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Hubungan rasio P(v-a)CO2/C(a-v)O2 terhadap lactate clearance sebagai penanda keberhasilan One Hour Bundle pada pasien sepsis: Pendekatan metode statistik regresi Taufik, Maulana; Nadeak, Rommy Fransiscus; Irina, Rr. Sinta; Wahyuni, Arlinda Sari
Jurnal SAGO Gizi dan Kesehatan Vol 6, No 2 (2025): Agustus
Publisher : Poltekkes Kemenkes Aceh

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30867/gikes.v6i2.2440

Abstract

Background: A prognostic predictive value in patients with sepsis and septic shock is needed to determine the aggressiveness of the therapy we will choose. Various methods are used to predict patient mortality. Based on this, a marker is needed to assess tissue perfusion disorders.Objectives: To determine the relationship between the P(v-a)CO2/C(a-v)O2 ratio and lactate clearance as a marker of the success of the one-hour bundle in sepsis patients.Methods: This study is a descriptive analytic study of 40 patients who assessed the description of lactate, ScvO2, and PvaCO2 gap values in septic patients. The study was conducted at the Emergency Department (IGD) and Intensive Care Unit (ICU) of H. Adam Malik Hospital Medan, during the period of April to May 2023. The collected data were then analyzed using descriptive statistical methods to calculate the mean, standard deviation, and range of the variables studied. The differences between groups were analyzed using the t-test to compare the mean values of the parameters studied. Correlation analysis was conducted using Pearson’s correlation test to assess the relationship between lactate, ScvO2, and PvaCO2 gap.Results: At T0, the mean lactate level was 22,06 mmol/L (median 16,85 mmol/L), the mean P(v-a)CO2 was 9,28 mmHg (median 8,50 mmHg), and the mean P(v-a)CO2/C(a-v)O2 ratio was 3,66 (median 3,56). At T1, the mean lactate level decreased to 12,52 mmol/L (median 9,00 mmol/L), the mean P(v-a)CO2 was 8,50 mmHg (median 7,50 mmHg), and the mean P(v-a)CO2/C(a-v)O2 ratio was 3,45 (median 2,57). The average lactate clearance was 48,29%. Bivariate analysis revealed a significant relationship between lactate clearance and the P(v-a)CO2/C(a-v)O2 ratio, with a P-value of 0,009 and a Spearman correlation of -0,521, indicating a strong negative correlation between the two variables.Conclusion: There is a significant relationship between the P(v-a)CO2/C(a-v)O2 ratio and lactate clearance in the success of the one-hour bundle for sepsis patients.
Manajemen Neuroanestesi pada Operasi Carotid Endarterectomy: Pasien dengan Riwayat Stroke Berulang Bangun, Chrismas Gideon; Irina, RR. Sinta; Bisri, Dewi Yulianti; Surahman, Eri
Jurnal Neuroanestesi Indonesia Vol 10, No 1 (2021)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2702.836 KB) | DOI: 10.24244/jni.v10i1.323

Abstract

Carotid endarterectomy (CEA) adalah prosedur bedah yang dilakukan untuk memulihkan aliran darah karotis dan mengurangi kejadian stroke embolik dan trombotik. Walaupun merupakan prosedur preventif, CEA membawa risiko komplikasi perioperatif: neurologik dan kardiak. Komplikasi mayor CEA adalah stroke intra dan postoperatif, infark miokard, dan kematian. Untuk mengurangi angka kejadian stroke intraoperatif maka dikembangkan teknologi monitoring intraoperatif salah satunya dengan elektroensefalogram (EEG). Pada kasus ini pasien laki-laki, 62 tahun, dengan riwayat stroke iskemik berulang dan kelemahan tungkai kiri direncanakan untuk CEA dengan anestesi umum. Ahli bedah memutuskan untuk menggunakan shunt secara selektif dengan menilai monitoring EEG saat dilakukan clamping. Akhirnya shunt tidak jadi dilakukan, operasi berjalan selama 6 jam, diwarnai dengan gejolak hemodinamik yang sering terjadi pada pasien dengan penyakit karotis akibat gangguan baroreseptor. Dengan penanganan anestesi yang cermat selama dan sesudah operasi, operasi berhasil dilakukan, dan hasil postoperasi kekuatan motorik kaki kiri meningkat dari 2 ke 4.Management Neuroanesthesia for Carotid Endarterectomy: Patients with a History of Recurrent StrokeAbstractCarotid endarterectomy (CEA) is a surgical procedure performed to restore carotid blood flow and reduce the incidence of embolic and thrombotic strokes. Although it is a preventive procedure, CEA carries the risk of perioperative complications: neurologic and cardiac. Major complications of CEA are intra and postoperative stroke, myocardial infarction, and death. To reduce the number of intraoperative stroke events, one of them is to develop intraoperative monitoring technology with electroencephalogram (EEG). In this case, a male patient, 62 years old, with statistics of recurrent stroke and left leg weakness was approved for CEA under general anesthesia. Surgeons decide to use shunt selectively by assessing EEG monitoring when clamping. Finally the shunt was not performed, the operation lasted for 6 hours, tinged with hemodynamic shocks that often occur in patients with carotid disease due to baroreceptor disorders. By managing anesthesia meticulously during and after surgery, the operation was successfully performed, and the results of the post on the left leg strengthening motor increased from 2 to 4.
Knowledge Level of Basic Life Support for Students and Staff at Senior High School Al-Azhar Asy Syarif Islamic Boarding School Deli Serdang, North Sumatra Primaputra Lubis, Andriamuri; Irina, Rr. Sinta
ABDIMAS TALENTA: Jurnal Pengabdian Kepada Masyarakat Vol. 8 No. 1 (2023): ABDIMAS TALENTA: Jurnal Pengabdian Kepada Masyarakat
Publisher : Talenta Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/abdimastalenta.v8i1.10419

