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Case Series: Lumbar Cerebrospinal Fluid Drainage in Aneurysm Clipping Bayu, Timor Krisna; Prandani, Muhammad Yogi; Farid, Anisa Fadhila; Adiyanto, Bowo
Jurnal Komplikasi Anestesi Vol 12 No 3 (2025)
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.v12i3.14679

Intracranial aneurysm rupture is a medical emergency often accompanied by subarachnoid hemorrhage (SAH), which requires immediate medical intervention to reduce the risk of morbidity and mortality. This case report provides an overview of lumbar cerebrospinal fluid drainage (LCFD) as a method to reduce increased intracranial pressure and prevent or treat hydrocephalus that can occur after SAH. It is done by inserting an epidural catheter in the subarachnoid lumbar. The effectiveness of LCFD is more significant in patients with MFS 3-4. This finding supports the use of LCFD in managing SAH aneurysm to improve patients’ prognosis. Management of this case involved meticulous preoperative evaluation, appropriate intraoperative intervention, and strict postoperative monitoring, including treatment of cerebral vasospasm that may arise as a complication of SAH. The results suggest that LCFD can successfully reduce complications and improve clinical outcomes in patients with ruptured aneurysms who have undergone aneurysm clipping. The success of this method emphasizes the importance of a multidisciplinary approach in the management of SAH to achieve optimal patient outcomes.

The Relationship Between the Time Elapsed from the Incident to Medical Management and the Outcome of Traumatic Brain Injury Patients Undergoing Craniotomy Agung Nugroho, Fauzi; Adiyanto, Bowo; Sudadi, Sudadi
Jurnal Komplikasi Anestesi Vol 12 No 3 (2025)
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.v12i3.27389

Backgrround: Traumatic brain injury (TBI) is one of the leading causes of global morbidity and mortality, with treatment outcomes influenced by several factors, including treatment timing. Objective: This study aims to analyze the relationship between the duration from injury to initial medical management and the duration from injury to craniotomy surgery on the outcomes of TBI patients at RSUP Dr. Sardjito Yogyakarta, using the Glasgow Outcome Scale Extended (GOSE) as an assessment tool and Length of Stay (LOS).Subject and Method: This is a prospective observational study conducted on TBI patients treated at RSUP Dr. Sardjito from May to October 2024. Data were collected from the patients' electronic medical records who underwent craniotomy procedures. The analysis was performed using regression tests to evaluate the impact of the duration between the incident and initial medical management, as well as the duration until craniotomy, on patient outcomes.Result: Among 71 included patients, the median age was 19 years (Q1: 7; Q3: 57), and 71.8% were male. Most patients (52.1%) presented with a GCS score of 13–15. GOSE outcomes showed good recovery in 28.2%, mild disability in 26.8%, slight disability in 9.9%, moderate disability in 21.1%, severe disability in 5.6%, and death in 8.4%, with a median length of stay of 10 days.

Case Series: Lumbar Cerebrospinal Fluid Drainage in Aneurysm Clipping Bayu, Timor Krisna; Prandani, Muhammad Yogi; Farid, Anisa Fadhila; Adiyanto, Bowo
Jurnal Komplikasi Anestesi Vol 12 No 3 (2025)
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.v12i3.14679

Intracranial aneurysm rupture is a medical emergency often accompanied by subarachnoid hemorrhage (SAH), which requires immediate medical intervention to reduce the risk of morbidity and mortality. This case report provides an overview of lumbar cerebrospinal fluid drainage (LCFD) as a method to reduce increased intracranial pressure and prevent or treat hydrocephalus that can occur after SAH. It is done by inserting an epidural catheter in the subarachnoid lumbar. The effectiveness of LCFD is more significant in patients with MFS 3-4. This finding supports the use of LCFD in managing SAH aneurysm to improve patients’ prognosis. Management of this case involved meticulous preoperative evaluation, appropriate intraoperative intervention, and strict postoperative monitoring, including treatment of cerebral vasospasm that may arise as a complication of SAH. The results suggest that LCFD can successfully reduce complications and improve clinical outcomes in patients with ruptured aneurysms who have undergone aneurysm clipping. The success of this method emphasizes the importance of a multidisciplinary approach in the management of SAH to achieve optimal patient outcomes.

