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INDONESIA
Jurnal Anestesiologi Indonesia
Published by Universitas Diponegoro
ISSN : 23375124     EISSN : 2089970X     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology Public Health
Jurnal Anestesiologi Indonesia (JAI) diterbitkan oleh Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif (PERDATIN) dan dikelola oleh Program Studi Anestesiologi dan Terapi Intensif Fakultas Kedokteran Universitas Diponegoro (UNDIP) bekerjasama dengan Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif (PERDATIN) cabang Jawa Tengah.
Arjuna Subject : -
Articles 22 Documents
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Search results for , issue "Publication In-Press" : 22 Documents clear
Rapid Response Systems as Secondary Responders to In-Hospital Clinical Deterioration: A Four-Year Observational Study Manggala, Sidharta Kusuma
JAI (Jurnal Anestesiologi Indonesia) Publication In-Press
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.80762

Abstract

ABSTRACTBackground:In-hospital cardiac arrest (IHCA) is a major cause of preventable inpatient mortality, especially in low- and middle-income countries (LMICs) where rapid response systems (RRS) are still developing. Evidence regarding RRS performance in Indonesia is limited. This study evaluated the performance and operational challenges of an institutional RRS over a four-year period at a large tertiary referral hospital in Jakarta.Objective:This study aimed to determine the proportion of immediate survival following RRS activation and to investigate secondary outcomes, including the association between activation indications and mortality, and system-level barriers.Methods:This retrospective observational cohort study included all inpatient RRS activations at Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia, from January 1, 2021, to December 31, 2024. Data from the hospital’s RRS registry were analyzed for activation triggers, interventions, immediate outcomes, and operational issues.Results:Among 246,367 inpatient admissions, there were 5,900 eligible inpatient RRS activations, yielding an activation rate of 23.9 per 1,000 admissions. Immediate survival occurred in 4,763 (80.7%) events, while 1,137 (19.3%) patients did not survive. Cardiac arrest (8.0%) and respiratory arrest (6.5%) were the strongest predictors of non-survival (OR 48.17 and 27.13 vs. Red EWS reference, both p<0.001). Most activations occurred out-of-hours (63.0%), with significantly higher mortality (71.3% vs. 61.1%, p<0.001). The most frequent single-parameter triggers were oxygen saturation ≤90% (38.5%) and sudden consciousness deterioration (15.8%). Mismatched activations—where the patient’s condition upon team arrival differed from the activation indication—were strongly associated with higher mortality (OR 17.3, 95% CI 14.3–20.2, p<0.001).Conclusion:The institutional RRS demonstrated a moderate activation rate and favorable immediate survival compared with similar LMIC settings. However, outcomes were influenced by delayed recognition, out-of-hours activation, and limited critical-care capacity. Strengthening early escalation culture, monitoring afferent-limb failure, expanding nighttime coverage, and increasing ICU capacity are essential to enhance RRS effectiveness and reduce preventable in-hospital mortality in resource-limited environments. Keywords: in-hospital cardiac arrest, Indonesia, low-and middle-income countries, patient deterioration, rapid response system, resuscitation
Effects of Dexmedetomidine Versus Propofol–Fentanyl on QoR-15 Recovery in Cranioplasty Fadli, Mhd; Irina, Rr Sinta; Bisono, Luwih
JAI (Jurnal Anestesiologi Indonesia) Publication In-Press
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.79220

Abstract

Background: Optimizing postoperative recovery is essential in neurosurgical anesthesia. Dexmedetomidine, a selective α2-adrenergic agonist, may improve sedation and recovery outcomes. This study compared intraoperative dexmedetomidine versus propofol-fentanyl in cranioplasty patients using the Quality of Recovery-15 (QoR-15) score.Methods: A prospective comparative study was conducted at Adam Malik General Hospital and Haji Medan Hospital from May - August 2025 involving 42 adult patients undergoing elective cranioplasty. Subjects were divided into two groups: dexmedetomidine (n=21) and propofol-fentanyl (n=21). Quality of Recovery-15 (QoR-15), a validated 15-item questionnaire assessing five domains of postoperative recovery (pain, physical comfort, emotional state, psychological support, and physical independence; total score range 0–150), was recorded at 12 and 24 hours postoperatively. Hemodynamic parameters, sedation depth, and operator satisfaction were assessed. Data were analyzed using t-tests and Fisher’s exact test with p < 0.05.Results: Patients receiving dexmedetomidine showed higher QoR-15 scores at 12 hours (p = 0.045) and 24 hours (p = 0.003). Heart rate was significantly lower (p = 0.02), while systolic and diastolic pressures showed no significant differences. Sedation depth and operative duration were comparable. Operator satisfaction reached 100% in both groups.Discussion: Dexmedetomidine improved recovery quality compared to propofol-fentanyl, with better hemodynamic stability and fewer sympathetic responses. These findings align with previous studies supporting its use in enhanced recovery anesthesia. Limitations include a small sample size and a lack of intraoperative sedation monitoring.Conclusion: Intraoperative dexmedetomidine offers superior recovery quality and stable hemodynamics, suggesting its potential for broader use in neurosurgical anesthesia.

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