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Fauzi, Rizqi Ahmad
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Medicine & Pharmacology

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Penatalaksanaan Perioperatif Atresia Esofagus dengan Fistula Trakeoesofageal Sari, Djayanti; Widyastuti, Yunita; Fauzi, Rizqi Ahmad
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.v7i3.7471

Abstract

Esophageal atresia with trachheoesophageal fistula occurs in 1 in 3,000 to 5,000 births. Esophageal atresia is often associated with other congenital anomalies like ventricular septal defects, patent ductus arteriosus or tetralogy of fallot. We reported a neonatal patient with esophageal atresia. Surgery was performed 2 days after being treated at the NICU. The operation lasted for 2 hours 25 minutes. The anesthetic technique is GA, semi open with Jackson Reese, ETT number 3, controlled breathing. The premedication was 0.1 mg atropine sulphate and 5 µg fentanyl, induction and maintenance were sevoflurane and O2, and with 1mg atracurium muscle relaxant. Postoperatively, patient was transported to the NICU in an intubated condition. The problems of anesthesia management on patients with esophageal atresia are evaluation of aspiration pneumonia, gastric overdistence, difficulty in ventilating the patient, the presence of other congenital abnormalities, and postoperative intensive care. Early recognition, prevention of aspiration, and immediate delivery to tertiary health care center will improve infant morbidity and mortality significantly.
Identifikasi Faktor Risiko Prediktif Prolonged Length of Stay (PLOS) di ICU RSUP Dr. Sardjito Yogyakarta Fauzi, Rizqi Ahmad; Jufan, Akhmad Yun; Widyastuti, Yunita
Jurnal Komplikasi Anestesi Vol 9 No 1 (2021): Volume 9 Number 1 (2021)
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.v9i1.8517

Abstract

Background: One method to improve the service quality in the Intensive Care Unit (ICU) is to develop a risk prediction system to assess and analyze associated risk factors that cause the prolonged length of stay (PLOS) at the ICU. In Indonesia, there is no risk prediction system developed from the population of Indonesians themselves who have different disease characteristics and patterns from European countries that have developed risk prediction such as APACHE IV and SAPS II. Objective: This study aims to identify the predictive factors of PLOS in ICU RSUP Dr. Sardjito. The long-term goal of this research is to develop a PLOS risk prediction model in the ICU based on the patient population treated at RSUP Dr. Sardjito. Methods: A retrospective cohort study was conducted on 451 patients in the ICU RSUP Dr. Sardjito. Variables that are thought to have a relationship with PLOS were tested using bivariate and multivariable logistic regression tests. After that, an assessment of the power of discrimination and calibration of the new PLOS predictive risk scoring system was carried out using the Area Under the Curve (AUC) method. A calibration test with Hosmer-Lameshow was done to get a comparison value between the observed and expected PLOS. Results: Factors identified as risk factors for PLOS in the ICU RSUP Dr.Sardjito were the medical cases, GCS value <8, use of vasoactive or inotropic drugs, sepsis, respiratory failure, and renal failure in both univariate and multivariate tests. Factors that have passed the multivariable test were used as predictors of PLOS in the ICU and a discrimination test was performed with the AUC. The discriminatory ability of the PLOS predictive model was 0,878 (95% CI). This value is classified as strong as a predictor model. The calibration test with Hosmer-Lameshow obtained a p-value of 0.547 (p>0.05) which means that this model was good. Conclusion: The medical cases, GCS value <8, use of vasoactive or inotropic drugs, sepsis, respiratory failure, and renal failure are predictive factors for PLOS in the ICU RSUP Dr. Sardjito. The discriminatory ability of these factors is strong and is able to predict the incidence of PLOS in the ICU RSUP Dr.Sardjito.
Co-Authors Akhmad Yun Jufan Djayanti Sari Yunita Widyastuti