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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 360 Documents
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Mepolizumab’s (Anti-Interleukin-5) Role in Severe Asthma: A Literature Review Atikanur, Atikanur; Wijaya, Dewi; Esha, Indi; Simanjuntak, Arya Marganda
Jurnal Respirologi Indonesia Vol 44, No 2 (2024)
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.v44i2.494

Abstract

One type of asthma that is difficult to treat is severe asthma, which is asthma that is uncontrolled even when the patient is taking medication or trigger factors. It can be treated with the finest therapy but will worsen if high-dose treatment is discontinued. Age, gender, obesity, hypersensitivity, and immunological factors are all directly related to the onset of asthma. A complicated illness, severe asthma has many clinical symptoms and treatment choices. Chronic airway inflammation and lung tissue remodeling are its defining features. This literature review aims to describe how mepolizumab works in patients with severe asthma. Mepolizumab mainly inhibits the IL-5 cytokine from binding to IL-5 receptor subunits through the nanomolar potential, which inhibits IL-5 from binding to receptors on the surface of eosinophils. In contrast to the placebo group, patients on mepolizumab had an average 50% decrease from the baseline Prednisone dosage. With Mepolizumab, the yearly exacerbation rate was 1.44 RR, while it was 2.12 RR with placebo. The injection of monoclonal antibodies, such as mepolizumab, as a form of therapy in addition to treating severe eosinophilic asthma is advised by the GINA guideline for 2022. Mepolizumab's mode of action blocks IL-5 from binding to receptors on eosinophil surfaces, which lowers eosinophil recruitment, activation, production, growth, and survival, as well as eosinophil-mediated inflammation.
Association between Smoking Habits and Outcomes of COVID-19 Patients in Persahabatan Hospital, Jakarta Ayesya Nasta Lestari; Feni Fitriani Taufik; Agus Dwi Susanto
Jurnal Respirologi Indonesia Vol 44, No 1 (2024)
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.v44i1.600

Abstract

Background: : Factors related to the severity and the outcome of coronavirus disease 2019 (COVID19) are emerging subjects of interest to be studied. Smoking has long been known to have a negative impact on the response to infection. The purpose of this study was to determine the association between smoking habits with the severity, the length of hospitalization and the outcome of COVID19 patients.Methods: This study was a prospective cohort study of COVID-19 patients admitted at Persahabatan Hospital, Jakarta, Indonesia. Subjects were included by consecutive sampling from August to October 2021. Subjects were assigned into smokers and non-smokers group. All subjects were assessed for their severity, length of hospitalization and outcome; in smoking patients, the Brinkman Index (IB) and the Fagerström Test for Nicotine Dependent (FTND) score were also recorded. Statistical tests were then carried out to assess the significant association between smoking history and the degree of severity, length of hospitalization and outcome of COVID-19 in all patients and the FTND and IB scores with the degree of severity, length of hospitalization and outcome of COVID-19 in smokers.Results: Authors found that 39/100 (39%) of participants were smokers. Smoking history had a correlation with the outcome (p=0.001) but not with the degree of severity (p=0.410) and length of hospitalization (p=0.780). Among subjects with smoking history, there were correlations found between FTND and the degree of severity and the outcome (p=0.022 and p=0.012), but not with the length of hospitalization (p=0.716). The Brinkman Index was correlated with only the degree of severity (p=0.020).Conclusion: Our study found that smoking habits were correlated with the degree of severity and outcomes in COVID-19 patients.
C-Reactive Protein and Procalcitonin as Markers for Post-Bronchoscopic Complications: A Literature Review Indriani, Sri Indah; Yovi, Indra; Syaf, Syarlidina; Simatupang, Elvando Tunggul Mauliate
Jurnal Respirologi Indonesia Vol 44, No 2 (2024)
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.v44i2.638

