Umarmono, Umarmono
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Vasoactive-inotropic score for prediction of critical patient mortality: A systematic review Umarmono, Umarmono; Purnawan, Iwan
Malahayati International Journal of Nursing and Health Science Vol. 8 No. 2 (2025): Volume 8 Number 2
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v8i2.481

Abstract

Background: A medical emergency is a clinical situation that requires immediate and planned treatment to prevent permanent disability or death. It involves sudden, progressive, and often life-threatening disturbances in vital body functions, such as cardiovascular, respiratory, or neurological disorders. The Vasoactive-Inotropic Score (VIS) is a clinical tool used to assess the need for vasoactive and inotropic drugs in critically ill patients. The VIS plays an important role as a prognostic indicator in critically ill patients, with higher VIS scores associated with increased risk of death. Purpose: To evaluate vasoactive-inotropic score for prediction of critical patient mortality. Method: A literature review with the aim of reviewing and evaluating previous research related to the use of VIS in predicting mortality in medical emergency patients using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram method. The search for scientific articles was conducted in October-November 2024 by determining the population/problem, intervention, comparison, and outcome (PICO) method. The database search process was carried out through the Publish or Perish application from PubMed, Scopus, Crossref, Semantic Scholar, and CINAHL. Determination of the article year range was focused on articles from 2018-2024 through keywords consisting of ''inotrope'' AND ''predictor'' AND ''mortality'', ''VIS'' AND ''Patient critical ill'', ''VIS'' OR Predictor mortality, ''VIS'' OR ''ICU''. Results: The Vasoactive-Inotropic Score (VIS) is an effective and practical clinical tool to be used as a predictor of mortality in emergency and critical patients. VIS provides a quantitative picture of the severity of hemodynamic disorders as well as the pharmacological need to maintain the patient's cardiovascular stability. Its use has been shown to be significant in a variety of critical conditions, such as postoperative cardiac surgery, cardiogenic shock, sepsis, and out-of-hospital cardiac arrest, where higher VIS values are often correlated with an increased risk of mortality. The accuracy of VIS in predicting mortality risk can be improved through integration with other clinical parameters, such as inflammatory biomarkers and organ dysfunction scores, which provide a more comprehensive picture of the patient's physiological status. Conclusion:  VIS is consistently used as a predictive tool with varying morbidity-mortality thresholds in critically ill patients depending on population size. Factors that influence VIS values ​​include patient demographic characteristics, hemodynamic status, disease severity, and quality of therapy received by the patient.
Efektivitas bahan oral care dalam upaya pencegahan ventilator-associated pneumonia (VAP) pada pasien kritis: A systematic review Utami, Mega; Martanti, Yuniar Dwi; Rukhayati, Yati; Umarmono, Umarmono; Kamaluddin, Ridlwan
Holistik Jurnal Kesehatan Vol. 19 No. 7 (2025): Volume 19 Nomor 7
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i7.1075

Abstract

Background: The most common nosocomial infection in Intensive Care Unit (ICU) patients on mechanical ventilators is ventilator-associated pneumonia (VAP). One recommended prevention strategy is oral care. However, the effectiveness of various oral care materials in preventing VAP remains unclear. Purpose: To assess the effectiveness of oral care materials in preventing ventilator-associated pneumonia (VAP) in critically ill patients. Method: This systematic review followed PRISMA guidelines. Articles were retrieved from PubMed, ScienceDirect, and Google Scholar databases published between 2014 and 2025. Included articles were RCTs or quasi-experimental studies that addressed oral care interventions in ventilator patients. Quality assessment was performed using CASP-JBI. Results: Based on the 10 articles reviewed, oral care materials used included chlorhexidine, hydrogen peroxide, orthodentol, lactoperoxidase, and probiotics. Oral care techniques included brushing and rinsing, performed two to three times daily. Most studies have shown a reduction in the incidence of VAP in the intervention group. Conclusion: Oral care is effective in preventing VAP, especially when performed regularly with appropriate techniques and materials. The combination of toothbrushing and antiseptics such as chlorhexidine has been shown to be optimal in reducing the risk of VAP.   Keywords: Critically Patients; Oral Care; Ventilator-Associated Pneumonia (VAP).   Pendahuluan: Infeksi nosokomial yang paling sering terjadi pada pasien di Intensive Care Unit (ICU) yang menggunakan ventilator mekanik adalah ventilator-associated pneumonia (VAP). Salah satu strategi pencegahan yang direkomendasikan adalah oral care. Namun, efektivitas berbagai bahan yang digunakan dalam oral care terhadap pencegahan VAP masih belum disepakati secara luas. Tujuan: Untuk mengkaji efektivitas bahan oral care dalam upaya pencegahan ventilator-associated pneumonia (VAP) pada pasien kritis. Metode: Penelitian systematic review yang mengikuti pedoman PRISMA. Artikel diperoleh dari database PubMed, ScienceDirect, dan Google Scholar dengan tahun terbit 2014–2025. Artikel yang disertakan adalah penelitian RCT atau quasi eksperimen yang membahas intervensi oral care pada pasien ventilator. Penilaian kualitas menggunakan CASP-JBI. Hasil: Berdasarkan 10 artikel yang dikaji, bahan oral care yang digunakan meliputi chlorhexidine, hydrogen peroxide, orthodentol, lactoperoxidase, dan probiotik. Teknik oral care yang digunakan antara lain brushing dan rinsing dengan frekuensi dua hingga tiga kali per hari. Sebagian besar studi menunjukkan penurunan kejadian VAP pada kelompok intervensi. Simpulan: Oral care efektif mencegah VAP, khususnya jika dilakukan secara teratur dengan teknik dan bahan yang tepat. Kombinasi brushing dan antiseptik seperti chlorhexidine terbukti paling optimal dalam menurunkan risiko VAP.   Kata Kunci: Oral Care; Pasien Kritis; Ventilator-Associated Pneumonia (VAP).