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INDONESIA
Jurnal Respirologi Indonesia
Published by Perhimpunan Dokter Paru Indonesia
ISSN : 08537704     EISSN : 26203162     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology
Jurnal Respirologi Indonesia (JRI) is an online and printed scientific publication of the Indonesian Society of Respirology (ISR). The journal is published thrice-monthly within a year (January, April, July and October). The journal is focused to present original article, article review, and case report in pulmonary and critical care medicine.
Arjuna Subject : -
Articles 364 Documents
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Cost-Effectiveness Analysis of Budesonide/Formoterol and Fluticasone/Salmeterol for Stable Chronic Obstructive Lung Disease Amelia Lorensia; Monica Dyah Puspitasari; Soedarsono Soedarsono; Rivan Virlando Suryadinata
Jurnal Respirologi Indonesia Vol 42, No 4 (2022)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v42i4.378

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) is one of the four largest types of non-communicable diseases in the world, requiring long-term and routine treatment. Treatment with the inhalation route is in the form of a dry-powder inhaler (DPI) which is easy to use and carry. Combination of corticosteroid and long-acting beta-2 agonist (LABA) in the form of DPI available in Indonesia are budesonide/formoterol and salmeterol/fluticasone. The purpose was to identify therapy was more cost-effective between budesonide/formoterol than fluticasone/salmeterol in clinical symptoms using COPD assessment test (CAT) value and lung function in FEV1/FVC (Forced Expiratory Volume in First Seconds/Forced Vital Capacity) ratio.Methods: This research study was pre-post design with cost-effectiveness analysis, in outpatient COPD patients in a hospital in Gresik Regency, from October 2019 to January 2020. There were two outcomes of respondents in this study, namely lung function seen from the value of FEV1, and clinical symptoms seen from the value of CAT. The study used hospital perspective.Results: There were 38 respondents involved. Fluticasone/salmeterol therapy was more effective than the budesonide/formoterol group in improving FEV1/FVC ratio, while budesonide/formoterol was more effective than the fluticasone/salmeterol group in improving clinical symptoms by CAT assessment. The average cost effectiveness ratio (ACER) value of lung function between the fluticasone/salmeterol group (IDR.176.465/Liter) was lower than that of budesonide/formoterol (IDR.296.832/Liter). The ACER clinical symptoms value between the fluticasone/salmeterol group (IDR.16,283/score) was smaller than that of budesonide/formoterol (IDR.17,340/score). Conclusion: Fluticasone/salmeterol was more cost-effective than budesonide/formoterol in improving lung function. Meanwhile, for clinical symptoms, fluticasone/salmeterol was trade-off with budesonide/formoterol.
Analysis of Clinical Manifestation at Admission and Comorbidity on Clinical Outcome of COVID-19 Patients in RSUDZA Banda Aceh Isma, Heliyana; Arliny, Yunita; Yanifitri, Dewi Behtri; Budiyanti, Budiyanti; Zulfikar, Teuku
Jurnal Respirologi Indonesia Vol 42, No 4 (2022)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v42i4.288

Abstract

Background: Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV- 2 virus and has become a pandemic until now. Clinical outcomes in patients vary depending on many factors, such as demographics, vital signs, laboratory results, and comorbidities.Methods: This study aims to analyze clinical outcomes in COVID-19 patients associated with the patient's general information (age, sex), demographic factors, admission vital signs, degree of symptoms at admission, blood laboratory results at admission, and comorbidities. This study is an analytic observational study with a cross-sectional design. All variables were examined based on medical records at the time of admission to the hospital. A multivariate analysis was conducted to determine what factors most influence clinical outcomes in treated COVID-19 patients.Results: There were 183 COVID-19 patients included in this study with moderate to critical degrees. Factors that influence the clinical outcome of COVID-19 patients are the presence of comorbidities, old age, high blood pressure and heart rate, anemia, leukocytosis, and increased blood sugar and creatinine at admission. Multivariate analysis showed that clinical symptoms of severe COVID-19 were a factor that influenced poor clinical outcomes in COVID-19 patients, with OR=5.6 (95% CI=2.223-13.90).Conclusion: Age, comorbidity, blood pressure, heart rate, hemoglobin, random blood glucose, and creatinine at admission influence the clinical outcome of admitted COVID-19 patients.
Surfactant Protein A Serum Level in Cement Worker Gunawan Gunawan; Sita Laksmi Andarini; Muhammad Ilyas; Arif Santoso; Ahmad Hudoyo; Irawaty Djaharudin; Harun Iskandar; Nur Ahmad Tabri
Jurnal Respirologi Indonesia Vol 42, No 4 (2022)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v42i4.363

