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All Journal Jurnal Komplikasi Anestesi
Hernawan, Agung Diky
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Medicine & Pharmacology

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Protokol Transfusi Masif pada Obstetrik Uyun, Yusmein; Pratomo, Bhirowo Yudo; Hernawan, Agung Diky
Jurnal Komplikasi Anestesi Vol 8 No 1 (2021): Volume 8 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.v8i1.7488

Abstract

World population’s access to safe blood is limited. Only 30% of countries in the world have comprehensive transfusion services in their countries. Meanwhile, massive transfusion therapy has poor survival rate with mortality rate of about 45-67%. The patient’s age, duration and severity of shock, Disseminated Intravascular Coagulation (DIC), and the amount of blood transfused affect the fnal outcome. Coagulopathy has a high mortality rate within 4-6 days after hospitalization. Many obstetrics and gynecology patients have the potential to require blood transfusions. Cesarean section (SC) and hysterectomy are two of the surgical procedures that are frequent and potentially bleeding, requiring blood transfusion. Other conditions are postpartum hemorrhage, placenta previa, and ruptured ectopic pregnancy. Bleeding in the obstetric feld is still a highest cause of maternal death in Indonesia.
Determinan Prolonged Length Of Stay (PLOS) ICU pada Pasien Pediatrik yang Menjalani Pembiusan Di Masa Pandemi Covid-19 Hernawan, Agung Diky; Sari, Djayanti; Widyastuti, Yunita
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.v10i2.8300

Abstract

Background: In Indonesia, the utilization of ICU is not balanced, due to the limited ICU space or the length of time ICU patient care. ICU services include patients with organ dysfunction or post-anesthesia patients, especially pediatrics. Period 1 March 2020 Indonesia was hit by the COVID-19 pandemic. The need for ICU space increases, most of the infected patients fall into respiratory failure conditions both adults and pediatrics. Problems that are interconnected and become the basis for researchers in determining the determinants of PLOS ICU are post-anesthesia pediatric patients who need ICU care, limited ICU space and the problem of the COVID-19 pandemic. Objective: To identify the determinant factors of ICU Prolonged Length of Stay (PLOS) in pediatric patients undergoing anesthesia during the COVID-19 pandemic. Method: This research is a retrospective cohort observational study. The study sample was 173 pediatric patients undergoing anesthesia and postoperative care in the ICU at Dr Sardjito General Hospital for the period April 2020 - March 2021. The variables were tested using Student's t-test for numerical data, Chi square test for categorical/dichotomous data. The results of p <0.25 were followed by a logistic regression test. The results of p<0.05 were entered into the multivariate analysis and were considered significant. Results: The factors identified as the determinants of PLOS in the ICU Dr. Sardjito General Hospital were major surgery with a P value of 0.048 (OR 8.87), blood transfusions with a P value of 0.019 (OR 2.34) and mechanical ventilation with a P value of 0.010 (OR 3.44) ) is the most significant variable on PLOS in the ICU with a p<0.05. Conclusion: Major surgery, blood transfusions and mechanical ventilation/ventilators are the determinants of PLOS in the ICU of Dr. Sardjito General Hospital, pediatric patients undergoing anesthesia during the COVID-19 pandemic
Manajemen Akhir Hayat Pasien Sakit Kritis Di ICU COVID-19 Adiyanto, Bowo; Widodo, Untung; Hernawan, Agung Diky
Jurnal Komplikasi Anestesi Vol 9 No 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.v9i1.8654

Abstract

End-of-life condition was showed with symptoms of brain-stem death and functional impairment of breathing effort that persisted at fifth day of care. Physician explained to patient’s family about end-of-life condition, prognose, probability, and a desicion making that would had to make. Family decided to accept this condition, wish to continue medication but not to resuscitate if patient’s condition became worst. A chaplain gave spiritual care, end-of-life counceling, and praying to patient. Unfortunately, there was no intensive communication among medical teams about end-of-life condition. Patient care was underwent until the time of death with permitted family at patient’s bedside, not gave cardiopulmonal resuscitation as family’s wishes and pronaounced death in front of family.
Co-Authors Bhirowo Yudo Pratomo Bowo Adiyanto Djayanti Sari Untung Widodo, Untung Yunita Widyastuti Yusmein Uyun