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All Journal Jurnal Anestesiologi Indonesia Jurnal Anestesi Perioperatif Indonesian Journal of Anesthesiology and Reanimation (IJAR) Jurnal Kesehatan Tambusai Solo Journal of Anesthesi, Pain and Critical Care Majalah Anestesia & Critical Care (MACC) Jurnal Komplikasi Anestesi
Prasamya, Erlangga
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Chemical Engineering, Chemistry & Bioengineering Dentistry Education Health Professions Medicine & Pharmacology Nursing Public Health

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Evaluating the Role of Magnesium Sulphate as an Adjunct Therapy in Non-Obstetric Refractory Status Epilepticus Panjaitan, Sondang; Prasamya, Erlangga
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 5, No 2 (2025): October 2025
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v5i2.102964

Abstract

Background : Refractory Status Epilepticus (RSE) is a condition of persistent status epilepticus seizures despite appropriate anticonvulsant therapy. RSE can be fatal if not treated promptly and properly. Standard treatments for SE and RSE include benzodiazepines as first line, non-benzodiazepine agents as second line, and general anesthetic agents as third line. Magnesium Sulfate (MgSO4) is known as an anticonvulsant agent that is more often used in obstetric cases, but its use in non- obstetric RSE is limited. The purpose of this case report is to report a case of RSE that improved after administration of Mgs4Case Illustration : A 56-year-old male patient with a history of epilepsy and left ischemic stroke, was referred with decreased consciousness after falling. The patient experienced recurrent seizures, and after treatment with diazepam and phenytoin, recurrent seizures were still found despite additional doses. After being transferred to the ICU, the patient was given therapy with midazolam, propofol, and phenobarbital, but the seizures continued to recur. After 30 hours in the ICU, MgSO4 was given intravenously two grams followed by maintenance doses. The seizures stopped and the patient remained seizure- free during the 138-hour ICU stay, with improved neurological and hemodynamic conditions.Conclusion :  MgSO4 has been shown to be effective as an anticonvulsant agent in RSE in the ICU. Its use helps stop persistent seizures and supports the patient's clinical stability. This report shows the potential of MgSO4 as a useful adjunct therapy in the management of RSE in critically ill patients.
Protein First: Whey Protein Administration Strategy in Critically ill Patients Suharsoyo, Tomy; Prasamya, Erlangga
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 6, No 1 (2026): April 2026
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v6i1.116549

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Background: Critically ill patients in the intensive care unit (ICU) frequently develop hypercatabolic states associated with progressive muscle wasting and immune dysfunction. Meeting adequate protein targets remains a persistent challenge in standard ICU nutrition practice.Methods: A narrative review of the literature was conducted by searching PubMed, MEDLINE, and Google Scholar using the keywords “whey protein,” “critically ill,” “ICU nutrition,” “protein-first strategy,” “enteral nutrition,” and related terms. Articles published between 2015 and 2025 were prioritized, and foundational earlier studies were included where relevant. Randomized controlled trials, systematic reviews, meta-analyses, observational studies, consensus guidelines, and mechanistic studies were included. Articles without full-text availability or not relevant to critical care nutrition were excluded.Results: Whey protein is biologically characterized by rapid absorption, a rich essential amino acid profile, and a high leucine content that may activate the mTORC1 pathway to stimulate muscle protein synthesis. Whey protein–based enteral formulas have been shown in selected studies to facilitate achievement of recommended protein targets (1.2–2.5 g/kg/day) with acceptable gastrointestinal tolerance. Some evidence suggests potential benefits in nitrogen balance and inflammatory markers; however, evidence for consistent improvement in hard clinical outcomes—including mortality, ventilator duration, and ICU length of stay—across the general critically ill population remains limited. Most supportive studies are small, single-center, or focused on specific subpopulations, and several are feasibility assessments rather than outcome trials.Conclusion: Whey protein is a biologically plausible and practically useful component of individualized ICU nutrition. A “Protein First” approach using whey-based formulas may assist in meeting recommended protein targets; however, current evidence does not support claims of universal outcome benefit. Individualized dosing—with particular caution in patients with renal or hepatic impairment—remains essential.  
Co-Authors Akhmad Yun Jufan Argoseto, Argoseto Bowo Adiyanto Cakradwipa, Mada Oktav Calcarina Fitriani Retno Wisudarti Daniswara, Daniswara Hanafia, Mochamad Fauzi Hartono, Pinter Ika Cahyo Purnomo Ikhwandi, Arief Jufan, Ahmad Yun Nur, Rifdhani Fakhrudin Panjaitan, Sondang Pranuri, Gesit Entra Rachman, Farhan Ali Saputra, Dya Restu SATRIYAS ILYAS Sudadi Suharsoyo, Tomy Untung Widodo, Untung Utomo, Prattama Santoso Wijaya, Andryadi Wisudarti, Calcarina Retno