Abstract

In the respiratory system, bronchoscopy is a basic procedure utilized for both diagnostic and therapeutic purposes. Despite being a generally safe procedure, bronchoscopy can result in complications that range in severity from moderate to severe. Pulmonary infection is among the potential complications that can happen after a bronchoscopy procedure. An incidence of 0.2% to 5.2% has been described typically for complications such as empyema, lung abscess, and pneumonia that may develop after bronchoscopy procedures. Although these complications are uncommon, their prognosis can be quite bad. The risk of pulmonary infection, specifically pneumonia, has been related in several studies to sepsis and mortality in patients enduring bronchoscopy procedures. The initiation of the infection exposure process into the lung can be assisted through a variety of factors, including the underlying diagnosis and the type of intervention performed during the bronchoscopy procedure. A critical complication that needs additional consideration is the potential transmission of infection through bronchoscopy procedures. It is beneficial to consider prophylactic antibiotics before a procedure due to the possibility that infectious agents will be transferred from one patient to another. Antibiotic prophylaxis may involve the utilization of C-reactive protein (CRP) and Procalcitonin (PCT) testing as determining parameters. Serial PCT and CRP 24–96 hours post-bronchoscopy procedure might help to determine one of the post-bronchoscopy complications.
Duration of Hospitalization and Risk Factors of Readmission of Community-Acquired Pneumonia Incidence in Hospitalized Toddlers Corina Lisa; Merita Arini
Jurnal Respirologi Indonesia Vol 44, No 1 (2024)
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.v44i1.560

Abstract

Background: The Indonesia Health Profile Report 2020 stated that pneumonia is one of the causes of high infant and toddler mortality in Indonesia. Length of stay and readmission are crucial indicators of service quality for hospitalized pneumonia patients. This study aims to determine the duration of hospitalization and identify risk factors for readmission among toddlers hospitalized with CAP.Methods: This cross-sectional study was conducted with subjects of pneumonia toddlers hospitalized in Sarila Husada Hospital Sragen from November 2021 to Januari 2023Results: A total of 357 toddlers were hospitalized with CAP (median age = 17 months; IQR 7–24); the majority were under 36 months old (309 subjects; 86%); male (54%) predominated than female (46%). Median duration of hospitalization for CAP=2 days with IQR=3.0-5.0. Readmission events were only 5, higher among toddlers aged 2-36 months but not statistically significant. Factors associated with readmission in CAP toddlers were the history of previous hospitalizations during the past year due to infection (P=0.012; adjusted odds ratio [aOR]=13.6; confidence interval [CI]=1.49–12.34).Conclusion: The readmission rate was very low in our study. Toddlers 2–36 months of age and those with previous hospitalizations with infections are at higher risk of readmission in CAP.
Persistent Air Leak Anggita, Dwi; Wiriansya, Edward Pandu; Santoso, Arif; Putrawan, Harry Azka
Jurnal Respirologi Indonesia Vol 44, No 2 (2024)
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.v44i2.432

Abstract

In cases of pneumothorax in the chest tube, the presence of air in the pleural cavity that lasts more than 5 to 7 days can be suspected as a persistent air leak (PAL), especially if an increased amount of air is obtained accompanied by the appearance of bubbles in the water seal drainage (WSD) system. This is the most common complication after surgery (8–26%), although it can be primary spontaneous pneumothorax (PSP) (26%) or secondary spontaneous pneumothorax (SSP) (39%). One condition that often causes difficulties in PAL therapy is infection due to direct contact with the fistula. The presence of PAL is associated with higher morbidity and mortality, prolonged chest tube inserted, and longer hospitalization. Observations of air production in PAL are expected to occur spontaneously within 4 days, if the leak persists, pleurodesis is recommended. If it was possible, surgery is needed to close the leak. Bronchoscopy treatment is only recommended in special circumstances where surgery is contraindicated or the patient refuses the surgical procedure.
Successful Pulmonary Rehabilitation in COPD During COVID-19 Pandemic Era: A Case Report Widjanantie, Siti Chandra; Ayuningtyas, Putu Duhita; Susanto, Agus Dwi
Jurnal Respirologi Indonesia Vol 44, No 2 (2024)
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.v44i2.597

