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All Journal Jurnal Anestesiologi Indonesia Jurnal Anestesi Perioperatif Folia Medica Indonesiana Nusantara Medical Science Journal Bali Journal of Anesthesiology Indonesian Journal of Anesthesiology and Reanimation (IJAR) Journal of Anesthesiology and Clinical Research Jurnal Neuroanestesi Indonesia Majalah Anestesia & Critical Care (MACC) Jurnal Komplikasi Anestesi Jurnal Widya Medika

Elizeus Hanindito

Department Anesthesiology And Reanimation, Faculty Of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, Indonesia

Author-ID : 903158

Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Public Health Other

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Factors associated with the need for intraoperative packed red cells transfusion in pediatric liver transplant patients Kapuangan, Christopher; Utariani, Arie; Hanindito, Elizeus
Bali Journal of Anesthesiology Vol 3, No 1 (2019)
Publisher : DiscoverSys Inc.

Background: Massive hemorrhage is one of the most common problems encountered during a liver transplantation procedure. Correction of the blood loss using packed red cells (PRC) is essential during the procedure to improve outcome. This retrospective study aims to investigate preoperative and intraoperative factors that may predict the PRC need.Materials and Methods: Thirty-four patients who underwent pediatric liver transplantation procedure within 2010-2018 were included in this study. Their medical record was examined and the data was analyzed using a comparison of mean and regression model.Results: The mean bleeding in this study was found to be 906.62±674.30 mL, while the mean PRC transfusion was 566.71±307.30 mL. Correction of blood loss was also compensated with other means such as a crystalloid or colloid fluid.Conclusion: This study statistically demonstrated that pre-operative weight, as well as bleeding volume, significantly affect the PRC transfusion requirement (p <0.05). However, other factors such as hemoglobin and surgical duration may also be clinically significant factors to predict PRC transfusion need.

The ultrasonic cardiac output monitor (USCOM) as a tool in evaluating fluid responsiveness in pediatric patients underwent emergency surgery Kurniyanta, Putu; Utariani, Arie; Hanindito, Elizeus; Ryalino, Christopher
Bali Journal of Anesthesiology Vol 3, No 1 (2019)
Publisher : DiscoverSys Inc.

ABSTRACTBackground: Assessment fluid adequacy in pediatric patients underwent surgery is a challenge for anesthesiologists. Hemodynamic parameters used as fluid monitoring sometimes don’t accurately provide valid information. Ultrasonic Cardiac Output Monitor (USCOM) is one of the non-invasive methods that are easy to operate and may provide various hemodynamic parameters monitoring information.Objective: Analyze the effectiveness of Stroke Volume Variation (SVV) and Stroke Volume Index (SVI) by using USCOM in assessing fluid responsiveness in preoperative pediatric patients who underwent emergency surgeries. Method: This study was conducted on 16 pediatric patients underwent emergency surgeries. Before general anesthesia is given, blood pressure, mean arterial pressure, heart rate, cardiac index, SVV, SVI were recorded before and after administration of 10 mL/kg of fluid given within 20 minutes.Results: 10 subjects responded with SVV and SVI changes of more than 10% compared to 6 non-responders. SVV changes between responders and non-responders were 31.5±1.58 and 7.5±1.04, respectively. SVV percentage changes between responders and non-responders were 38.04±0.47 and 5.24±4.89, respectively.Conclusion: SVV and SVI recorded by USCOM showed significant fluid responsiveness changes in pediatric patients underwent emergency surgeries in 62.5% of the subjects.

