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All Journal Jurnal Indonesia Sosial Sains Jurnal Manajemen Pelayanan Kesehatan (The Indonesian Journal of Health Service Management)
Sukmapermata, Bunga
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Humanities Astronomy Biochemistry, Genetics & Molecular Biology Chemistry Computer Science & IT Decision Sciences, Operations Research & Management Earth & Planetary Sciences Economics, Econometrics & Finance Energy Environmental Science Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Library & Information Science Materials Science & Nanotechnology Neuroscience Physics Public Health Social Sciences

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Early Recognition of Anomalous Origin of Right Pulmonary Artery From The Ascending Aorta with Minimal Limited Resources Sukmapermata, Bunga; Yanti, Ni Putu Veny Kartika; Gunawijaya, Eka
Jurnal Indonesia Sosial Sains Vol. 6 No. 5 (2025): Jurnal Indonesia Sosial Sains
Publisher : CV. Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59141/jiss.v6i5.1713

Abstract

The anomalous origin of the right pulmonary artery (AORPA) is a rare congenital heart defect with a poor prognosis if not surgically corrected. Atypical symptoms often lead to underdiagnosis and delayed treatment, necessitating timely and accurate examination. The utility of diagnostic tools, especially in resource-limited settings, remains a subject of debate. This research aims to assess the effectiveness of echocardiography and cardiac CT in detecting AORPA in children suspected of having congenital heart disease (CHD), compared to catheter angiography and/or surgery. A case report of a male term newborn presenting with respiratory distress and heart failure was presented. Initial diagnosis was made via echocardiography, which was later confirmed by computed tomography angiography (CTA). A literature search was conducted using PubMed, Google Scholar, and ScienceDirect with keywords such as "anomalous origin of right pulmonary artery," "ascending aorta," "children," "echocardiography," and "cardiac CT". Two relevant articles were critically appraised. The case demonstrated that transthoracic echocardiography (TTE) provided a timely diagnosis of AORPA at 11 days old, even when MDCT was delayed due to the patient's critical condition. While MDCT is superior for detailed anatomical features, TTE proved valuable as an initial diagnostic modality in a resource-limited area. Literature review showed TTE diagnostic accuracy at 88.9%, and MDCT with high sensitivity and specificity for pulmonary arterial anomalies. Despite diagnosis, the patient deteriorated and died without surgical repair. Early diagnosis and prompt surgical correction are essential for improved outcomes.
Early Recognition of Anomalous Origin of Right Pulmonary Artery From The Ascending Aorta with Minimal Limited Resources Sukmapermata, Bunga; Yanti, Ni Putu Veny Kartika; Gunawijaya, Eka
Jurnal Indonesia Sosial Sains Vol. 6 No. 5 (2025): Jurnal Indonesia Sosial Sains
Publisher : CV. Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59141/jiss.v6i5.1713

Abstract

The anomalous origin of the right pulmonary artery (AORPA) is a rare congenital heart defect with a poor prognosis if not surgically corrected. Atypical symptoms often lead to underdiagnosis and delayed treatment, necessitating timely and accurate examination. The utility of diagnostic tools, especially in resource-limited settings, remains a subject of debate. This research aims to assess the effectiveness of echocardiography and cardiac CT in detecting AORPA in children suspected of having congenital heart disease (CHD), compared to catheter angiography and/or surgery. A case report of a male term newborn presenting with respiratory distress and heart failure was presented. Initial diagnosis was made via echocardiography, which was later confirmed by computed tomography angiography (CTA). A literature search was conducted using PubMed, Google Scholar, and ScienceDirect with keywords such as "anomalous origin of right pulmonary artery," "ascending aorta," "children," "echocardiography," and "cardiac CT". Two relevant articles were critically appraised. The case demonstrated that transthoracic echocardiography (TTE) provided a timely diagnosis of AORPA at 11 days old, even when MDCT was delayed due to the patient's critical condition. While MDCT is superior for detailed anatomical features, TTE proved valuable as an initial diagnostic modality in a resource-limited area. Literature review showed TTE diagnostic accuracy at 88.9%, and MDCT with high sensitivity and specificity for pulmonary arterial anomalies. Despite diagnosis, the patient deteriorated and died without surgical repair. Early diagnosis and prompt surgical correction are essential for improved outcomes.
EVALUASI DETERMINAN KEMATIAN PASIEN UNIT INTENSIF ANAK: STUDI RETROSPEKTIF RUMAH SAKIT TERSIER INDONESIA TIMUR Sukmapermata, Bunga; Hartawan, I Nyoman Budi; Suparyatha, Ida Bagus Gede; Kanya Wati, Dyah
Journal of Health Service Management Vol 28 No 04 (2025)
Publisher : Departemen of Health Policy and Management, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta Jl. Farmako Sekip Utara Yogyakarta 55281 Telp 0274-547490

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jmpk.v28i04.21465

Abstract

Background: Understanding the characteristics of pediatric mortality is essential for improving and evaluating the quality of care in Pediatric Intensice Care Unit (PICU). Such insights allow for more effective prioritization and allocation of limited resources, Objective: To identify the determinant factors contributing to mortality in PICU. Methods: This study was a descriptive study using medical record data from a tertiary referral hospital in Denpasar, Bali. Results: A total of 51 patients who died in the Pediatric Intensive Care Unit (PICU) were included. The median age of deceased patients was 3.33 years (IQR 0.5–9.92), with a higher proportion of female patients and those suffering from malnutrition. Most of the deceased patients were categorized as priority level 4 for PICU care. The most common diagnosis at admission was pneumonia, and the most patients were referred from other inpatient wards within the same hospital. A total of 35 cases progressed to sepsis, with a median procalcitonin level of 5.19 ng/mL (IQR 0.98–19.77), and sepsis accounted for 64.7% of the deaths in the PICU. The PELOD-2 score, calculated without lactate, had a median value of 6 (IQR 4–9), which may represent a threshold for mortality risk in our PICU. The mortality rate in our PICU during the study period was 22.27%. Conclusion: Infection remains the primary cause of death among pediatric patients in the PICU, particularly in those with severe comorbidities commonly referred to tertiary care centers. These findings emphasize the need to strengthen infection control measures in general wards and optimize fluid management within the PICU. Given the frequent mismatch between demand and capacity, stricter patient admission criteria are essential to ensure that intensive care resources are allocated to those with the highest clinical need and greatest potential for benefit.
Co-Authors Dyah Kanya Wati Eka Gunawijaya I Nyoman Budi Hartawan Ni Putu Veny Kartika Yanti, Ni Putu Veny Kartika Suparyatha, Ida Bagus Gede