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All Journal Berkala Kedokteran Heart Science Journal Eduvest - Journal of Universal Studies
Sakti, Pradhika Perdana
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Aerospace Engineering Biochemistry, Genetics & Molecular Biology Computer Science & IT Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Social Sciences

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Weaning Failure in Mechanical Ventilation: a Literature Review Sakti, Pradhika Perdana; Anjarwani, Setyasih
Heart Science Journal Vol. 4 No. 4 (2023): The Science and Art of Caring for Critically III Patients in Intensive Cardiac
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.04.2

Abstract

Mechanical ventilation is a method of ventilation support through positive pressure breath application. It is used in cases of ventilation and/ or oxygenation failure. Due to its related complications mechanical ventilation should be withdrawn from the patient as soon as possible, called a weaning process. The result of the weaning of mechanical ventilation determines the patient’s prognosis. Patient will go through several assessments before a weaning decision is made. Subsequently, patient will be placed on an unconstrained breathing test (SBT) to check whether the patient's respiratory muscle is equipped for accepting its work of relaxing. Weaning disappointment is characterized as disappointment on SBT or reintubation at 48 hours following extubation. Several factors related to weaning failure are increasing airflow resistance, decreasing compliance, respiratory muscle fatigue, and the patient’s underlying conditions. Techniques to conquer these variables are expected to lessen the pace of disappointment of the weaning system.
The Role of International Normalized Ratio (INR) in Heart Failure Patient With Sepsis: Hidden in Plain Sight Sakti, Pradhika Perdana
Eduvest - Journal of Universal Studies Vol. 4 No. 10 (2024): Journal Eduvest - Journal of Universal Studies
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/eduvest.v4i10.38811

Abstract

Heart failure is a clinical syndrome characterized by symptoms and signs caused by a structural and/or functional impairment of the heart. Sepsis in heart failure may cause significant mortality and morbidity rates. Clinically, the presence of heart dysfunction in heart failure worsens outcomes in unstable hemodynamic conditions, for instance, in cases of sepsis, particularly in patients with HFrEF. This research aims to survey the blend of heart failure and sepsis and current updates regarding using the International Normalized Ratio (INR) to detect sepsis. Information was collected from various sources, and updated literature was compiled into a review article. The presence of heart failure with sepsis is associated with horrible clinical results. If fluid alone is insufficient to restore perfusion, the fundamental structure of sepsis includes strong fluid recovery followed by vasopressor association (and possibly inotropic support). In any case, in patients with heart failure, high-portion fluid boluses and vasoactive experts might deteriorate the condition. Heart failure and sepsis can overlap and lead to hemodynamic disturbances and challenging treatment. Meanwhile, aggressive fluid resuscitation is necessary for sepsis; conventional heart failure management requires reducing fluid intake. The International Normalized Ratio (INR) is one of the coagulation parameters that may help determine sepsis in patients with heart failure, thus improving appropriate diagnosis and treatment.
Correlation Analysis of Mortality and Length of Stay in Sepsis Cases Among Heart Failure Patients with Low Ejection Fraction at Dr. Saiful Anwar General Hospital, East Java, Indonesia Sakti, Pradhika Perdana; Anjarwani, Setyasih; Rohman, Mohammad Saifur; Prasetya, Indra; Tjahjono, Cholid Tri
Berkala Kedokteran Vol 21, No 2 (2025)
Publisher : Fakultas Kedokteran Universitas Lambung Mangkurat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20527/jbk.v21i2.24597

Abstract

In Indonesia, heart failure (HF) prevalence reaches 5%, contributing to over 1.8 million annual hospitalizations, accompanied by a 29% readmission rate and a 30-day mortality rate of 17%. The burden of infectious diseases, notably sepsis, further complicates the clinical landscape. Patients with sepsis residing in tropical regions often exhibit mortality rates surpassing global averages. Sepsis-associated coagulopathy (SAC) serves as a significant complication in this context. This study investigates the correlation between SAC, indicated by international normalized ratio (INR) levels, and outcomes in patients with heart failure with reduced ejection fraction (HFrEF) who develop sepsis. Utilizing a retrospective cohort approach, we analyzed medical records from Saiful Anwar Regional General Hospital, Malang, East Java, involving adult HFrEF patients who underwent INR testing. Purposive sampling was applied. Statistical analyses, including the Mann-Whitney Test, Kaplan-Meier Analysis, Log-Rank Test, Cox Proportional Hazards Regression, and Multiple Linear Regression, were conducted employing SPSS software. Results revealed a mean survival of 7.69 days in the Non-SAC group compared to 6.78 days in the SAC group, though the difference was not statistically significant (p=0.080). Notably, additional clinical complications predominantly influenced survival outcomes. This study elucidates that elevated INR levels, indicative of SAC, correlate with increased mortality and decreased survival in HFrEF patients with sepsis. Furthermore, the exacerbating effect of clinical complications on mortality highlights the imperative for early SAC detection and management of cardiovascular implications to enhance patient prognosis.
Co-Authors Anjarwani, Setyasih Cholid Tri Tjahjono Indra Prasetya Mohammad Saifur Rohman