Abstract

Background: Chronic obstructive pulmonary disease (COPD) patients are at high risk for COVID-19 infection and severe pulmonary complications. Exercise-based pulmonary rehabilitation (PR) in outpatient settings is essential for COVID-19 survivors with COPD comorbidities, providing the most critical patient benefits, but it is challenging during the pandemic.Case: A sixty-four-year-old man with COPD since 2 years ago, a history of COVID-19 one month ago, and Pulmonary Tuberculosis since 1 year ago presented with chief complaints of tiredness, cough, and breathlessness after walking for more than 100 meters. We performed PR, including breathing retraining exercise, chest mobility exercise, active cycle breathing technique (ACBT), posture correction, and aerobic exercise with static ergo-cycle for 8 weeks.Discussion: After 8 weeks of PR, there was a 3% increase in the O2 saturation level from 94-95% room air to 98%, an increase of single breath counting test (SBCT) from 20 to 38 counts, improvement of peak cough flow from 100-110-100 to 420-435-425 L/minute, and peak flow meter from 140-150-145 to 380-400-400 L/minute. Before PR the patient could not perform the sit-to-stand test (STS) and a 6-minute walking test (6MWT), but after 8 weeks of PR, STS was 5 times in 30 seconds, and 6MWT maximum distance was 248 meters. COPD assessment test (CAT) score improved from 23 to 9, and the Modified Medical Research Council (mMRC) dyspnea scale improved from 3 to 2.Conclusion: Eight weeks of pulmonary rehabilitation showed benefits for the patient in reducing dyspnea and improving exercise tolerance and quality of life, especially in hospital-based settings.
Association Between Ferritin Levels and Sepsis in Patients with COVID-19 at Dr. M. Djamil Hospital Diana Nur Asrini; Oea Khairsyaf; Afriani Afriani
Jurnal Respirologi Indonesia Vol 44, No 1 (2024)
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.v44i1.545

Abstract

Background: Ferritin is an important mediator of immunomodulatory dysregulation and pro-inflammatory effects, which contribute to cytokine storms that could lead to sepsis in a critically ill patients with COVID-19. The role of ferritin as a biomarker of sepsis in those patients is yet fully understood. The aim of this study is to investigate an association between ferritin levels and sepsis in patients with COVID-19.Method: This study was a retrospective, cross-sectional study of 474 COVID-19 hospitalized patients at Dr. M. Djamil Hospital, Padang.Result: Most of the COVID-19 patients in this study were between the ages of 18 and 49 (38,61%), female (55.91%), with moderate clinical illness (40.50%), and had one comorbidity (41,14%) with obesity as the most common comorbidity (37.97%). More than half of patients (54,22%) had ferritin levels of ≥500 ng/mL (median 1,201 ng/mL with a range of 503–12,010 ng/mL). The incidence of sepsis was significantly higher in the group whose ferritin level was ≥ 500 ng/ml compared to those with less ferritin level (P<0.001; OR=3.33; 5.99% vs 17.91%; CI 95%=1.74-6.36).Conclusion: There is a statistically significant association between the ferritin level and sepsis in patiens with COVID-19 at DR M Djamil Hospital.
Update on the Global Initiative for Chronic Obstructive Lung Disease (GOLD 2023) Adrianison Adrianison; Rohani Lasmaria Simbolon; Elvando Tunggul Mauliate Simatupang
Jurnal Respirologi Indonesia Vol 44, No 1 (2024)
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.v44i1.451

