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All Journal Indonesian Journal of Anesthesiology and Reanimation (IJAR) Solo Journal of Anesthesi, Pain and Critical Care
Irianto, Helen Yudi
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Chemical Engineering, Chemistry & Bioengineering Health Professions Medicine & Pharmacology Nursing Public Health

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Acute Respiratory Distress Syndrome (ARDS) Management Severe COVID-19 Irianto, Helen Yudi; Jufan, Akhmad Yun
Indonesian Journal of Anesthesiology and Reanimation Vol. 5 No. 2 (2023): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V5I22023.96-101

Abstract

Introduction: The Coronavirus disease 2019 (COVID-19) caused a global pandemic and many management challenges. Acute Respiratory Distress Syndrome (ARDS) is one of the most common pneumonia complications in COVID-19 cases. ARDS in COVID-19 have worse outcomes and increased risk of intensive care unit (ICU) admission. Objective: This case report aims to recognize and understand ARDS management in a severe COVID-19 case. Case Report: A 68-year-old man with diabetes mellitus and hypertension arrived at the Emergency Room (ER) after experiencing five days of fever, cough, diarrhea with frequency of four times a day, weakness, and a positive antigen result for COVID-19 at admission. Anosmia was absent. The patient had been vaccinated for COVID-19 twice. The main problem was his desaturation of 88%, blood pressure of 156/73 mmHg, heart rate of 80x/minute, and respiratory rate of 20x/minute. However, the patient was alert and admitted to the isolation ward. After 21 days of hospitalization, the patient's condition worsened. The patient developed ARDS and was referred to the COVID ICU for 25 days and 20 days to the non-COVID ICU, where he was intubated, and a tracheostomy was performed. After 45 days of admission to the ICU, the patient's condition improved. Discussion: COVID-19 patients with ARDS should be immediately intubated when conditions such as dyspnea, RR>30x/min, SpO2<92% (for patients with no comorbidities) or <95% (for patients with comorbidities), unconsciousness, or shock appears. Furthermore, other conditions, such as an HR> of 120x/min and a ROX index of <3.851, should be considered an indication for intubation. Conclusion: Timely intubation improves the outcome of COVID-19 patients with ARDS.
Relationship Between Simple Oxygen Extraction Ratio to Cardiac Index and Mean Arterial Pressure in Septic Shock Patient Treated in ICU Dr. Sardjito Hospital Yogyakarta irianto, helen yudi; Jufan, Akhmad Yun; Widodo, Untung
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 3, No 2 (2023): October 2023
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v3i2.76067

Abstract

Background : Oxygen extraction ratio (O2ER)  having any relationship with  cardiac index and mean arterial pressure in septic shock patient.Objective: Discover any relation between simplified oxygen extraction ratio with cardiac index and mean arterial pressure in shock septic condition at ICU of RSUP Dr Sardjito YogyakartaMethod : 32 subject with crossectional study was performed by inclution criteria such as : patient in ICU diagnosed as shock septic, more than 18 years old, inerted cvc in right atrium, inserted arterial line in  arterial radialis or brachialis which connected mostcare. BGA (arterial and venous ) sampel was taken by I-STAT® together with recording mean arterial pressure (MAP) and cardiac index value.Result :  Correlation between O2ER and cardiac index p=0,009 (p<0,05) with r -0,456. Correlation between O2ER and MAP p=0,006 (p<0,05) with r-0,474.Conclusion :Anesthesia management of TGA TGA cases is to avoid reducing cardiac output and SVR and keep the PVR lower than the SVR.
Co-Authors Akhmad Yun Jufan Untung Widodo, Untung