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All Journal Jurnal Anestesiologi Indonesia Jurnal Komplikasi Anestesi
Meta Restu Synthana
Departemen Anestesiologi Dan Terapi Intensif, Fakultas Kedokteran, Kesehatan Masyarakat, Dan Keperawatan, Universitas Gadjah Mada, Yogyakarta, Indonesia
Health Professions Medicine & Pharmacology Public Health

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Terapi Oksigen Hiperbarik Synthana, Meta Restu; Wisudarti, Calcarina Fitriani Retno; Pratomo, Bhirowo Yudo
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.v4i2.7296

Abstract

Terapi oksigen hiperbarik merupakan terapi dengan memberikan 100% oksigen pada dua sampai tiga kali dari tekanan pada level air laut. Terapi oksigen hiperbarik efektif dalam mengatasi berbagai penyakit antara lain luka karena trauma akut, ulserasi yang tidak membaik dengan terapi, crush injury, luka bakar, gas gangren, dan sindrom kompartemen dapat pula digunakan pada kasus-kasus keracunan gas misal keracunan gas karbonmonoksida. Terapi oksigen hiperbarik memiliki komplikasi dan efek toksik karena hiperoksia. Terapi ini sering digunakan pada pasien-pasien kritis misal karena keracunan karbonmonoksida, luka bakar, gas gangren, abses intrakranial, emboli, sehingga klinisi khususnya anestesiologist perlu mengetahui mekanisme, efek serta komplikasi terapi oksigen hiperbarik.
Manajemen Extracorporeal Membrane Oxygenation (ECMO) pada Pasien COVID-19 Derajat Kritis Synthana, Meta Restu; Kurniawaty, Juni; Wisudarti, Calcarina Fitriani Retno
Jurnal Komplikasi Anestesi Vol 10 No 2 (2022)
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.v10i2.8304

Abstract

We reported 42 years old male patient with weight 84 kg, height 167 cm, and BMI of 30.1 kg/m2 with a diagnosis of severe COVID-19 and ARDS. The patient was previously known to have comorbids of type 2 DM, stage 1 hypertension, cardiac arrhythmias, and grade 1 obesity. On the 7th day of care, the patient clinically and radiologically worsened and we decided to intubate and support with mechanical ventilation. An ECMO indication was assessed, the patient was indicated to have ECMO, so that ECMO was installed immediately after the patient was intubated. ECMO was successfully running 7 hours after the patient was intubated. During hospitalized the patient also received renal replacement therapy, hemadsorption therapy, and plasma exchange. The patient deceased on 31st day of ECMO.
Management of Continuous Renal Replacement Therapy Following Coronary Artery Bypass Grafting in the Intensive Care Unit Synthana, Meta Restu; Jufan, Akhmad Yun; Wisudarti, Calcarina Fitriani Retno
JAI (Jurnal Anestesiologi Indonesia) Publication In-Press
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.76588

Abstract

Background: Acute kidney injury (AKI) after cardiac surgery is a serious complication with a high occurrence, leading to increased morbidity and mortality. Continuous renal replacement therapy (CRRT) is the preferred method for replacing kidney function in patients with hemodynamic instability, especially during the critical postoperative period in the intensive care unit (ICU).Case: A 76-year-old man with a history of ischemic heart disease and chronic heart failure underwent off-pump coronary artery bypass grafting (CABG). The patient had comorbidities including obesity, obstructive sleep apnea (OSA), chronic obstructive pulmonary disease (COPD), pneumonia, and chronic kidney disease (CKD). During intensive postoperative care, the patient experienced a progressive decrease in urine output, rising urea and creatinine levels, and significant fluid overload. CRRT with continuous venovenous hemodiafiltration (CVVHDF) mode was started on the first day of ICU admission, and clinical improvement was observed after four days of therapy.Discussion: Patients with multiple comorbidities often experience a deterioration in kidney function after surgery, requiring prompt intervention. The critical role of CRRT in stabilizing fluid and metabolic balance, while simultaneously maintaining hemodynamic stability, cannot be overstated. Careful monitoring of volume status, hemodynamics, and laboratory results is essential to determine the duration of therapy and evaluate its effectiveness.Conclusion: CRRT is an effective treatment for patients after CABG with AKI and hemodynamic instability. A team-based approach and proper monitoring are crucial for the success of therapy and patient recovery.
The Correlation Between Syndecan-1 Post Cardiopulmonary Bypass and Duration of Ventilator Use in Open Heart Surgery Patients at Dr. Sardjito General Hospital, Yogyakarta Fatmi Eka Putri; Synthana, Meta Restu; Kurniawaty, Juni
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.v13i2.29233

Abstract

Background: Open heart surgery involves the use of a cardiopulmonary bypass machine (CBP) to replace the heart and lungs during surgery. The use of CBP can damage the endothelial glycocalyx, which triggers increased levels of syndecan-1, an indicator of endothelial degradation. Elevated syndecan-1 levels are associated with various complications, such as coagulation disorders, edema, and organ dysfunction. In the lungs, endothelial glycocalyx damage can lead to edema and lung parenchymal damage, which can impair overall lung function and lead to a decreased PaO2/FiO2 ratio, requiring prolonged postoperative ventilator use.Objective: This study aimed to determine the relationship between post-CBP syndecan-1 levels and the duration of ventilator use in open heart surgery patients at Dr. Sardjito General Hospital, Yogyakarta.Methods: This study was a prospective, analytical, observational cohort study conducted at Dr. Sardjito General Hospital, Yogyakarta. The sample consisted of adult patients undergoing open heart surgery, with the exclusion criteria being patients using preoperative mechanical assist devices. Syndecan-1 levels were measured using the ELISA method using the Elabscience Human SDC1 kit. Data were analyzed using SPSS. Bivariate and multivariate analyses were also performed to evaluate factors influencing ventilator duration.Results: The study was conducted on 34 subjects with a mean age of 46 ± 13.71 years. The average CPB duration was 92.94 ± 47.57 minutes, with preoperative syndecan-1 levels of 8.86 ± 5.08 ng/ml, while post-CPB levels were 11.74 ± 3.71 ng/ml, with delta syndecan-1 levels of 2.87 ± 4.18 ng/ml.
Co-Authors Akhmad Yun Jufan Bhirowo Yudo Pratomo Calcarina Fitriani Retno Wisudarti Fatmi Eka Putri Juni Kurniawaty Muhdar Abubakar Djayanti Sari