Abstract

The overall increase in morbidity and mortality associated with chronic obstructive pulmonary disease (COPD) is inextricably linked to the concept of Global Initiative for Chronic Obstructive Lung Disease (GOLD) updates. An element of every GOLD update is directed toward policymakers, healthcare professionals, and people in general in order to evaluate the immediate and prolonged consequences of COPD. At this time, international interest is focused on the acceleration of the GOLD 2022 update to GOLD 2023 in an effort to enhance clinical management approaches for COPD, including individualized and comprehensive COPD treatment. The GOLD 2023 update will encompass the following aspects: definition and taxonomy, screening and case identification, diagnosis pathway, pharmacological and non-pharmacological approaches to managing stable COPD, and exacerbation management, as discussed in this review. GOLD 2023 explains that the diagnosis of emphysema has been classified as a pathologic diagnosis, in comparison with GOLD 2022. In the meantime, the clinical and epidemiological diagnosis of COPD is chronic bronchitis. The risk factor for tobacco smoke, which was once thought to be the primary cause of COPD, is described in GOLD 2023, together with the most recent taxonomy that has been developed to identify additional contributing components. The word "GET", which refers to the interaction of three risk factors-gene (G), environment (E), and lifetime (T)-that can cause lung damage and accelerate the aging or development of the lungs, is also linked to the most recent taxonomy of COPD. The switch from the "ABCD" approach to the "ABE" method for diagnosis and management of stable COPD is another significant modification included in the GOLD 2023 update. The number of COPD cases worldwide is expected to rise in the upcoming years as an outcome of long-term exposure to risk factors. Consequently, with the goal of increasing patient survival rates, GOLD 2023 highlights the significance of screening and early case discovery through the provision of non-pharmacological care.
Comparison of NEWS, SIRS, and qSOFA Score as Predictors of Mortality and Length of Stay in Patients Pneumonia with Sepsis Harsini Harsini; Aditya Alfarizi; Jatu Aphridasari; A Farih Raharjo; Reviono Reviono
Jurnal Respirologi Indonesia Vol 44, No 1 (2024)
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.v44i1.505

Abstract

Background: Pneumonia is a major health problem in all age groups and often related with sepsis. In 2021, Surviving Sepsis Campaign Guidelines mentioned several clinical scoring systems to identify patients with potentials of developing sepsis, such as systemic inflammatory response syndrome (SIRS), national early warning score (NEWS), quick sequential organ failure assessment (qSOFA) and sequential organ failure assessment (SOFA). The guideline stated that there is no gold standard for diagnosing sepsis, contradicting The Sepsis-3 Guideline in 2016 that mentioned SOFA score as a gold standard for diagnosing sepsis.Methods: Subjects were all patients with pneumonia and sepsis who were treated in Dr.Moewardi Hospital within 1 January to 31 December 2022. Data from subjects’ medical records were collected to assess their NEWS, SIRS, qSOFA, and SOFA score on the day of admission. Since evaluation of SOFA score needs a number of components requiring laboratory results and takes longer time so they made a simpler tool called qSOFA to avoid delayed treatment of the patients.Results: NEWS is more consistent with SOFA compared to SIRS and qSOFA (Kappa value = 0.726 vs 0.320 vs 0.22; respectively). NEWS, SIRS, and qSOFA were all significantly correlated with mortality (P<0.001) with NEWS having the strongest correlation (r=0.482 vs 0.216 vs 0.175; respectively). Only NEWS showed significant correlation with the length of stay (r=0.129; P<0.001).Conclusion: NEWS was the most consistent score to SOFA compared to SIRS and qSOFA. NEWS was also the best predictor for mortality and was the only score correlated with length of hospital stay.
Non-Invasive Respiratory Support Strategy in Adults with Acute Respiratory Failure Soebekti, Wahyu; Zulfikar, Teuku; Priyanto, Herry
Jurnal Respirologi Indonesia Vol 44, No 2 (2024)
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.v44i2.650

Abstract

Patients with acute respiratory failure wil sometimes need invasive mechanical ventilation (IMV). High-demand events such as a pandemic will render the already limited bed in the ICU unavailable for another patient who also needs IMV. Acute respiratory failure can be divided into two categories: hypoxemic respiratory failure and hypercapnic respiratory failure. Non-invasive strategies presently available for treatment of acute respiratory failure are non-invasive ventilation (NIV), continuous positive airway pressure (CPAP), and high flow nasal oxygen (HFNO). Strong evidence has been present for the use of NIV in acute exacerbations of COPD, cardiogenic pulmonary edema, and ARF in immunocompromised patients, while in hypoxemic respiratory failure, there is low to moderate certainty of evidence pointing to the benefit of CPAP and HFNO. Correctly and selectively using these non-invasive strategies can reduce mortality and prevent intubation.

Page 26 of 36 | Total Record : 360

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