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All Journal Jurnal Anestesi Perioperatif Solo Journal of Anesthesi, Pain and Critical Care
Deviatika, Fiandila Elvana
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Chemical Engineering, Chemistry & Bioengineering Education Health Professions Medicine & Pharmacology Nursing Public Health

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Superior Vena Cava Obstruction After Pediatric Cardiac Surgery: A Case Series Synthana, Meta Restu; Wisudarti, Calcarina Fitriani Retno; Kurniawaty, Juni; Deviatika, Fiandila Elvana
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.v14n1.4510

Abstract

Background: Superior vena cava (SVC) obstruction is a rare but potentially life–threatening complication following pediatric cardiac surgery, particularly in patients with congenital heart disease. Mechanical factors related to central venous catheterization and underlying venous anomalies may increase the risk of this condition.Case: We reported a case series of three pediatric patients who developed postoperative SVC obstruction following corrective cardiac surgery and were managed in the intensive care unit (ICU). All patients underwent insertion of a central venous catheter (CVC) via the internal jugular vein for perioperative hemodynamic support. Postoperatively, all patients developed clinical manifestations consistent with SVC obstruction, including facial and upper extremity edema, venous congestion, hemodynamic instability, and reduced urine output. Vascular ultrasonography confirmed partial to severe SVC obstruction in all cases. Two patients had associated anatomical variations, including a persistent left SCV, which may have contributed to altered venous drainage. Management strategies included CVC repositioning or removal, anticoagulation therapy, and surgical release of the obstruction when indicated. These interventions resulted in clinical and hemodynamic improvement in all affected patients.Discussion: This case series highlights the importance of recognizing mechanical and anatomical risk factors for SVC obstruction in pediatric cardiac surgery, including catheter size, tip position, and congenital venous anomalies.Conclusion: careful selection of CVC size, optimal tip placement, and ultrasound guidance for catheter positioning and postoperative assessment may help prevent this serious complication. Early diagnosis and timely intervention are essential to reduce morbidity and improve outcomes in this vulnerable population.
Extracorporeal Liver Support in Liver Failure: A Comprehensive Review of MARS, SPAD, Prometheus, ADVOS, and Bioartificial Systems Synthana, Meta Restu; Jufan, Akhmad Yun; Wisudarti, Calcarina Fitriani Retno; Deviatika, Fiandila Elvana
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 5, No 2 (2025): October 2025
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v5i2.107158

Abstract

Background : Acute and chronic liver failure are life-threatening conditions often requiring liver transplantation as definitive therapy. To delay or substitute the need for transplantation, various extracorporeal liver support systems have been developed. This article aims to review current artificial and bioartificial liver support systems including the Molecular Adsorbent Recirculating System (MARS), Single Pass Albumin Dialysis (SPAD), Prometheus, ADVanced Organ Support (ADVOS), and Bioartificial Liver (BAL) devices.Discussion : MARS and SPAD utilize albumin-based dialysis to remove protein-bound and water-soluble toxins. Prometheus applies a fractionated plasma separation and adsorption approach, while ADVOS enables individualized acid-base correction. Bioartificial liver systems integrate hepatocyte bioreactors with plasma dialysis to provide more physiological metabolic support. While these systems show promise in improving clinical outcomes, long-term survival benefit remains under investigation.Conclusion :  Extracorporeal liver support systems offer essential bridging and supportive therapies for patients with liver failure. Selection should be tailored to patient condition, therapeutic goals, and technology availability.
Co-Authors Akhmad Yun Jufan Calcarina Fitriani Retno Wisudarti Juni Kurniawaty Muhdar Abubakar Djayanti Sari Meta Restu Synthana