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POST-INTENSIVE CARE DEPRESSION FOLLOWING CRITICAL ILLNESS IN PATIENTS AFTER USING MECHANICAL VENTILATION Faizatuz Azzahrah Syamsudi; Bambang Pujo Semedi; Betty Agustina Tambunan
Nurse and Health: Jurnal Keperawatan Vol 11 No 1 (2022): Nurse and Health: Jurnal Keperawatan January-June 2022
Publisher : Institute for Research and Community Service of Health Polytechnic of Kerta Cendekia, Sidoarjo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36720/nhjk.v11i1.360

Abstract

Background: Critical illness survivors have been improved due to advances in critical medicine, but they can experience psychological impairments after ICU discharge. Depression is one of the psychological impairments in Post-Intensive Care Syndrome (PICS). Post-Intensive Care Syndrome is a collection of symptoms that occur post-ICU discharge. This can be experienced by post-intensive care patient after using mechanical ventilation. Post-intensive care depression has an impact on the patient quality of life after ICU discharge. Objectives: This study aimed to determine post-intensive care depression in patients after using mechanical ventilation and to investigate correlation duration of mechanical ventilation and ICU length of stay with post-intensive care depression. Methods: This study was an observational analytic study with a cross-sectional design and retrospective medical record. We used total sampling technique. We enrolled all post-intensive care patient after using mechanical ventilation at Gedung Bedah Pusat Terpadu Dr. Soetomo General Hospital in a range of January-December 2020. The number of samples in this study was 97 Patients. We collect detailed sociodemographic data and clinical data from medical record. The symptoms of post-intensive care depression were assessed at least 3 months after ICU discharge with Beck Depression Inventory-II (BDI-II). The data were analyzed using Chi-Square statistical test. Results: Out of 97 post-intensive care patients after using mechanical ventilation, 43 patients fulfilled the inclusion criteria and 27.91% among them had mild depression (BDI-II score = 14-19). There is no significant correlation between post-intensive care depression and duration of mechanical ventilation (p-value = 0.398) and there is no significant correlation between post-intensive care depression and ICU length of stay (p-value = 0.303). Conclusion: Post-intensive care patients after using mechanical ventilation are prone to have mild depression at least three months after ICU discharge. However, there is no significant correlation duration of mechanical ventilation and ICU length of stay with post-intensive care depression.
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (301.979 KB) | DOI: 10.24244/jni.vol8i1.213

Abstract

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.
Retention of basic life support in medical students of Airlangga University Inna Maya Sufiyah; Bambang Pujo Semedi; Sundari Indah Wiyasihati
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 9, No 2, (2018)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol9.Iss2.art9

Abstract

Background: Cardiac arrest is one of the leading cause of death in the world with steadily increasing number over the years. Basic life support has been proven to lower the risks of tissue damage and further complication. Several study shows that BLS skill are lacking in some doctors and nurses.Objective: Therefore, the purpose of this study is knowing the retention of basic life support in medical student of Airlangga University.Methods: This descriptive study used cross sectional design. Subjects were students at faculty of medicine in Airlangga University who trained one year ago and completed their study of Basic Life Support. Fifty two subject were asked to practice their BLS techniques then scored based on modified American Hearth Assosiation (AHA)’s Basic life support skill checklist.Results: Based on the data, the percentage of students who did the retest correctly: response checked by shouting 92.31% students, response checked by tapping 69.23% students, call for help 44.23% students, airway checked 48.08% students, breathing checked 46.15% students, correct hand placement 100% students, compression rate 78.85% students, compression ratio 75% students, position 94.23% students, and compression depth 78.85% students. Conclusion: One year post training and test, 14 from 52 students could complete all the steps in basic life support skill. Less than a half of the students successfully done 3 out of 10 points that were being tested. Meanwhile, many aspects in circulation point show higher results all above 75%.
Albumin, Leukosit, And Protrombin As Predictors Of Sepsis Mortality Among Adult Patients In Soetomo General Hospital, Surabaya, Indonesia Rahmat Sayyid Zharfan; Ahmad Lukman Hakim; Abdul Khairul Rizki Purba; Soni Sunarso Sulistiawan; Bambang Pujo Semedi
Indonesian Journal of Anesthesiology and Reanimation Vol. 1 No. 1 (2019): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (195.271 KB) | DOI: 10.20473/ijar.V1I12019.8-12