Studi Komparatif Ukuran Pipa Nafas Tanpa Cuff Pada Pasien Pediatri Berdasar Diameter Subglotis Dengan Metode Konvensional Khildan Miftahul Firdaus; Elizeus Hanindito; Bambang Pujo Semedi
Jurnal Anestesi Perioperatif Vol 8, No 3 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v8n3.2126

tersendiri. Pipa endotrakeal (ETT) yang terlalu kecil/besar meningkatkan risiko komplikasi. Prediksi ukuran ETT berdasar atas usia merupakan metode yang paling sering digunakan namun ternyata tidak selalu tepat pada aplikasinya. Parameter lain seperti diameter subglotis atau diameter kelingking tangan dapat menjadi alternatif untuk memprediksi ukuran ETT pediatri. Tujuan penelitian ini menganalisis dan membandingkan akurasi prediksi ukuran ETT tanpa cuff berdasar berbagai variabel pada pasien pediatri di RSUD Dr Soetomo Surabaya mulai Februari hingga April 2020. Subjek penelitian ini pasien usia 2–9 tahun, PS ASA 1–2 yang akan dilakukan operasi elektif. Saat preoperatif, usia, berat, dan panjang badan dicatat. Saat intraoperatif, diameter kelingking tangan dan diameter subglotis menggunakan USG diukur dan dicatat. ETT yang digunakan adalah ETT tanpa cuff berdasar atas diameter subglotis. ETT dianggap tepat apabila memberikan audible air leak pada tekanan 10–25 cmH2O. Bila ETT terlalu kecil/besar maka dilakukan reintubasi. Tiap-tiap parameter dilakukan uji korelasi, agreement test, serta predictive performance menggunakan MAPE, dan RMSE. Dari 48 pasien, didapatkan hasil bahwa prediksi ukuran ETT tanpa cuff berdasar atas diameter subglotis memiliki akurasi yang paling baik hingga 91,67% (r=0,973, koefisien kappa 0,892; p<0,001, MAPE 0,803%, dan RMSE 0,144). Simpulan, prediksi berdasar atas diameter subglotis merupakan metode yang akurat untuk memprediksi ukuran ETT tanpa cuff pediatri. Subglottic Diameter Ultrasonographic Assessment for Estimating Pediatric Uncuffed Endotracheal Tubes Compared to Conventional MethodsAnatomical differences in pediatric airways could be quite a challenge. Choosing endotracheal tube (ETT) optimum size is essential as a larger or smaller tube may cause undesirable complications. ETT size prediction based on age formula is most commonly used, but is not always successful. The little finger diameter and subglottic diameter are alternative parameters to predict pediatric uncuffed ETT optimum size. This study analyzed and compared the multiple variable-based formulas’ accuracy to predict the pediatric uncuffed ETT optimum size. The ETT prediction used subglottic diameter-based formulas. Clinically fit ETT has an audible air leak within the pressure of 10–25 cmH2O. If the ETT predicted was relatively too small/big than clinically fit ETT, it was changed to one size smaller/ bigger. Each variable was then analyzed by correlation test, regressed against clinically fit ETT to test the agreement rates, and predictive performance was assessed using mean absolute percentage error (MAPE), and root mean square error (RMSE). From 48 patients it found that subglottic diameter formulas offered the best result in predicting optimum size uncuffed ETT in pediatrics with an agreement rate up to 44 of 48 patients got the right clinically fit uncuffed ETT (91.67%, r=0.973, kappa 0.892, p-value<0.001, MAPE 0.803%, and RMSE 0.144). In conclusion, the prediction based on subglottic diameter using USG is the best method to predict the optimum size of uncuffed ETT in pediatrics.

