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All Journal The Indonesian Journal of General Medicine
Landong Sijabat
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Dentistry Health Professions Medicine & Pharmacology Public Health Veterinary

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The Analysis Study of Risk Factor and Management of Perioperative Hypertension: A Comprehensive Systematic Review Landong Sijabat; Guinanti Novettiandari
The Indonesian Journal of General Medicine Vol. 6 No. 1 (2024): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/0tg1ax61

Abstract

Background: Perioperative hypertension, a common and significant clinical concern, occurs when blood pressure rises above normal levels during the perioperative period, encompassing the preoperative, intraoperative, and postoperative phases. This systematic review aims to analyze the existing literature on the risk factors, management strategies, and clinical outcomes associated with perioperative hypertension. Methods: The study followed PRISMA 2020 guidelines, reviewing English-language publications from 2014 to 2024. Editorials, duplicate reviews from the same journal, and papers lacking a DOI were excluded. The literature search was conducted using PubMed, SagePub, SpringerLink, and Google Scholar. Result: A total of 2,172 articles were initially identified through online databases (PubMed, SagePub, SpringerLink, and Google Scholar). After three rounds of screening, eight relevant studies were selected for full-text analysis. Conclusion: Perioperative hypertension management relies on anesthesia induction, monitoring, and antihypertensive medications. Proper control reduces complications like stroke, myocardial infarction, and organ damage, ensuring better outcomes. Consistent blood pressure management throughout the perioperative period is crucial for patient recovery.
What is The Effectiveness of Intravenous Magnesium Supplementation Compared to Standard Care on Clinical Outcomes in Critically Ill Patients with Hypomagnesemia? : A Systematic Review Landong Sijabat; Raka Jati Prasetya; Mutia Juliana
The Indonesian Journal of General Medicine Vol. 34 No. 1 (2026): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/fvm8m476

Abstract

Introduction: Hypomagnesemia is common in critically ill patients and is associated with adverse outcomes. However, the effectiveness of intravenous (IV) magnesium supplementation remains controversial. Methods: This systematic review screened 80 studies including RCTs, etc across general ICUs, cardiac surgery, sepsis, neurological conditions, and other critical illnesses. Outcomes assessed included mortality, arrhythmias, neurological recovery, length of stay, and adverse events. Results: In post-cardiac surgery, IV magnesium significantly reduced supraventricular arrhythmias (RR 0.77; 95% CI: 0.63–0.93) and ventricular arrhythmias (RR 0.52; 95% CI: 0.31–0.87) [1,2]. In sepsis, magnesium improved lactate clearance and reduced ICU stay from 15 to 8 days (p<0.01) [3], with a network meta-analysis showing reduced short-term mortality (RR 0.33; 95% CI: 0.14–0.79) [4]. In AKI on CRRT, magnesium was associated with significantly lower 90-day mortality (aHR 0.38; 95% CI: 0.18–0.83) [5]. In aneurysmal SAH, magnesium reduced vasospasm (OR 0.61; 95% CI: 0.37–0.99) and delayed cerebral ischemia (OR 0.57; 95% CI: 0.37–0.88) but did not improve overall neurological outcome [6,7]. In TBI, the largest RCT showed no benefit and potential harm [8]. In general ICU patients with borderline hypomagnesemia, routine supplementation did not improve 24-hour clinical outcomes [9]. Extended infusion strategies improved magnesium retention compared to rapid boluses [11,12]. Adverse events were generally mild, though higher doses in TBI increased mortality [8]. Discussion: The effectiveness of IV magnesium is highly context-dependent. Strongest evidence supports arrhythmia prevention post-cardiac surgery. Sepsis and AKI on CRRT show promising signals for mortality and organ function, but evidence certainty is low. Neurological benefits are limited to intermediate events without improving final outcomes. Routine supplementation for mild hypomagnesemia in general ICU is not supported. Conclusion: IV magnesium supplementation is recommended for arrhythmia prophylaxis in post-cardiac surgery. Its role in sepsis and AKI on CRRT requires further high-quality RCTs. Magnesium should not be routinely administered for mild hypomagnesemia in general ICU or for neuroprotection in TBI.
What are The Most Effective Management Strategies for Obstetric Emergencies in ICU Settings, and How do They Impact Maternal and Neonatal Mortality Rates? : A Systematic Review Landong Sijabat; Raka Jati Prasetya; Mutia Juliana
The Indonesian Journal of General Medicine Vol. 34 No. 1 (2026): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/z43b0823

Abstract

Background: Obstetric emergencies requiring intensive care unit (ICU) admission contribute significantly to maternal and neonatal mortality worldwide, yet optimal management strategies remain heterogenous across settings. Methods: This systematic review synthesized 80 studies (1990-2025) examining management strategies for obstetric emergencies in ICUs. Outcomes included maternal mortality, neonatal mortality, and effectiveness of interventions. Results: Hypertensive disorders (42.96% in Africa) and hemorrhage (24.15%) were the leading admission causes. Multidisciplinary team approaches, early intervention (<6 hours for hemorrhage), and protocolized care consistently improved outcomes. Whole blood transfusion reduced transfusion volumes versus component therapy (2,607 mL vs. 4,683 mL, p=0.03) with zero maternal deaths. The non-pneumatic antishock garment combined with balloon tamponade eliminated hemorrhage-related mortality (0% vs. 3 deaths). Continuous renal replacement therapy reduced sepsis mortality by 35%. Skills training for postpartum hemorrhage reduced maternal mortality from 75% to 0%. Maternal mortality ranged from 0%-41.2%, with African centers reporting 30.69% versus 3.03% in dedicated obstetric ICUs. Neonatal mortality ranged 4.2%-52%. Critical timing factors included ICU admission <24 hours from symptom onset and delivery before critical deterioration. Discussion: Effective management requires condition-specific, early, multidisciplinary approaches. Resource disparities explain much outcome variation, with unbooked status and delayed referral as key modifiable risk factors. Standardized protocols, early warning systems, and uterine-conserving techniques show strongest evidence. Conclusion: Early, protocol-driven, multidisciplinary ICU management significantly reduces maternal and neonatal mortality in obstetric emergencies. System strengthening and skills training are as crucial as technological interventions.
Co-Authors Guinanti Novettiandari Mutia Juliana Raka Jati Prasetya