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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 363 Documents
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Assessment of Clinical Ethics Application and Patient Satisfaction in Anesthesiology Services: A Cross-Sectional Study Forensa, Habibie Arzt; Suryadi, Taufik; Kulsum, Kulsum
JAI (Jurnal Anestesiologi Indonesia) Vol 18, No 1 (2026): JAI (Jurnal Anestesiologi Indonesia)
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.71867

Abstract

Background: Clinical ethics is currently widely discussed in anesthesiology practice in hospitals. The implementation of clinical ethics is very important in providing patient care. Anesthesiology services are a type of medical service that is full of ethical dimensions because each procedure, from pre-operative, perioperative, and post-operative, is directly correlated with the four quadrants of clinical ethics. There have been few studies conducted regarding the implementation of clinical ethics and the quality of patient satisfaction.Objective: The purpose of this study was to describe the implementation of clinical ethics in anesthesiology and the quality of patient satisfaction.Methods: An observational study using cross sectional design was conducted at Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia, in October-December 2023 on 111 patients receiving anesthesiology services, male and female, aged 2-65 years, who will undergo elective surgery.Result: The present study found that the implementation of clinical ethics in anesthesiology services was 62.45%, with each category being medical indications (72.26%), patient preferences (66.21%), quality of life (60.21%), and contextual features (51.12%). Meanwhile, the level of patient satisfaction with anesthesiology services was as follows: strongly satisfied (69.37%), satisfied (18.02%), neutral (8.10%), not satisfied (2.71%), and strongly not satisfied (1.80%). Factors influencing the lack of implementation of clinical ethics in anesthesiology services include short consultation times, inadequate patient understanding of clinical ethics issues, and excessively detailed information. One way to improve the implementation of clinical ethics is by providing comprehensive clinical ethics information during anesthesia consultations and pre-operative care.Conclusion: The implementation of clinical ethics in anesthesiology services was moderate. Higher perceived clinical ethics practices may be associated with increased patient satisfaction; however, causal conclusions cannot be drawn from this study.
The Efficacy of High-Albumin Formula Supplementation (Albumed milk) on Serum Albumin Levels in Critically Ill Patients with Sepsis Wiwi Jaya; Arie Zainul Fatoni; Prataganta Iradat; Buyung Hartiyo Laksono
JAI (Jurnal Anestesiologi Indonesia) Vol 18, No 1 (2026): JAI (Jurnal Anestesiologi Indonesia)
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.71031

Abstract

Background: Septic, an infection-induced condition, triggers an inflammatory response leading to life-threatening organ dysfunction and hypoalbuminemia. Albumed milk, containing extracts from egg whites and sprouts, has been considered a potential intervention to prevent hypoalbuminemia.Objective: This study aimed to evaluate the impact of albumed milk on elevating serum albumin levels in septic patients in the intensive care unit (ICU).Methods: An experimental study involved two groups totaling 40 patients. The control group received a standard ICU diet, while the treatment group received half of the regular ICU diet supplemented with 30 grams of albumed milk every 8 hours. Albumin levels were measured on days 0 and 3.Results: A significant reduction in average albumin levels occurred in the control group at 0.605 units (p-value = 0.006). Conversely, the treatment group showed a non-significant decrease, with an average reduction in albumin level of 0.03 units (p = 0.839).Conclusion: Albumed milk administration preserves albumin levels in septic patients compared to control patients without albumed, who show albumin level reduction. This highlights the potential utility of albumed milk as a supplementary measure in mitigating septic-related hypoalbuminemia. 
Lower Preoperative and Postoperative Hemoglobin Levels in Patients with Postoperative Cognitive Dysfunction Compared to Those Without Postoperative Cognitive Dysfunction Following Heart Valve Replacement Widya Istanto Nurcahyo; Chandra Hermawan Manapa; Zainal Muttaqin; Cindy Elfira Boom; Muhammad Farhan; Mohamad Sofyan Harahap; Dodik Tugasworo; Rea Sava Kinanti Sianturi
JAI (Jurnal Anestesiologi Indonesia) Vol 18, No 1 (2026): JAI (Jurnal Anestesiologi Indonesia)
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.79631