The Relationship Between the Time Elapsed from the Incident to Medical Management and the Outcome of Traumatic Brain Injury Patients Undergoing Craniotomy Agung Nugroho, Fauzi; Adiyanto, Bowo; Sudadi, Sudadi
Jurnal Komplikasi Anestesi Vol 12 No 3 (2025)
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.v12i3.27389

Backgrround: Traumatic brain injury (TBI) is one of the leading causes of global morbidity and mortality, with treatment outcomes influenced by several factors, including treatment timing. Objective: This study aims to analyze the relationship between the duration from injury to initial medical management and the duration from injury to craniotomy surgery on the outcomes of TBI patients at RSUP Dr. Sardjito Yogyakarta, using the Glasgow Outcome Scale Extended (GOSE) as an assessment tool and Length of Stay (LOS).Subject and Method: This is a prospective observational study conducted on TBI patients treated at RSUP Dr. Sardjito from May to October 2024. Data were collected from the patients' electronic medical records who underwent craniotomy procedures. The analysis was performed using regression tests to evaluate the impact of the duration between the incident and initial medical management, as well as the duration until craniotomy, on patient outcomes.Result: Among 71 included patients, the median age was 19 years (Q1: 7; Q3: 57), and 71.8% were male. Most patients (52.1%) presented with a GCS score of 13–15. GOSE outcomes showed good recovery in 28.2%, mild disability in 26.8%, slight disability in 9.9%, moderate disability in 21.1%, severe disability in 5.6%, and death in 8.4%, with a median length of stay of 10 days.

Comparing Sniffing Position Between Inflatable Vs Fixed Pillow for Glottic Visualization during Laryngoscopy Adiyanto, Bowo; Ikhwandi, Arif
Jurnal Komplikasi Anestesi Vol 13 No 1 (2025)
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.v13i1.28464

Background: Effective glottic visualization is crucial for successful tracheal intubation and reducing complications during airway management. The sniffing position is commonly used, with various pillow types employed to optimize the alignment of the airway axes. We performed a study to evaluate the effectiveness of an inflatable intubation pillow for glottic visualization, intubation time, and first-attempt intubation success.Objective: We performed a study to evaluate the effectiveness of an inflatable intubation pillow for glottic visualization, intubation time, and first-attempt intubation success.Methods: A randomized controlled trial was conducted with 222 patients undergoing general anesthesia and endotracheal intubation at Dr. Sardjito General Hospital, Yogyakarta. Patients were randomly assigned to two groups: Group I (inflatable pillow) and Group S (fixed pillow). The primary outcome was glottic visualization, assessed using the Cormack–Lehane score, while secondary outcomes included intubation time and the number of intubation attempts. Multivariate analyses adjusted for potential confounders such as BMI, sex, and age.Results: The inflatable pillow group showed a higher proportion of grade 1 glottic visualization (64%) compared to the fixed pillow group (55%), but this difference was not statistically significant after adjusting for confounders. The inflatable pillow group demonstrated a significantly shorter intubation time (35 seconds) compared to the fixed pillowConclusion: The use of an inflatable pillow in the sniffing position significantly reduced intubation time, improving procedural efficiency. However, it did not show a significant improvement in glottic visualization or first-attempt intubation success after adjusting for confounding factors. BMI was the primary determinant of glottic visualization

english English Pasmawati, Desti; Fitriani R.W, Calcarina; Adiyanto, Bowo
Jurnal Komplikasi Anestesi Vol 13 No 2 (2026)
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.v13i2.28917

Background : Sepsis is one of the causes of morbidity and mortality patients hospitalized in the intensive care unit (ICU) which requires early detection and management to predict outcomes. Lactate-albumin ratio has a predictive value of mortality in patient with sepsis that is similar to APACHE II and SOFA scores. Objective : To determine the relationship between the lactate-albumin ratio and mortality and length of stay patient with sepsis in ICU of Dr. Sardjito Hospital. Method : Research design using a retrospective cohort observational study by collecting data from the medical records of sepsis patients at ICU of Dr. Sardjito Hospital. Data were calculate the optimal cutoff using the ROC curve. The relationship between lactate-albumin ratio levels and mortality was analyzed using the chi-square test method followed by logistic regression. Results : The total study subjects were 136 patients. The cut-off value for the Lactate-Albumin ratio in predicting mortality 0,878, sensitivity 73.0 % and specificity 57.1% (AUC = 0,687; 95% CI 0,56-0,81; p=0,007). The cut-off value for the Lactate-Albumin ratio in predicting ICU length of stay 0,878, sensitivity 71,2% and specificity 63,6% (AUC = 0,684; 95% CI 0,53-0,84; p=0,043). Multivariate analysis showed that an increase in the Lactate-Albumin ratio was independent and significant factor as a predictor of mortality (OR=3,43; 95% CI 1,29-9,16; p=0,013) and ICU length of stay (OR=4,33; 95% CI 1,19-15,68; p=0,036). Conclusion : An increase in the Lactate-Albumin ratio is independently and significantly associated with an increased risk of mortality and length of stay in sepsis patients.

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