berusia 30 tahun, P2A0, persalinan spontan pada usiakehamilan 38 minggu, dengan berat badan lahir bayi 2400 gram. Babygram menunjukkan udara gaster prominen dan pipa gastrik pada proyeksi midvertebra dengan ujung pipa setinggi korpus Vth 2. Intubasi dan penempatan ETT dilakukan dengan teknik tradisional yaitu ETT dimasukkan hingga endobronkhial kemudian ditarik perlahan sampai ETT berada di atas karina dan suara auskultasi kedua paru sama. Intubasi dilakukan tanpa pelumpuh otot Dan ventilasi tekanan positif. Diantara beberapa teknik intubasi pada padaTracheoOesophageal Fistula, pada pasien ini dilakukan teknik intubasi tradisional dengan minimal insuflasi dan menghindari ventilasi tekanan positif.Diskusi : Terdapat beberapa teknik untuk melakukan intubasi dan penempatan ETT pada pasien dengan TEF dan EA: teknik tradisional, dengan Fogarty Ballon Catheter, Double Fogarty Catheters, Cuffed ETT, dan ventilasi satu paru. Preoperatif dan intra-operatif bronkhoskopi dilakukan untuk menentukan tempat dan anatomi fistula dan sebagai petunjuk penempatan ETT. Oleh karena tidak ada bronkoskopi fleksibel ukuran neonatus di rumah sakit kami, kami menggunakan teknik intubasi tradisional, menjaga napas tetap spontan, dan hindari ventilasi tekanan postif.Kesimpulan : Manajemen jalan napas pasien EA dan TEF dapat dilakukan dengan teknik tradisional dengan minimal insuflasi ke lambung dan tanpa ventilasi tekanan positif.
Tatalaksana Perawatan Intensif Pasien PPOK Eksaserbasi Akut dengan Gagal Napas Tipe II Widodo, Untung; Adiyanto, Bowo; Aprianti, Tutut
Jurnal Komplikasi Anestesi Vol 6 No 2 (2019): Volume 6 Number 2 (2019)
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.v6i2.7354

Abstract

A fifty-two years old male was diagnosed COPD with acute exacerbation had care in intensive care unit for 7 days. Patient hospitalized for dyspneu, decreased consciousness and was diagnosed with acute exacerbation of obstructive pulmonary disease with mix type of respiratory failure. Patient was intubated, mechanically ventilated, and given COPD medical therapy during ICU treatment. Routine blood gas analysis and chest X-rays evaluation has been done to determine the improvement of ventilation. Ventilator weaning was performed so that the patient can breathe adequately and blood gas analysis showed improve.
Mengenali Medical Error dan Optimalisasi Patient Safety di Intensive Care Unit (ICU) Adiyanto, Bowo; Suwarman
Jurnal Komplikasi Anestesi Vol 7 No 2 (2020): Volume 7 Number 2 (2020)
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.v7i2.7458

Abstract

Characteristics of patients treated in the ICU are patients with critical conditions, acute, with many comorbidities, the number of actions and medications and treatments by multidisciplinary and multi-specialist. This condition is a challenge to be able to develop safety culture in the ICU. The safety culture in the ICU must be aware of and have high vigilance that the potential for medical errors is quite high in the ICU and has a severe impact on patients. Systematic strategies and multifactorial approaches are needed to improve patient safety and reduce medical errors at the ICU. Improving safety culture, ensuring commitment to national patient safety regulations, investing in safe infrastructure, optimizing the role of units in identifying potential errors and standardizing services according to the latest evidence base are the basic factors needed to support safe and quality patient care at ICU . It is important for the next stage to manage and measure the processes and outcomes in the service, and ensure that patients receive optimal therapy in accordance with evidence base practice. In addition to focusing on patient safety areas that have been regulated by national regulations, focus on areas with an appropriate evidence base to be applied in ICU care such as protocol development, checklists, care bundles, simulation-based education, and CUSP programs to optimize the role of units in the program patient safety. The efforts mentioned above to be able to succeed certainly require organization, leadership, multidisciplinary and multi-specialist cooperation, as well as individual service ends who are committed and consistent to the development of safety culture in the ICU.
Manajemen Perioperatif Pasien Insulinoma dengan Komorbid Epilepsi Adiyanto, Bowo; Kurniawaty, Juni; Pambudi, Estu Agung
Jurnal Komplikasi Anestesi Vol 7 No 3 (2020): Volume 7 Number 3 (2020)
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.v7i3.7473

Abstract

Insulinoma is a rare benign functional neuroendocrine in pancreas. Inappropriate secretion of insulin in patient with insulinoma results in hypoglycaemic episode with clinical symptoms. Meanwhile, epilepsy is a manifestation of brain disorder with a variety of clinical symptoms, cause by the release of electrical charges from brain neuron. We reported a 50 years old man with insulinoma which was planned for laparoscopic tumor resection. Patient also have epilepsy as a comorbid. The choice of anesthesia technique is intubation general anesthesia. Hypoglycemia is the main problem that can happen in preoperative and intraoperative period, so blood glucose was monitored every 30 minutes. Anesthesia consideration in this patient was avoiding hypoglycemia in preoperative and intraoperative period and avoiding proconvulsan anesthetic agent because the patient also have epilepsy as comorbid.
Manajemen Anestesi pada Seksio Sesaria dengan Hipotiroid Kurniawaty, Juni; Adiyanto, Bowo; Joni, Rendy Pranda
Jurnal Komplikasi Anestesi Vol 7 No 3 (2020): Volume 7 Number 3 (2020)
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.v7i3.7474

Abstract

Thyroid disease is a disorder that affects the thyroid gland. Thyroid hormones regulate metabolism and affect nearly every organ in the body. The management of anesthesia on the hypothyroid is crucial and consist of preoperative, intraoperative, and postoperative management. We reported a 36-year-old female patient with multigravida and hypothyroid on therapy, which would performed sectio caesarea. Patient had hypothyroid and consumed levothyroxine since a year earlier. Spinal regional anesthesia with low doses was administered and sedation was neither prescribed before nor during surgery to maintain hemodinamic stability. A pregnant women with hypothyroidism need special management of anesthesia. Hypothyroid patients are very sensitive to anesthetic drugs so that preoperative sedation should be avoided. During intraoperation, surveillance of haemodynamics must be strict because hypothyroidism can trigger refractory hypotension. Sedation drugs should not use both in preoperative and intraoperative period.
Co-Authors Adiyatma, Krisna Hario Akhmad Yun Jufan Akhsaniati, Novi Dwi Ancilla, Cornelia Aprianti, Tutut Arif Setyo Wibowo Arifin, Achmad Reza Bhirowo Yudo Pratomo Cakradwipa, Mada Oktav Calcarina Fitriani Retno Wisudarti Djayanti Sari Hanafia, Mochamad Fauzi Harianto, Widi Yuli Hartono, Pinter Hernawan, Agung Diky IG Ngurah Rai Artika Ika Cahyo Purnomo Joni, Rendy Pranda Juni Kurniawaty Muhdar Abubakar Djayanti Sari Maryani, Nova Naomi, Diah Anis Nur, Rifdhani Fakhrudin Palupi, Isnafianing Pambudi, Estu Agung Pasmawati, Desti Prasamya, Erlangga Rahma, Aulia Zuhria Rikardi, Fachrizal Sadewo, Yuri Sarjono, Pramuditya Haryo Shila Suryani, Shila Sofwan, Fachruddin Sudadi Suparno Suparno Sutiyoso, Noor Aditya Suwarman Untung Widodo, Untung wandito, Gayuh Utomo Wijaya, Andryadi