Abstract

Background: Postoperative cognitive dysfunction (POCD) is a prevalent complication that occurs after surgery, impacting cognitive function. Cognitive performance may be hindered by anemia, as it reduces the delivery of oxygen to the brain and leads to tissue hypoxia, affecting metabolism and ultimately diminishing cognitive function.Objective: The objective of this study is to examine the potential correlation between hemoglobin levels and the occurrence of POCD in individuals undergoing heart valve replacement surgery.Methods: This retrospective cohort study included all individuals aged 20 years and above who underwent heart valve replacement surgery from July to December 2021. Hemoglobin levels were assessed both before and after the surgical procedure, and cognitive function was evaluated using the Indonesian-adapted Montreal Cognitive Assessment (MOCA-INA) on the third day after the operation. Statistical analysis involved the use of either Student's t-test or the Mann–Whitney nonparametric test.Results: A total of 70 participants were included in the study from July to December 2021. The majority of the participants were female (57.1%), and a significant proportion were below 60 years old (81.4%). The average preoperative hemoglobin levels were higher (13.30 g/dL) than the average postoperative hemoglobin levels (10.78 g/dL). In terms of cognitive function, 61.4% of participants experienced postoperative cognitive dysfunction (POCD), with a higher mean MoCA-INA score before surgery (28.41) than after surgery (22.37), along with a delta Hb of -0.27. Furthermore, postoperative hemoglobin levels were significantly lower in POCD patients than preoperatively (p = 0.003).Conclusion: The occurrence of postoperative cognitive dysfunction (POCD) was linked to the hemoglobin levels after heart valve replacement.
Rapid Response Systems as Secondary Responders to In-Hospital Clinical Deterioration: A Four-Year Observational Study Sidharta Kusuma Manggala; Andi Ade Wijaya Ramlan; Dita Aditianingsih; Riyadh Firdaus; Arief Cahyadi; Aino Nindya Auerkari; Noor Hafidz; Luther Holan Parasian; Adhrie Sugiarto; Yoan Devina; Aivi Mujono; Avisa Cetta Cresma
JAI (Jurnal Anestesiologi Indonesia) Vol 18, No 1 (2026): JAI (Jurnal Anestesiologi Indonesia)
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

Background: 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 four years 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 (RSCM), 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 odds ratio (OR) 48.17 and 27.13 vs. red early warning score (EWS) reference, both p<0.001). Most activations occurred out of hours (63.0%), and mortality was significantly higher (71.3% vs. 61.1%; p < 0.001). The most frequent single-parameter triggers were oxygen saturation ≤90% (38.5%) and sudden deterioration of consciousness (15.8%). Mismatched activations, where the patient’s condition upon team arrival differed from the activation indicationwere strongly associated with higher mortality (OR 17.3, 95% confidence interval (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 (ALF), expanding nighttime coverage, and increasing intensive care unit (ICU) capacity are essential to enhance RRS effectiveness and reduce preventable in-hospital mortality in resource-limited settings.
Effects of Dexmedetomidine Versus Propofol–Fentanyl on QoR-15 Recovery in Cranioplasty Mhd Fadli; Rr Sinta Irina; Luwih Bisono
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.Objective: 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, depth of sedation, 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. 
Analysis of the Relationship Between Intensive Care Unit Patient Characteristics and Patient Mortality at Adam Malik Hospital, Medan Rahadhi Putera; Tasrif Hamdi; Cut Meliza Zainumi
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.v0i0.78266