Abstract

Background: Pneumoconiosis occurs almost in entire worldwide. Pneumoconiosis had threatened cement workers. Serologic abnormalities had found in pneumoconiosis. Surfactant Protein A (SP-A) levels increased in silica-exposed workers. Surfactant Protein A (SP-A) may be a helpful biomarker for the early diagnosis of pneumoconiosis, but it has not yet been studied in Indonesia.Methods: The design of this study was observational with cross-sectional. A sampling of cement-exposed workers was done by consecutive sampling. The subjects were 88, approach population of 67 cement exposed workers from September 2017 – March 2018 and 17 healthy people as control. The serum level of SP-A was measured by the ELISA method. Cement exposed workers is a worker in the production area and workers in the quarry area.Results: The total number of research subjects met the criteria was 67, and the control subjects were 21. The mean serum SP-A level in the study subject group or the exposed group was 6.02 ng/ml, and the mean SP-A level in the control group was 4.50 ng/ml. The difference in SP-A levels between the exposed and control groups was different but not significant, with value of P=0.084.Conclusion: SP-A levels in the exposed and control groups were different but not statistically significant.
Clinical Profile of COVID-19 Patients from March 2020 to March 2021 in Abepura Regional General Hospital (RSUD Abepura), Papua Yenny Belinda Jioe; Helena Pakiding; Nancye Lorein; Dessy Yuliana; Febrianti Manga Mangontan; Fergina Stefany Berhitu
Jurnal Respirologi Indonesia Vol 42, No 4 (2022)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v42i4.375

Abstract

Background: SARS-COV-2 infection has widely spread and caused high morbidity and mortality rates. Despite more than one year of the COVID-19 pandemic in Indonesia, there is no scientific report regarding COVID-19 from Papua. This study aims to assess the clinical profile of COVID-19 patients in Abepura Regional General Hospital (RSUD Abepura), Papua.Methods: We retrospectively recorded patients' age, sex, race, comorbidities, admitting and principal diagnoses, length of stay (LOS), and outcome (deceased/discharged) from the medical records from March 2020 to March 2021. Categorical data were described in frequencies and percentage, while numerical data were described in mean±SD or median and IQR. We analyzed the association between independent variables (age, sex, race, comorbidities, and diagnoses) with LOS and mortality rate.Results: We included 461 patients (58.6% female) with a median age of 36.90 (26.35-49.35) years who were hospitalized for 17 (12-25) days, in which 5.4% mortality occurred. Overall COVID-19 patients were dominated by non-Papuan race (75%). The most frequent comorbidities were hypertension (19.1%), electrolyte imbalance (10.2%), and diabetes (10.0%). Increased mortality rates were significantly associated with older age (≥65 years), cerebrovascular conditions, hypertension, coronary heart disease, liver disease, diabetes, and electrolyte imbalance (P<0.05). Moreover, several comorbidities, such as hypertension, coronary heart disease, diabetes and electrolyte imbalance, and a principal diagnosis of critical COVID-19, were associated with a significantly shorter period of LOS (P<0.05).Conclusion: Mortality and LOS due to COVID-19 in RSUD Abepura, Papua, are influenced by older age and several comorbidities.
The Effect of Long-Acting Beta-2 Agonist Monotherapy and Long-Acting Anticholinergic Monotherapy to Quality-of-Life in Group B Stable COPD Patients Tri Setia Negara Sinulingga; Pandiaman Pandia; Amira P. Tarigan; Putri Chairani Eyanoer
Jurnal Respirologi Indonesia Vol 42, No 4 (2022)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v42i4.370

