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All Journal Jurnal Anestesiologi Indonesia Jurnal Neuroanestesi Indonesia
Fajri, Doni
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Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Neuroscience Public Health

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Adverse Event : Myocardial Injury after Non-Cardiac Surgery (MINS) Post Craniectomy in Critical Care Fajri, Doni; Anggraeni, Novita; Hidayat, Nopian; Ananda, Pratama
Jurnal Neuroanestesi Indonesia Vol 14, No 2 (2025)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v14i2.664

Abstract

Intracerebral hemorrhage (ICH) describes the non-traumatic parenchymal hemorrhage caused by the rupture of cerebral vessels, accounting for 2030% of all strokes. ICH will cause compression on the surrounding brain tissues, eventually giving rise to increased intracranial pressure. Decompressive craniectomy (DC) effectively reduce intracranial pressure. Myocardial injury is defined as an elevation of cardiac troponin levels with or without associated ischemic symptoms. Case a male, 66 years old patient was admitted to the ICU after undergoing Emergency Craniectomy Hematoma Evacuation due to Spontaneous ICH. After 52 hours of treatment, the patient was found to have ventricular tachycardia (VT) on the monitor and restlessness. The patient was also found to have comorbid hypertension. On a 12-Lead ECG we found NSTEMI, and Troponin I level was measured at 453.0 ng/L (positive). This patient was treated with anticoagulants, antiplatelet and statin, with monitoring of the ECG daily. On The 6th day patient was moved to High Care Unit (HCU). Myocardial Injury after Noncardiac Surgery is defined by elevated postoperative cardiac troponin concentrations, with or without accompanying symptoms or signs. It typically occurs within 30 days after surgery. The management of MINS involves the use of anticoagulants and antiplatelet therapy. Anticoagulant therapy should be considered between benefit and risk of re-bleeding post operative. MINS is a rare condition but is associated with an increased risk of 30-day mortality. A multidisciplinary treatment approach and a coordinated team effort are essential for improving the outcomes of patients with this condition.
Malignant Hyperthermia Fajri, Doni; Hidayat, Nopian; Masjkur, Diana
JAI (Jurnal Anestesiologi Indonesia) Vol 17, No 2 (2025): Jurnal Anestesiologi Indonesia (Issue in Progress)
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.62676

Abstract

Malignant hyperthermia (MH) is a life-threatening clinical syndrome caused by hypermetabolism involving skeletal muscle. MH is very rare, but it is one of the causes of death in the operating room. MH is an autosomal dominant disease and can be triggered when exposed to certain anesthetic drugs. Genetic tests can help diagnose, but the gold standard is the caffeine halothane contracture test (CHCT). Initial symptoms are a decrease in pH and oxygen, as well as an increase in CO2, lactate, potassium, and temperature. The increase in lactate reflects tissue hypoxia. Dantrolene is an antidote to MH, by reducing calcium loss from the sarcoplasmic reticulum in skeletal muscle and returning metabolism to normal conditions. Immediate detection and treatment can improve MH outcomes.
Co-Authors Ananda, Pratama Hidayat, Nopian Masjkur, Diana Novita Anggraeni