Perbandingan Visualisasi Laring dan Glotis pada Maneken Intubasi Sulit menggunakan Video Laryngoscope C-MAC dan VL-Scope Abdul Kadir Munsy; Nancy Margarita Rehatta; Maulydia Maulydia; Agustina Salinding; Arie Utariani; Teguh Sylvaranto; Elizeus Hanindito
JAI (Jurnal Anestesiologi Indonesia) Vol 10, No 3 (2018): Jurnal Anestesiologi Indonesia
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Latar Belakang: Video laryngoscope C-MAC terbukti sangat membantu dalam tindakan intubasi terutama pada pasien kasus dengan difficult airway. Departemen Anestesiologi dan Reanimasi Rumah Sakit Dokter Soetomo Surabaya telah menciptakan video laryngoscope VL-Scope dengan fitur perekam audiovisual dengan harga yang jauh lebih murah.Tujuan: Membandingkan waktu yang dibutuhkan oleh video laryngoscope C-MAC dan VL-Scope pada simulasi maneken imobilisasi cervical spine dengan rigid collar neck.Metode: Penelitian dengan desain eksperimental acak ini melibatkan residen untuk melakukan intubasi dengan 2 video laringoskop yaitu C-MAC dan VL-Scope pada simulasi maneken imobilisasi cervical spine dengan rigid collar neck. Penelitian dilakukan dengan cara mengobservasi perbedaan waktu yang diperlukan untuk melihat plica vocalis, lama intubasi dan penekanan pada gigi menggunakan laringoskop C-MAC dan video laringoskop VL-ScopeHasil: Video laryngoscope C-MAC mempersingkat waktu rata-rata untuk menilai derajat Cormarck and Lehane (8.57 ± 2,64 ) dan intubasi (17.89 ± 5,92) dibandingkan dengan video laringoskop VL-Scope (12.24±5,83) dan (20,68±5,83) detik. Namun frekuensi kejadian penekanan terhadap gigi saat tindakan laringoskopi adalah sama menggunakan kedua alat tersebut 2/37(5,4%)Kesimpulan: Intubasi menggunakan video laryngoscope C-MAC lebih efektif pada maneken imobilisasi cervical spine dengan rigid collar neck namun angka kejadian penekanan gigi pada tindakan tersebut adalah sama.

Comparison of Length of Stay and Deep Vein Thrombosis (DVT) Incidents in Dr. Soetomo Hospital Elizeus Hanindito; Prananda Surya Airlangga; Soni Sunarso Sulistiawan; Bambang Pujo Semedi; Lucky Andriyanto; Arie Utariani; Nancy Margarita Rehatta
Folia Medica Indonesiana Vol. 54 No. 4 (2018): December
Publisher : Faculty of Medicine, Universitas Airlangga

Vein thrombosis may occur both in deep and superficial vein of all extremities. Ninety percent of vein thrombosis may progress into pulmonary embolism which is lethal. Deep vein thrombosis (DVT) is frequently found in critically ill patients in ICU, especially patients who are treated for a long time. This study aims to analyse the comparison between length of stay and DVT incidents in critically ill patients. A cross-sectional study was employed. We include all patients who were 18 years or older and were treated in ICU of Dr Soetomo public hospital for at least 7 days. The patients were examined with Sonosite USG to look for any thrombosis in iliac, femoral, popliteal, and tibial veins and Well’s criteria were also taken. This study showed that length of stay is not the only risk factor for DVT in patients treated in ICU. In our data, we found out that the length of treatment did not significantly cause DVT. Other risk factors such as age and comorbidities in patients who are risk factors may support the incidence of DVT events. The diagnosis of DVT is enforced using an ultrasound performed by an expert in the use of ultrasound to locate thrombus in a vein. Length of treatment is not a significant risk factor for DVT. Several other factors still need to be investigated in order for DVT events to be detected early and prevented.