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Introduction: Sepsis is presented as acomplex and multifactorial syndrome where the morbidity and mortality rates still high around the world. Strong evidencewith regard to early predictive factors for mortality and morbidity is rare to be provided. Objective: The aim of this study was to analyse the prominent predictors from the values of laboratory findings among patients with sepsis. Method and Material: The study was aan analytic observational study with a case-control approach. The data were extracted from patients's medical records between 2014 and 2015. This study involved 50 septic patients admitted to Dr. Soetomo General Hospital, Surabaya, Indonesia. Blood urea nitrogen (BUN), creatinine serum, albumin, leukocytes count, haemoglobin, hematocrite, platelets, sodium, potassium, chloride, prothrombin time (PT), and activated partial thromboplastin time (APTT) were collected from blood samples. Logistic regression was used to estimate sepsis related mortalities frequencies and the relationship between laboratory findings and under 28-days mortality. Result and Discussion: From 50 patients, 22 patients were died (44%). The regression model was intially conducted using all three biomarkers as covariates, then using backward elimination, the covariate with the highest p-value was eliminated. The process was repeated until covariates with statistically significant remained. Multivariate analysis showed that albumin, leukocytes count, and prothrombin time (PT) were the findings associated with high mortality. The independent predictors of mortality identified by further multivariate regression analysis were taken into account as a lower than 3.5 g/dL of albumin, above12.000/µL of leukocytes count, and prolonged more than 14 seconds of prothrombin time; with p value <0,05 respectively (0.029; 0.049; 0.027). Conclusion: Notably, low albumin level, elevated levels of leukocytes, and prolonged prothrombin time were clinically considered as independent predictors of mortality among adult patients with sepsis.
Knowledge of General Practitioner Doctors and Midwives Who Has and Has Not Attended Neonatal Resuscitation Course Has No Significant Difference Vincent Geraldus Enoch Lusida; Bambang Pujo Semedi; Bambang Herwanto
Indonesian Journal of Anesthesiology and Reanimation Vol. 1 No. 2 (2019): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (405.07 KB) | DOI: 10.20473/ijar.V1I22019.38-42

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Introduction: Infant death is most prominent in the neonatal period. The success of neonatal resuscitation practice has many contributing factors. One of which is the health workers' knowledge of the Neonatal Resuscitation Program (NRP) algorithm. Therefore, it is necessary to conduct studies to evaluate the health workers' knowledge of the Neonatal Resuscitation Program who are educated in neonatal resuscitation course and has taken part in Neonatal Life Support practice in primary health care (PHC)  Objective: This study aims to analyze the knowledge of general practitioners and midwives who has or has not attended in neonatal resuscitation course in Surabaya PHC Methods and Materials: this research is descriptive, cross-sectional research. All Basic Emergency Obstetric and Newborn Care (BEmONC) PHC in Surabaya which are Jagir PHC, Banyu Urip PHC, Medokan Ayu PHC, Tanah kali Kedinding PHC, Tanjungsari PHC, Balongsari PHC, Sememi PHC, Simomulyo PHC is included in this research from 2018 to 2019. A nine-item questionnaire referenced from The Textbook of Neonatal Resuscitation 7th Edition is given to ten respondents in each BEmONC PHC. Results and Discussion: from the total sample of 78 respondents, 32 (41,0%) receive a high score, 20 (25,7%) receive a middle score, and 26 (33,3%) receive a low score. The data shows that there is no significant score difference between respondents who has or has not participate in the NRP course (p=0,419). Conclusion:  There is no correlation between difference knowledge midwives and general practitioners who had and had not attended neonatal resuscitation training at basic emergency obstetric and newborn care in public health center Surabaya.
Intracranial Hemorrhage in Patients With Hemophilia A Nugroho Setia Budi; Prananda Surya Airlangga; Bambang Pujo Semedi
Indonesian Journal of Anesthesiology and Reanimation Vol. 2 No. 2 (2020): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (767.662 KB) | DOI: 10.20473/ijar.V2I22020.59-66

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Introduction: Intracranial hemorrhage in inherited bleeding disorders is a medical emergency. The location of bleeding in most children is subdural and the most common cause is hemophilia. Although intracranial bleeding that occurs in people with hemophilia ranges from less than 5% of events, it is a life-threatening medical emergency so appropriate treatment is needed. Case Report: A boy patient 11 years old, 20kg weights have a seizure at home and followed by a decrease in consciousness. It was founded abnormalities in the form of anemia, prolonged FH (PPT 4x and APTT 4x), and hypocalcemia. The patient then was given main therapy; FVIII 100 IU/dL according to the FVIII target level calculated. The therapy continued with 500IU/12 hours according to the daily target of FVIII 50IU/dL. Discussion: The patient's condition was getting better day by day. The patient's consciousness started to improve after 14 days of postoperative. One month after that, the patient received koate treatment as the episodic handler. Diagnosing the exact cause in patients who have intracranial hemorrhage provides appropriate management so that the patients could be helped. Conclusion: Good collaboration between anesthesiologists, neurosurgeons, and pediatrics will increase the probability of successful management of critical bleeding without major sequelae.
Opioid-Sparring and Multimodal Analgesia as Parts of Enhanced Recovery After Surgery (ERAS) Applied In The Ksatria Airlangga Floating Hospital Pratama Ananda; Bambang Pujo Semedi; Christrijogo Sumartono Waloejo; Arie Utariani
Indonesian Journal of Anesthesiology and Reanimation Vol. 3 No. 1 (2021): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (136.648 KB) | DOI: 10.20473/ijar.V3I12021.17-21