Abstract

Background: The intensive care unit (ICU) is a vital unit in hospitals that treats critical patients with physiological instability or organ failure.Objective: The general objective of this study is to determine the relationship between patient characteristics and ICU mortality, with the specific objective of analyzing the number of patients who died, characteristics (gender, age, type of disease, type of microorganism, route of admission, antibiotic use, tracheostomy time, and SOFA score)Methods: This study used a cross-sectional descriptive analytical design, Inclusion criteria were medical records of patients aged >18 years in the ICU ward.Result: Patient characteristics showed that most patients were admitted to the ICU via referral from other hospitals (132 patients). Fluoroquinolone antibiotics were the most frequently used (118 patients, 10.83%). 140 deceased patients had a sequential organ failure assessment (SOFA) score range of 10-11, with no significant difference (P 0.35). The highest mortality was observed in patients >65 years old (31.43%) and males (57.14%), often associated with respiratory diseases. Most deceased patients had a length of stay of 1-3 days (68.57%) and did not use ventilators (97.14%). Non-surgical patients had the highest mortality, with septic shock, acute myocardial infarct, and chronic heart failure as the primary diagnoses.Conclusion: Mortality of ICU patient in this research has a multifactorial cause consisting of admission route, microorganism type, tracheostomy timing and antibiotic usage.
Correlation Between ScVO2, PCO2 Gap (Artery-Vein PCO2 Gradient) and Respiratory Quotient with Cardiac Output in Septic Shock Patients Eliezer Iswara Anindita; Pradana Bayu Rakhmatjati; Dina Paramita; Taufan Pramadika
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.v0i0.68347

Abstract

Background: Septic shock is a life-threatening condition characterized by cardiovascular dysfunction, which can cause multi-organ failure and high mortality rates. Central venous oxygen saturation (ScVO2), PCO2 Gap, and respiratory quotient are potential markers of tissue perfusion and oxygenation, while cardiac output is an important indicator of cardiovascular function. These findings may help guide clinical management and prognosis assessment in patients with septic shock.Objective: To determine the correlation between ScVO2, PCO2 Gap (arterial-venous PCO2 gradient), and respiratory quotient on cardiac output in septic shock patients.Methods: This observational study was conducted on 30 septic shock patients treated in the intensive care unit (ICU). Blood samples were taken via central venous catheter (CVC) and arterial line to check central venous saturation (ScVO2), PCO2 Gap, and calculate the respiratory quotient. Then cardiac output is measured using echohemodynamics.Results: Based on analysis using the Spearman Rho test, the results show that the correlation between ScVO2 and cardiac output has a correlation value of -0.367 (p = 0.046). The correlation between PCO2 Gap and cardiac output has a correlation value of -0.520 (p=0.003). The correlation between respiratory quotient and cardiac output in this study had a correlation value of -0.833 (p < 0.001).Conclusion: There is a correlation between ScVO2, PCO2 Gap (arterial-venous PCO2 gradient), and respiratory quotient on cardiac output in septic shock patients.
Base Deficit and Increased Lactate Level as Predictors of Blood Transfusion in Trauma Patients With Acute Bleeding at the Emergency Department RSUP Prof. dr. I.G.N.G. Ngoerah Esther Gisela Nenoharan; I Made Gede Widnyana; IGAG Utara Hartawan; Made Wiryana; Tjokorda Gde Agung Senapathi; I Made Agus Kresna Sucandra; Dewa Ayu Mas Shintya Dewi; FX Adinda Putra Pradhana; Kadek Anggie Wigundwipayana
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.v0i0.80615

Abstract

Background: Bleeding caused by trauma is still a prominent factor in death and organ system complications. Base deficit (BD) and lactate levels are experiencing disturbances which result in hypoxic acidosis conditions at the tissue and cellular levels.Objective: This study aims to determine the relationship between low base deficit levels, high lactate values, related to the need for blood transfusions in trauma patients with acute blood loss.Method: This research is an observational analytic study with a prospective cohort study design. The target population of this study were all trauma patients with acute bleeding admitted to the emergency room Prof Dr. dr. IGNG Ngoerah.Result: Age results showed a mean ± SD of 25.08 ± 6.38 years, the most gender was male, there were 36 subjects (72%), Hb levels had an average of ± 10.47 ± 2.85 g/dL, BMI results had mean ± SD 23.47 ± 3.54 kg/m2, the most common type of trauma was multiple trauma, the ISS score was found to have a mean ± SD 23.38 ± 9.09. The results for the value of the base level obtained a mean ± SD of 4.08 ± 5.08 mmol/L, with the transfusion group with an average of -6.41 ± 4.65 mmol/L. Low base level <-3 mmol/L had RR 3.69 (95% CI 1.83-7.45; P<0.001) and Adj RR 18.56 (95% CI 14.00-24.75; p=0.002 ). The average lactate result was found to have a mean ± SD 3.77 ± 2.29 and in the transfusion group 4.78 ± 2.38 mmol/L with high lactate levels (> 4 mmol/L) RR 5.53 (CI 95% 2, 25-13.64; P<0.001) and Adj RR 41.21 (95% CI 35.05-57.74; p<0.001).Conclusion: Low base deficit and high lactate levels are associated with the need for blood transfusions in patients with acute bleeding. 
Cytokine-Mediated Systemic Inflammation in Patient with Sepsis in ICU: A Systematic Literature Review and Meta- Analysis of Interleukin-6 and Tumor Necrosis - Maulitia Neny Yusuprihastuti; Juniarti Juniarti; Linda Weni; Diniwati Mukhtar; Hari Hendriarto Satoto
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.v0i0.82097