Efektivitas Body Surface Area dibanding Predicted Body Weight dalam Menentukan Volume Semenit untuk Mencapai Target PaCO2 pada Operasi Tumor Otak Nanang Nurofik; Prananda Surya Airlangga; Bambang Pujo Semedi; Arie Utariani; Elizeus Hanindito; Hamzah Hamzah
Jurnal Neuroanestesi Indonesia Vol 8, No 1 (2019)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Latar Belakang dan Tujuan: Manajemen neuroanestesi pada operasi tumor otak bertujuan untuk mencegah terjadinya cedera otak sekunder dan memberikan lapangan operasi yang baik. Hal ini dapat dicapai melalui brain relaxation therapy. Penelitian ini bertujuan menganalisis efektifitas Body Surface Area (BSA) dan Predicted Body Weigh (PBW) untuk menentukan volume semenit dalam mencapai target PaCO2 pada pasien yange menjalani operasi tumor otak.Subjek dan Metode: Penelitian analitik observasional dengan desain cross-sectional melibatkan 31 pasien yang menjalani operasi tumor otak di RSUD Dr Soetomo Surabaya. Pasien yang memenuhi kriteria, dilakukan pengukuran tinggi badan dan berat badan, kemudian dibagi dalam 2 kelompok BSA dan PBW. Kelompok BSA mendapat volume semenit 4xBSA (laki-laki) dan 3.5xBSA (perempuan). Kelompok PBW mendapat volume semenit 100mL/kgBB. Tiga puluh menit setelah pengaturan ventilasi mekanik, dilakukan pemeriksaan analisa gas darah untuk menilai PaCO2.Hasil: Penentuan volume semenit menggunakan BSA menghasilkan volume yang lebih besar dibanding PBW pada pasien normal hingga obesitas.Penggunaan BSA dibanding PBW secara signifikan memiliki PaCO2 lebih rendah (33.55±3.43: 39.29±3.32 mmHg) dengan nilai p=0.0001. Simpulan: Penggunaan BSA dalam menentukan volume semenit efektif dalam mencapai target PaCO2 pada pasien yang menjalani operasi tumor otak. Effectiveness of Body Surface Area over Predicted Body Weightto determine Minute Volume to achieve PaCO2 Target in Brain Tumor SurgeryBackground and Objective: Neuroanesthesia management in brain tumor surgery aims to prevent secondary brain injury and provide a good operating field. This goal can be achieved by brain relaxation therapy .This study aims to analyze the effectiveness of Body Surface Area (BSA ) and Predicted Body Weigh (PBW) in determining minute volume to achieve PaCO2 target in brain tumor surgery patient.Subject and Methods: This was an observational analytic study with a cross-sectional approach. Thirty patient with brain tumor surgery were enrolled in this study. Patient who met the inclusions criteria was measured for height and weight then divided into two groups of BSA and PBW. The BSA group gets a minute volume 4xBSA for men and 3.5xBSA for women. The PBW group received minute volume 100mL / kg. Thirty minutes after adjusting mechanical ventilation, a blood gas analysis was examined to measure PaCO2 value.Results: Minute volume which is predicted by BSA had a greater volume than PBW in normal to obese patient. Body surface area is statistically significant compared to PBW in reducing PaCO2 average (33.55±3.43: 39.29±3.32 mmHg) with p value = 0.0001.Conclusion: Body surface areaas more effective to determine minute volume compare to PBW to achievePaCO2 target in brain tumor surgery patient.

Mortality Assessment of Pediatric Septic Patients Through Pediatric Sofa+Anion Gap and Pelod-2 Scores Johaan Pawe Siampa; Arie Utariani; Elizeus Hanindito
Folia Medica Indonesiana Vol. 58 No. 4 (2022): December
Publisher : Universitas Airlangga

Highlight: Sepsis and septic shock cause morbidity and mortality in pediatric patients. The accuracy of pediatric sequential organ failure assessment and anion gap (pSOFA+AG) was compared with AG and pediatric logistic organ dysfunction-2 (AG+PELOD-2). The mortality assessment of pediatric septic patients showed that pSOFA was more sensitive than PELOD-2, while pSOFA+AG was not more sensitive than PELOD-2. Abstract: Sepsis and septic shock are some of the causes of morbidity and mortality (50-60%) in pediatric patients treated in intensive care rooms. This study aimed to compare the accuracy of pediatric Sequential Organ Failure Assessment (pSOFA) score combined with anion gap (AG) score to Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score in the assessment of mortality in pediatric septic patients at the Resuscitation Room of Dr. Soetomo Geeneral Academic Hospital, Surabaya, Indonesia. This was a retrospective observational cohort study using pediatric sepsis diagnosis guidelines based on the 2016 Pediatric Sepsis Consensus and medical records between January-December 2018. All data of patients aged 1 month to 16 years with suspected infection at the Resuscitation Room were collected based on predisposing infections, signs of infection, and warning signs. Organ dysfunction was assessed by calculating the pSOFA+AG scores, PELOD-2 scores, and corrected anion gap (cAG) in the first 24 hours. Sepsis mortality was assessed by comparing the results of the pSOFA, pSOFA+AG, and PELOD-2. The results showed 94.9% sensitivity and 70.0% specificity (p<0.0001) in the pSOFA, 89.9% sensitivity and 71.3% specificity (p<0.0001) in the PELOD-2, 79.7% sensitivity and 65% specificity (p<0.0001) in the AG, 79.7% sensitivity and 73.8% specificity (p<0.0001) in the cAG, and 79.3% sensitivity (p<0.0001) in the pSOFA+AG. In conclusion, pSOFA was more sensitive than PELOD-2, while the use of pSOFA+AG was not more sensitive than PELOD-2 in assessing the mortality of pediatric septic patients.

