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All Journal Journal of Anaesthesia and Pain Jurnal Kesehatan Tambusai The International Journal of Medical Science and Health Research
Wijaya, Andryadi
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Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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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.
MANAJEMEN PASIEN DENGAN SYOK SEPSIS, CONGESTIVE HEART FAILURE, CORONARY ARTERIAL DISEASE, CHRONIC KIDNEY DISEASE POST FISTULEKTOMI DI ICU wijaya, andryadi; Jufan, Akhmad Yun; Prasamya, Erlangga
Jurnal Kesehatan Tambusai Vol. 6 No. 2 (2025): JUNI 2025
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jkt.v6i2.45876

Abstract

Sepsis merupakan kondisi disregulasi sistem imun akibat infeksi dengan angka mortalitas tinggi yang dapat mencapai 26%. Komplikasi seperti Acute Kidney Injury dapat meningkatkan risiko kematian hingga 50%. Masalah utama dalam manajemen sepsis adalah kompleksitas penanganan pasien dengan komorbid multipel seperti gagal jantung kongestif (CHF) dan chronic kidney disease (CKD). Tujuan penelitian ini adalah mengevaluasi manajemen dan luaran klinis pasien dengan syok sepsis disertai komorbid CHF dan CKD post fistelektomi di ruang intensif. Kasus: Pasien menjalani fistelektomi drainase dan dirawat di ICU dengan dukungan ventilasi mekanik, vasopresor (norepinefrin, dobutamin, epinefrin), dan antibiotik spektrum luas (meropenem). Pemeriksaan laboratorium menunjukkan leukositosis signifikan, anemia, hipoalbuminemia, serta gangguan fungsi hati dan ginjal. Setelah empat hari perawatan intensif dengan monitoring hemodinamik ketat, pasien menunjukkan perbaikan klinis, berhasil diekstubasi, dan direncanakan pindah ke ruang perawatan biasa. Simpulan: Manajemen pasien dengan syok sepsis disertai komorbid CHF dan CKD memerlukan pendekatan multidisiplin yang komprehensif. Kontrol sumber infeksi melalui pembedahan, terapi sepsis sistematis, dan pemantauan ketat di ruang intensif berperan penting dalam meningkatkan luaran klinis dan survival pasien.
Multidisciplinary Management of Severe Hemorrhagic Stroke with Triple Challenge: Subarachnoid Hemorrhage, Intracerebral Hemorrhage, and Hydrocephalus-A Case Report Wijaya, Andryadi; Jufan, Akhmad Yun
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/ub.jap.2025.006.03.05

Abstract

Background: Hemorrhagic stroke, particularly subarachnoid hemorrhage (SAH) and intracerebral hemorrhage (ICH), is a neurological emergency associated with high morbidity and mortality, especially when complicated by increased intracranial pressure (ICP). This report aims to describe the comprehensive management of a patient with severe hemorrhagic stroke complicated by SAH, ICH, and hydrocephalus Case: This case report describes the management of a 69-year-old female with extensive SAH, ICH, ruptured anterior communicating artery aneurysm, and obstructive hydrocephalus. The patient presented with decreased consciousness post-seizure. Initial management included emergency external ventricular drain (EVD) placement and subsequent surgical clipping of the aneurysm. Non-invasive ICP monitoring using optic nerve sheath diameter (ONSD) demonstrated a reduction from 0.68 cm to 0.49 cm over seven days, reflecting successful ICP control. Complications included vasospasm managed with nimodipine, hypernatremia and polyuria suggestive of central diabetes insipidus treated with desmopressin, and nosocomial pneumonia due to serratia marcescens. Antibiotic therapy was escalated from ceftriaxone to meropenem and de-escalated to cefepime based on culture results. Despite optimal intensive care, the patient showed no significant neurological improvement (persistently low Glasgow Coma Scale [GCS]) and failed ventilator weaning. Given a poor prognosis (WFNS grade 4, Hunt & Hess grade 4, ICH score 3), the patient was transitioned to palliative care.  Conclusion: This case highlights the importance of multidisciplinary management, non-invasive ICP monitoring, and timely transition to palliative care in severe hemorrhagic stroke.
Co-Authors Akhmad Yun Jufan Bowo Adiyanto Prasamya, Erlangga