Abstract

ABSTRACTObjectives: To systematically evaluate and quantify the prognostic value of circulating interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels for mortality and disease severity in adult intensive care unit (ICU) patients with sepsis.Study design: This study was conducted as a systematic review and meta-analysis of observational studies and randomized controlled trials. Evidence quality was assessed using the Newcastle–Ottawa Scale for observational studies. Quantitative synthesis was performed using meta-analytic techniques.Data sources: A comprehensive literature search was performed in PubMed, Scopus, Web of Science, and Embase from database inception to the most recent available date. Reference lists of relevant articles were also manually screened to identify additional eligible studies.Data synthesis: Two studies evaluating IL-6 (196 ICU sepsis patients) demonstrated significantly higher IL-6 levels in non-survivors compared with survivors, with a large and consistent pooled effect size (SMD −1.92; 95% CI −2.27 to −1.57) and no interstudy heterogeneity, supporting IL-6 as a robust prognostic biomarker. TNF-α data from two studies (270 patients) also showed significantly elevated levels in non-survivors (SMD −2.70; 95% CI −3.05 to −2.35); however, substantial heterogeneity and slight funnel plot asymmetry reduced the certainty and generalizability of its prognostic value.Conclusions: Elevated IL-6 and TNF-α levels are associated with increased mortality in ICU patients with sepsis. IL-6 demonstrates more consistent and reliable prognostic performance, supporting its use for early risk stratification in critical care, whereas TNF-α may serve as a complementary biomarker.Registration: This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. Prospective registration in the PROSPERO database.Keywords:interleukin-6; intensive care unit; mortality; sepsis; tumor necrosis factor-α
Safe and Effective Perioperative Management in Patients with Atrial Septal Defect and Pulmonary Contusion: A Case Study with Supraclavicular Block RTH Supraptomo; Andy Nugroho; Muhammad Baihaqi Siddik
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.v0i0.78083

Abstract

Background: Peripheral nerve blocks offer a safer anesthetic alternative in patients with congenital heart disease (CHD) by reducing cardiovascular and pulmonary risks associated with general anesthesia. The supraclavicular brachial plexus block provides effective anesthesia for upper limb surgery with improved hemodynamic stability, reduced complications, and better postoperative analgesia. This case report aims to demonstrate the safety and effectiveness of supraclavicular brachial plexus block as a perioperative anesthetic strategy in a high-risk patient with CHD and pulmonary contusion.Case: A 67-year-old woman with a large secundum atrial septal defect (ASD), severe pulmonary hypertension, right ventricular dysfunction, and bilateral lung contusions on day 10 was scheduled for open reduction internal fixation (ORIF) of a distal radius fracture. Due to high cardiopulmonary risk, regional anesthesia was chosen. An ultrasound- and nerve stimulator-guided supraclavicular block using 20 mL of levobupivacaine 0.375% was performed. The procedure was completed successfully with stable hemodynamics and preserved spontaneous ventilation. Postoperatively, the patient was monitored in a high-care unit (HCU).Discussion: Maintaining hemodynamic stability and avoiding increases in pulmonary vascular resistance (PVR) are critical in acyanotic left-to-right shunt CHD. General anesthesia and mechanical ventilation may disrupt Qp:Qs balance and worsen pulmonary function, especially in pulmonary contusion. Regional anesthesia minimizes these risks while providing adequate surgical conditions.Conclusion: Supraclavicular brachial plexus block is a safe and effective alternative for upper limb surgery in high-risk CHD patients with acyanotic shunt lesions and pulmonary complications.

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