Abstract

Background: Based on the 2019 Global Initiative for Chronic Obstructive Lung Disease (GOLD), treatment for group B stable COPD patients is a long-acting beta-2 agonist (LABA) or long-acting anticholinergic (LAMA). Some studies experienced that LAMA was better than LABA but the opposite was also found in several studies. COPD patients often experience a decline in physical activity which causes a decrease in quality of life. We aimed to compare the effect of LABA or LAMA on quality of life in group B stable COPD patients.Methods: This was a study with case series design conducted on 50 COPD patients divided into two groups. The first group consisted of patients who used LABA for at least 3 months. The second group used LAMA for at least 3 months. All subjects filled in the SGRQ. The calculation of SGRQ was carried out using Microsoft Excel Calculator SGRQ.Results: A total 41 men and 9 women were enrolled in this study. There was no significant difference between the use of indacaterol monotherapy and tiotropium monotherapy on the quality of life although tiotropium showed a better quality of life (76%) than indacaterol monotherapy (64%).Conclusion: There was no significant difference in the use of indacaterol and tiotropium on the quality of life although in this case tiotropium showed better results (P=0.538).
Mesenchymal Stem Cells Role in COVID-19 Myocardial Injury Triya Damayanti; Mega Juliana; Yasmina Hanifah; Erlina Burhan; Putri Suci Ramadhany
Jurnal Respirologi Indonesia Vol 42, No 4 (2022)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v42i4.192

Abstract

Coronavirus Disease-19 (COVID-19) has become a global pandemic that affected the lives of billion individuals. The clinical spectrum of the disease varies from asymptomatic form to severe manifestation in term of acute respiratory distress syndrome (ARDS), shock and septic shock and multiple organ dysfunction syndrome (MODS). Clinical studies have also reported an association between COVID-19 and cardiovascular manifestation, such as myocardial injury, arrhythmias, acute coronary syndrome (ACS) and thromboembolism. Myocardial injury has been reported frequently and is associated with high mortality. The currently approved strategies for COVID-19 are supportive rather than curative treatment. Cell-based approaches, primarily using mesenchymal stem cell (MSC) has demonstrated safety and possible efficacy as an adjuvant therapy in COVID-19 patient. Mesenchymal stem cells have shown important role in the therapy of cardiovascular disease due to their prominent features including their ability to differentiate into cardiovascular cells, immunomodulatory properties, antifibrotic activity and ability to undergo neovasculogenic.
The Effect of N-Acetylcysteine as Adjuvant Therapy of Hypoxemia in COVID-19 Patients, Assessed by Interleukin-6 Level and PaO2/FiO2 Ratio Simon Petrus Hardiyanto Rumaratu; Ngakan Putu Parsama Putra; Yani Jane Sugiri; Susanthy Djajalaksana; Aditya Sri Listyoko; Harun al Rasyid
Jurnal Respirologi Indonesia Vol 42, No 3 (2022)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v42i3.227

Abstract

Background: Interleukin 6 (IL-6) is a cytokine that plays an essential role in lung damage and mortality. Arterial-to-inspired oxygen (PaO2/FiO2) ratio, also known as the Horowitz index, is a measure of hypoxemia in respiratory failure. N-Acetylcysteine (NAC) might be helpful in managing coronavirus disease 2019 (COVID-19) patients by decreasing the cytokine storm, which will lead to a decrease in disease severity. This study aims to analyze the effect of NAC as adjuvant therapy on IL-6 level and PaO2/FiO2 ratio in COVID-19 patients.Methods: This is a quasi-experimental, non-equivalent control group designed study of confirmed COVID-19 patients moderate to critical in Saiful Anwar Hospital Malang. Seventy-five patients received NAC intravenously 5000mg/72 hours as adjuvant therapy for seven days, and 16 subjects in the control group. IL-6 level and PaO2/FiO2 ratio were measured on day one and day 8 in both groups from blood samples. Wilcoxon, Mann-Whitney U Test, and Pearson correlation were conducted for statistical analysis.Results: The decrease in IL-6 level on days 1 to 8 in the NAC group is significantly lower (94.49±253.51) than in the control group (P=0.002). The increase in PaO2/FiO2 ratio from day 1 to day 8 in the NAC group is significantly improving (126.94±76.05), the same as the control group (P<0.001). There is a weak correlation between IL-6 level and PaO2/FiO2 ratio after administration of NAC (r=0.154, P=0.186).Conclusion: There is a significant decrease in IL-6 level after administration of NAC. NAC has no significant effect on hypoxemia in COVID-19 patients.
The Compliance of Mask Use to Prevent the Spread of COVID-19 among High School Students in Banda Aceh Novita Andayani; Sarah Firdausa; Teuku Romi Imansyah Putra; Rezania Razali; Syawqiyyah Salsabyla; Murtaza Murtaza
Jurnal Respirologi Indonesia Vol 42, No 4 (2022)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v42i4.254