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Introduction: Enhanced Recovery After Surgery (ERAS) protocol is a perioperative multimodal service program designed to achieve a faster surgical recovery period and a better outcome, the key in reducing morbidity in surgery is by reducing the "surgical injury” and reducing the body's stress response caused by the surgery. The success of the ERAS protocol depends on the interpretation and collaboration of the multidisciplinary team, therefore though the protocol is carried out in a hospital that has sufficient facilities and resources, the obstacle in the implementation of ERAS can still happen. The implementation of ERAS protocol in the non-permanent hospital service facility becomes a challenge in itself. Case Reports: From the two case reports of the implementation of ERAS protocol in the Ksatria Airlangga Floating Hospital (RST-KA) it is obtained that the key success of the anesthesia in ERAS protocol above lies on the administration of opioid-sparring therapy where it will reduce the use of opioid. Although there are many obstacles obtained in the RST-KA, the use of ERAS protocol can be conducted by making effective use of opioid-sparring combined with the administration of multimodal analgesia. Conclusion: Therefore, it can be concluded that the ERAS protocol can be applied in the social service concept in the non-permanent health facility.
The Role of "Robotic Assisted Intensivist” As Solution Of Resources Management In Covid-19 Pandemic Era Anna Surgean Veterini; Bambang Pujo Semedi; Cita Rosita Sigit Prakoeswa; Damayanti Tinduh
Indonesian Journal of Anesthesiology and Reanimation Vol. 3 No. 1 (2021): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (490.872 KB) | DOI: 10.20473/ijar.V3I12021.34-38

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Providing expertise in the care of critically ill patients is one of the main needs of critical care medicine, especially in the COVID-19 pandemic era. This goal is particularly challenging, given the acknowledged shortage of intensive care specialists. We need the bedside nurse to have real-time access to get continuous reporting monitoring. The intensivist also has access to bed site examination at some time when they are not possible for coming to the intensive care unit (ICU). The big problems during COVID-19 are the limited personal protective equipment, the limited number of intensivist doctors, and the nature of the disease was very contagious and deadly. It is necessary to find a solution so as not to cause new problems, namely the death of medical staff and nurses due to frequent contact with Covid-19 patients. In this article, the author wants to open a view to getting solutions to problems in the field by presenting human replacement technology.
COMPLICATIONS OF POSTOPERATIVE ANESTHESIA IN PEDIATRIC PATIENTS Wahyu Krishna Adjie Arsana; Bambang Pujo Semedi; Tri Wahyu Martanto; Purwo Sri Rejeki
Jurnal Inovasi Global Vol. 2 No. 1 (2024): Jurnal Inovasi Global
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/jig.v2i1.49

Abstract

Penelitian komplikasi pasca operasi di RSUD berfokus pada pasien anak dengan tujuan utama memahami karakteristik demografi dan kejadian komplikasi pasca operasi tertentu. Dari segi demografi, mayoritas responden adalah laki-laki yaitu sebesar 61,8% sampel dengan rata-rata usia pasien 8 tahun. Rentang usia responden bervariasi, mulai dari usia minimal 2 tahun hingga maksimal 17 tahun. Selain itu, aspek riwayat kesehatan juga dievaluasi. Tidak ada satu pun responden yang memiliki riwayat infeksi saluran pernapasan atas (ISPA) atau penyakit refluks gastroesofagus (GERD), dua kondisi yang dapat mempengaruhi hasil pembedahan. Dalam konteks komplikasi pasca operasi, hasil penelitian menunjukkan bahwa tidak ada kejadian croup, bradikardia, atau desaturasi pada responden. Hal ini menunjukkan tingkat keberhasilan yang baik dalam manajemen bedah dan pemulihan pasca operasi. Namun ada catatan khusus terkait hipotermia. Sebanyak 34,7% sampel mengalami hipotermia pasca operasi, sedangkan hanya 0,8% yang tidak mengalaminya. Komplikasi ini menyoroti pentingnya memantau suhu pasien setelah operasi. Secara keseluruhan temuan ini menyoroti bahwa meskipun keberhasilan dalam mencegah beberapa komplikasi serius, masih ada aspek tertentu dari pemulihan pasca operasi yang memerlukan perhatian lebih, seperti penanganan hipotermia.
Effectiveness and Safety of Prolonged Needle Decompression Procedures in Tension Pneumothorax Patients with COVID-19 Mirza Koeshardiandi; Zulfikar Loka Wicaksana; Bambang Pujo Semedi; Yoppie Prim Avidar
Indonesian Journal of Anesthesiology and Reanimation Vol. 4 No. 1 (2022): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (305.887 KB) | DOI: 10.20473/ijar.V4I12022.47-54