Abstract

Background: Basic life support is an emergency action that can be done by ordinary people to free the airway, help to breathe and maintain blood circulation without using aids. Knowledge of basic life support (BLS) is a knowledge and skill because if you only know the theory without doing training or practice, then the motivation to help becomes lacking and mentally untrained when dealing with real events. Purpose: To determine the level of knowledge of students and staff of Madrasah Aliyah Al-Azhar Asy Syarif Islamic Boarding School Deli Serdang about BLS. Method: The design used in this study is a cross-sectional method. Data collection was in the form of a questionnaire containing questions about BLS training. Questionnaire collection was carried out twice, namely the pretest which was carried out before the BLS material and training were given by the instructor and the posttest which was carried out after the BLS material and training were given. Results: Respondents' post-test scores obtained fewer values, 5 respondents (4.24%) had enough values, and 113 respondents (95.76%) had good scores. It was found that respondents got quite a good score after training on BLS. Conclusion: Based on the level of knowledge of students and staff at MA Al-Azhar Asy Syarif Islamic Boarding School Deli Serdang about BLS, it is included in the good category.
The Efficacy of Channa Striata Extract Administration in Improving Albumin and Creatinine Levels in Sepsis Patients in the Intensive Care Unit Panggabean, Mathilda; Lubis, Andriamuri Primaputra; Irina, Rr. Sinta; Amelia, Rina
Indonesian Journal of Applied Research (IJAR) Vol. 5 No. 1 (2024): Indonesian Journal of Applied Research (IJAR)
Publisher : Universitas Djuanda

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30997/ijar.v5i1.414

Abstract

Albumin levels in the blood are an indicator for assessing the severity of sepsis. In sepsis patients, administering albumin extract from Channa striata has better potential to replace Human Albumin by 20%. This study aims to determine the role of Channa striata extract (CSE) in improving albumin and creatinine in sepsis patients. This research is a quasi-experimental research with a pre-post-test design. Sepsis patients who meet the inclusion and exclusion criteria and sign the informed consent form will be divided into treatment and control groups. Both groups received the same therapy protocol, except for the treatment group, which will be given CSE at a dose of 5gr, three times a day, for five days. Albumin, creatinine, and SOFA score measurements will be taken before the treatment and on the 7th day. All data will be tabulated and analyzed using statistical software. This study consisted of 2 groups, with a sample size of 20 patients for each group. It was found that the mean age of the research sample was 56.1 + 11.8 years. In the treatment group, there was no decrease in albumin levels before and after (2.76 + 0.41 to 2.76 + 0.40), p=0.952. There was no significant difference in assessing creatinine levels before and after treatment, p>0.05. There was an increase in SOFA score before and after treatment in both groups, p<0.05. Channa striata extract is clinically significant for improving the condition of sepsis patients in the ICU.
Correlation of Postoperative Cerebral Oxygen Saturation and Duration of Intensive Care Unit Stay Following Heart Valve Surgery Putri, Deby Yuliananda Rosa; Irina, Rr. Sinta; Tanjung, Qadri Fauzi
Jurnal Anestesi Perioperatif Vol 14, No 1 (2026)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v14n1.4034

Abstract

Background: Postoperative neurological complications and prolonged recovery are key concerns in heart valve surgery, and monitoring regional cerebral oxygen saturation (rScO₂) using Near–Infrared Spectroscopy (NIRS) offers a non–invasive way to assess cerebral oxygenation. This study aimed to evaluate the relationship between perioperative rScO₂ and ICU length of stay and its potential clinical significance.Methods: A cross–sectional, observational, analytic study was conducted in 48 patients undergoing heart valve surgery at Haji Adam Malik General Hospital, Medan. Regional cerebral oxygen saturation was measured at three time points: preoperative (T0), immediately postoperative (T1), and 8 hours post–extubation (T2).Results: Spearman correlation analysis revealed a significant negative relationship between right rScO₂ at T1 and ICU length of stay (r=–0.406; p=0.034), and similarly, left rScO₂ at T1 (r=–0.343; p=0.017), indicating that lower postoperative cerebral oxygenation correlates with longer ICU stays, emphasizing its potential clinical relevance.Discussion: These findings suggest that the immediate postoperative period may represent a critical window in which cerebral oxygenation reflects hemodynamic stability and early recovery trajectory. However, interpretation should be cautious due to the cross–sectional design, small sample size, and lack of adjustment for potential confounders, limiting causal inference.Conclusion: Lower immediate postoperative rScO₂ is associated with prolonged ICU length of stay, suggesting its potential role as an early indicator of recovery trajectory, although causal interpretation remains limited.