Abstract

Background: COVID-19 is an air-borne disease caused by the SARS-CoV-2 virus that is spreading the globe. Masks are an attempt to break the chain of transmission of COVID-19. The purpose of this study is to examine the relationship between COVID-19 awareness and the use of masks to prevent the spread of COVID-19 among high school students in Banda Aceh City.Methods: This study is an observational analytic study using a cross-sectional design. The number of samples is 402 students of SMA Negeri Banda Aceh. The subject recruitment used the proportional random sampling technique.Results: This study was carried out from November 5 to November 21, 2020, with research questions distributed via Google Form. The Spearman correlation test was utilized in the statistical study. According to the findings, 69.4% of respondents had good knowledge of COVID-19, and 83.3% of respondents praised the use of masks. Statistical analysis reveals a p-value of 0.000 (p-value of 0.005) and a correlation coefficient of 0.275.Conclusion: There is a modest correlation between Banda Aceh City Public High School students' understanding of COVID-19 and their wearing of masks to prevent COVID-19 transmission.
Lidocaine Nebulization Compared to Lidocaine Spray in Decreasing Pain, Cough and Breathless in Flexible Fiber Optic Bronchoscopy Vita Ovaria; Yusup Subagio Sutanto; Ahmad Farih Raharjo
Jurnal Respirologi Indonesia Vol 42, No 4 (2022)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v42i4.368

Abstract

Background: Flexible optical fiber bronchoscopy (FFB) is a visual airway tract examination for diagnostic and therapeutic purposes. This procedure often causes discomfort for patients, such as cough, breathlessness and pain. Lidocaine is a topical anesthetic premedication used in bronchoscopy. This study compared the use of lidocaine nebulization and lidocaine spray in inhibiting pain, cough and breathlessness in complexity of flexible fiber optic bronchoscopy.Methods: Pretest and posttest control group clinical study was conducted in patients prior to bronchoscopy at RSUD Dr. Moewardi from February to March 2020. The samples were taken by consecutive sampling technique, then randomly assigned into either lidocaine spray or nebulization. Cough and pain were assessed with VAS score while breathlessness was assessed with Borg score. The data were analyzed statically by using Chi-square test with P<0.05 was considered significantResults: Cough scores were -17.78±11.66 for nebulization and -8.33±6.18 for spray (P=0.005). Pain score were -16.67±11.38 and -9.44±7.25 for nebulization and spray respectively (P=0.045). Borg score obtained the scores for nebulization and 0.06±0.42 for spray (P=1.000).Conclusion: Both lidocaine nebulization and spray were effective in decreasing breathlessness during bronchoscopy. However, lidocaine nebulization was more effective in decreasing cough and pain.
Association Between Feritine Levels and Severity of COVID19 In RSUP Dr. M. Djamil Padang Elsa Purnama Sari; Irvan Medison; Russilawati Russilawati
Jurnal Respirologi Indonesia Vol 42, No 3 (2022)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v42i3.244

Abstract

Background: Ferritin is one of the inflammatory markers used as a predictor for severity of COVID-19. Early assessment of severity is expected to be a priority in disease management. This study aims to determine the association between ferritin levels and the severity of confirmed COVID-19 patients at RSUP dr. M. Djamil Padang. Methods: This study is a retrospective cohort study on confirmed COVID-19 patients from January to May 2021. Chi-square analysis was calculated to assess the association between ferritin levels and clinical grade, the severity of the chest X-ray and the level of need for oxygen therapy. To assess the risk opportunities for ferritin levels based on each dependent variable, an association analysis was performed by calculating the Odds Ratio..Results: Characteristics of the patients were mostly female (54.25%), aged more than 50 years (59,00%), clinical grade above category 4 (54,75%), required oxygen therapy (74,75%), the severity of chest X-ray was mild (75.50%), ferritin level < 500 ng/ml (52.75%) and had no comorbidities (51.25%). This study found that ferritin levels correlated with clinical grade, severity of chest X-ray, and level of need for oxygen therapy with HFNC and ventilator (p<0.001). Ferritin levels > 1000 ng/mL have a risk opportunity for clinical grade category 7 OR 8.28 (95% CI 2.69-25.41), severe chest X-ray severity OR 5.52 (95% CI 2.55- 11.97) and need for oxygen therapy with HFNC and ventilator, OR 4.76 (2.70-8.39) vs OR 7.69 (3.97-14.92)Conclusion: High ferritin levels significantly increase the risk of a severe clinical severity, severe chest X-ray and the level of need for oxygen therapy using HFNC and a ventilator in COVID-19 patients.Keywords: COVID-19, ferritin levels, severity

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