Effectiveness of Ketoprofen Suppositoria as Preemptive Analgesia for Postoperative Pain in Patients Undergoing Elective Surgery with General Anesthesia Lupi Lestari; Elizeus Hanindito; Arie Utariani
Indonesian Journal of Anesthesiology and Reanimation Vol. 2 No. 1 (2020): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Introduction: Effective postoperative pain management provides improved patient comfort and satisfaction, earlier mobilization, fewer pulmonary and cardiac complications, reduced risk deep vein thrombosis, fast recovery, and reduced cost of care. Preemptive analgesia, initiated before the surgical procedure to prevent pain in the early postoperative period, has the potential to be more effective than a similar analgesic treatment initiated after surgery. As a part of multimodal analgesia, the use of NSAIDs should always be considered for acute postoperative pain management. NSAIDs can be used preoperatively as a part of the preemptive regimen and for postoperative pain control to increase the efficacy of opioids and reduce its side effects. Material and Method: This research was experimental research with a case-control design of the study. The samples separated into two groups, the first group got ketoprofen suppository before the induction, and the second group didn't get the ketoprofen suppository The intensity of pain measured with the Numeric Rating Scale (NRS) or Wong-Baker Faces Pain Scale was the variable studied at different postoperative times (30 min, 60 min, 120 min, 2-6 hours, 6-12 hours). The total amount of rescue analgesics (fentanyl) and side effects were other variables of this study. Result and Discussion: The result is ketoprofen suppository as preemptive analgesia administrations can reduce postoperative pain. Numeric Rating Scale was significantly lower in the ketoprofen group compared to the control group (p < 0,05) at 30 min, 60 min, 230 min, 2-6 hours, 6-12 hours. The number of postoperative analgesics needed in the recovery room was significant differences among both groups (p < 0,05). Conclusion: Preemptive analgesia in patients who underwent an operation with general anesthesia with ketoprofen suppository was effectively in blocking noxious stimuli and central sensitization, with subsequent prevention of acute postoperative pain.

Effectivity of 5% Dextrose-Diluted and Ringer Lactate-Diluted Propofol to Reduce Intravenous Injection Pain in Pediatric Patient Dian Raseka Parna; Arie Utariani; Elizeus Hanindito
Indonesian Journal of Anesthesiology and Reanimation Vol. 2 No. 1 (2020): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Introduction: Propofol has been known as one out of many inductive drugs which, can cause pain during intravenous injection. There has been a high prevalence of injection pain in pediatric patients. The mechanism of injection pain has not been known. Some therapeutic methods have been tested to reduce the pain, with several success rates. Objective: To compare the effectivity of 5% dextrose-diluted propofol and ringer lactate-diluted propofol, with dilution comparison of 1:1, in their role to reduce intravenous injection pain in pediatric patients, from age 2-15 years old during elective surgery in the Integrated Surgical Building Center of Dr. Soetomo General Hospital Surabaya. Method and Material: Forty-five patients PS ASA I-II, which fulfill inclusion criteria, were induced with general anesthesia. Patients had been selected randomly into three groups. Group I (control group) were injected with propofol without dilution. Group II was injected with propofol with a dilution of 5% dextrose, into 5 mg/ml liquid. Group III was injected with propofol with a dilution of ringer lactate, into 5 mg/ml liquid. Result and Discussion: The level of pain was evaluated afterward, with responding to the four-point scale and spontaneous expression. Patients' blood pressure, mean arterial pressure, heart rate, and oxygen saturation were also examined after injection. Compared to the control group, those in groups with 5% dextrose-diluted and ringer lactate-diluted propofol are not effective in reducing intravenous injection pain, with analytical statistics p=0.503 (p > 0.05). Also, the dilution of propofol has no significant difference to the hemodynamic measurement of patients. Systolic and diastolic blood pressure, and mean arterial pressure were declined after the induction, but statistically insignificant. The heart rate of patients was inclined but also not significant. Conclusion: 5% dextrose-diluted and ringer lactate-diluted propofol with a comparison of 1:1 were not significantly effective in reducing intravenous injection pain in pediatric patients.