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Introduction: Coronavirus disease-19 (COVID-19) has become a pandemic that is still ongoing today. This is a new challenge for health workers in handling emergency cases. Several COVID-19 patients arrived at the hospital with severe respiratory problems. Meanwhile, other pathological conditions causing respiratory failure must also be considered, such as pneumothorax. Objective: This study aimed to examine the effective emergency procedures to treat COVID-19 cases with tension pneumothorax. Case Report: A 45-year-old male patient arrived with a referral letter from a pulmonologist with a diagnosis of simple pneumothorax and pneumonia. The patient also presented a positive SARS COV-2 PCR test result. The patient complained about a worsening of shortness of breath. A symptom of dry cough for 14 days was also reported. Chest radiograph examination subsequently indicated right tension pneumothorax. In the emergency ward, needle decompression procedure connected to the vial containing sterile intravenous fluids was performed. Re-examination of the chest x-ray demonstrated right pulmonary re-expansion. The patient was monitored and after four days, needle decompression was removed and no chest tube was inserted because complete resolution of the lungs had occurred. This case illustrates that tension pneumothorax causes worsening of the patient's condition with COVID-19 diagnosis. In another case of tension pneumothorax in a COVID-19 patient, needle decompression of the 2nd intercostal space and the mid-clavicular line was performed as initial treatment followed by chest tube insertion as definitive treatment. However, in this case, chest tube approach was not carried out because the patient had demonstrated clinical and radiological improvement and a worsening condition had not occurred. Conclusion: Prolonged needle decompression connected to a vial containing sterile intravenous fluids as deep as 2 cm from the water surface is an effective procedure in the management of tension pneumothorax even without the installation of a chest tube.
Co-Authors Abdul Khairul Rizki Purba Mustofa Indwiani Astuti Agustina Salinding Ahmad Lukman Hakim Ahmed Eliaan Shaker Abuajwa Airi Mutiar Alivery Raihanada Armando Andre Ferdinand Karema Anna Surgean Veterini Ardiansyah Arifoel Hajat Aryati Aryati Avidar, Yoppie Prim Bambang Herwanto Bambang Purwanto Bambang Purwanto Betty Agustina Tambunan Budiono Budiono Christrijogo Soemartono Waloejo Cita Rosita Sigit Prakoeswa Cornellius Hendra Purnama Aria Sumantrie Damayanti Tinduh Dwi Rachmawati Eddy Rahardjo Edwar, Pesta Parulian Maurid Elizeus Hanindito Faizatuz Azzahrah Syamsudi Fajar Tri Mudianto Fajra Arif Hatman Habibah Teniya Ariq Fauziyah Hamzah Hamzah Hanif Hanif Hardiono Hardiono Harida Zahraini Herdiani Sulistyo Putri IG Eka Sugiartha IGAA Putri Sri Rejeki Imam Susilo Inna Maya Sufiyah Khildan Miftahul Firdaus Kuntaman Kuntaman Lila Tri Harjana Lucky Andriyanto Marsha Zahrani Marsheila Harvy Mustikaningtyas Martanto, Tri Wahyu Maulydia, Maulydia Mirza Koeshardiandi Muh Kemal Putra Muhammad Wildan Afif Himawan Nanang Nurofik Ninik Asmaningsih Soemyarso Notopuro, Paulus Budiono Nugroho Setia Budi Nurofik, Nanang Prananda Surya Airlangga Pratama Ananda Prihatma Kriswidyatomo Pudji Lestari Puspa Wardhani Puspa Wardhani Puspitasari, Yessy Putu Laksmi Febriyani Rahmat Sayyid Zharfan Rehatta, Nancy Margarita Rejeki, Purwo Sri Rezki Muhammad Hidayatullah Robby Dwestu Nugroho Samuel Hananiel Rory Sandi Ardiya Rasitullah SATRIYAS ILYAS Setiawan, Philia Soni Sunarso Sulistiawan Sulistiawan, Soni Sunarso Sundari Indah Wiyasihati Teguh Sylvaranto Utariani, Arie Verio Damar Erlantara Putra Vincent Geraldus Enoch Lusida Wahyu Krishna Adjie Arsana Wahyu Mananda Widodo Widodo Yopie Wiguna Zulfikar Loka Wicaksana