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All Journal The Journal of Society Medicine (JSOCMED)
Natapraja, Tresna Kusumah
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Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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Management af a Patient with Guillain-Barré Syndrome Miller Fisher Type and Hospital-Acquired Pneumonia in the Intensive Care Unit : a Case Report Suwarman; Natapraja, Tresna Kusumah
Journal of Society Medicine Vol. 3 No. 11 (2024): November
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i11.177

Abstract

Introduction: Guillain-Barré Syndrome (GBS) is an acute, flaccid polyneuropathy that occurs following an infection and is mediated by an autoimmune process. Patients with GBS frequently experience respiratory complications that necessitate mechanical ventilation. Neurological impairments associated with GBS, such as decreased airway patency, ineffective cough, and difficulty swallowing, increase the risk of pulmonary infections like hospital-acquired pneumonia (HAP). Case Report: We present the case of a 59-year-old woman who experienced respiratory failure due to GBS and HAP and required treatment in the Intensive Care Unit (ICU). The patient was managed with Therapeutic Plasma Exchange (TPE), which resulted in clinical improvement. It took 18 days for the patient to be weaned off mechanical ventilation. Conclusion: A detailed review of the management strategies for GBS and HAP is essential to enhance future treatment approaches and ensure they align with current literature.
Epidural Anesthesia with Eissenmenger Syndrome Undergoing Caesarean Section : a Case Report Kurnia, Fentti selli; Natapraja, Tresna Kusumah
Journal of Society Medicine Vol. 3 No. 11 (2024): November
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i11.178

Abstract

Introduction: Heart disease in pregnant women can cause both morbidity and mortality. Eissenmenger syndrome is a pulmonary hypertension due to high pulmonary vascular resistance with a right-to-left or bidirectional shunt at the aortopulmonary, ventricular, or atrial level. To prevent hemodynamic instability and hypoxemia, it is essential to maintain a balance between PVR and SVR. Case Report: We reported the case of a 28-year-old pregnant woman with a gestational age of 34-35 weeks, diagnosed with Eissenmenger syndrome due to shortness of breath and cyanosis in the extremities, classified as ASA III E. After epidural anesthesia was administered, a 1.5 hour cesarean section was performed and a male baby was born. Postoperatively, the patient was transferred to the ICU. Conclusion: This case highlights the importance of maintaining a balance SVR and PVR, and continuous monitoring in pregnancy patient complicated by Eissenmenger syndrome. It requires a multidisciplinary approach involving obstetricians, anesthesiologists, and pediatricians.
Co-Authors Kurnia, Fentti selli Suwarman