Ketamine Versus Tramadol Effectiveness as Postoperative Oral Analgesics on Pediatric Patients Age 5-10 Years in Elective Surgery at Dr. Soetomo Hospital Surabaya Herdiani Sulistyo Putri; Elizeus Hanindito; Herdy Sulistyono
Indonesian Journal of Anesthesiology and Reanimation Vol. 2 No. 2 (2020): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Introduction: The use of ketamine and tramadol as postoperative analgesics for pediatric are still relatively rare, especially orally administrated. As an analgesic, ketamine blocks the NMDA receptor, the main excitatory transmitter in CNS; whereas tramadol blocks serotonin and norepinephrine uptake, thus preventing pain transmission on the spinal cord. Objective: The aim of this study is to compare the effectiveness of oral ketamine and oral tramadol as analgesics for postoperative acute pain in children. Method: A double-blind randomized clinical trial was conducted at Dr. Soetomo Hospital. The hospital ethical committee had approved this study. The subject includes thirty children aged 5-10 years old who fulfilled the inclusion criteria. They were divided into either ketamine groups or the tramadol group, in which each group consisting of fifteen patients. The regimen dosage that been given was 2mg/kg tramadol and ketamine as postoperative oral analgesics in the form of simple syrup. The FLACC table was used to evaluate pain score before and after administration of drugs (30-minutes, 1-hour, 2-hours, 3-hours, 4-hours, and at discharge from the recovery room). Result and Discussion: Based on the quantitative parameter of the FLACC (scale 0-10), there was a significant difference (p<0.05) between the first-hour postoperative administration and patient discharge from the recovery room. The patient of ketamine group had far lower FLACC value compared to the tramadol group. Rescue analgesics in the form of intravenous fentanyl were given to one patient (6.7%) in the ketamine group and four patients (26.7%) in the tramadol group. Conclusion: Ketamine proved to be a better and more effective postoperative oral analgesic compared to tramadol in this study.

Co-Authors Abdul Kadir Munsy Agustina Salinding Ahmad Nur Islam Arina Setyaningtyas Christopher Ryalino Corry Quando Yahya, Corry Quando Dian Raseka Parna Hamzah Hamzah Hamzah Hamzah Hanna Aulia Namirah Herdiani Sulistyo Putri Herdy Sulistyono Hori Hariyanto Johaan Pawe Siampa Kapuangan, Christopher Khildan Miftahul Firdaus Larasati, Sarah Ayu Lucky Andriyanto Lupi Lestari Maman Surya Permana Maulydia, Maulydia Meilissa Eka Susanti Mia Ratwita Andarsini Muhammad Ramli Ahmad Nanang Nurofik Nurofik, Nanang Prananda Surya Airlangga Puspita, Eka Ari Puspita, Eka Ari Putu Kurniyanta Rehatta, Nancy Margarita Santoso, Kohar Hari Santoso, Kohar Hari Santoso Hari SATRIYAS ILYAS Semedi, Bambang Pujo Sulistiawan, Soni Sunarso Syukur, Rusmin Bolo Teguh Sylvaranto Utariani, Arie

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