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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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Does the SOFA Score Have the Ability to Predict Length of Stay and Mortality as well as Other Scorings? Adhiputri, Artrien; Hapsari, Brigitta Devi Anindita; Reviono, Reviono; Alfarizi, Aditya; Damayanti, Raninditya
Jurnal Respirologi Indonesia Vol 45 No 1 (2025)
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.v45i1.637

Abstract

Background: In the intensive care unit (ICU), critically sick pneumonia has a high mortality rate, so forecasting the prognosis is crucial for making decisions. Early detection of clinical deterioration and the implementation of early intervention and care can be achieved through the use of scoring systems. The Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring system is a better system in predicting mortality in critically ill patients. However, in this study, we aim to observed  the use of the Sequential Organ Failure Assessment (SOFA) score as a predictor of mortality and length of stay (LOS). Methods: From April to August 2023, we treated 125 critically sick pneumonia patients in the ICU as part of a prospective observational research. An integrated ICU mortality calculator was used to assess the performance of the APACHE II, Simplified Acute Physiology Score II (SAPS II), and SOFA scores. Descriptive statistics will be used for data analysis, and the Fisher exact test and Chi-square test will be used for testing. logistic regression and linear regression methods are used in multivariate analysis. If the p-value is less than 0.05, it will be statistically significant. Results: APACHE II, SAPS II, and SOFA scores were significant in predicting the outcome of critically ill pneumonia patients (cut-off of ≥14.5, ≥34.5, and ≥3.5, respectively). The Spearman rank correlation for LOS shows that APACHE II, SOFA, and SAPS II scores have a very weak relationship with the p-values are 0.121, 0.766, and 0.436, respectively. Conclusion: The SOFA score is a good mortality predictor in critically ill pneumonia patients yet is simpler and easier to use in all settings in the hospital.
Endoscope to Identify A Smoker's Oral Mucosa for Early Obstructive Airway Disease Detection Yanti, Budi; Muhamad, Zarfan Fawwaz; Duta, Teuku Fais; Maulana, Muhammad Iqbal; Irmayani, Irmayani; Ossa, Yuli Fatzia; Sherina, Sherina
Jurnal Respirologi Indonesia Vol 44 No 3 (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.v44i3.640

Abstract

Background: The synergistic association between oral cavity disorders and airway disorders in smokers has long been recognized. Periodontal disease and airway obstruction are 20 times more likely in smokers. Smoking causes increased inflammatory cytokines in the oral mucosa; generally, airway obstruction has been associated with increased inflammatory markers in the airway mucosa. This study developed a prototype to visualize smokers' oral mucosa to identify potential airway obstruction disease.Methods: This study collected many types of oral mucosal lesions that are typically found in smokers, such as leukoplakia, nicotinic stomatitis, black hairy tongue, oral cancer, and smoker melanosis, from various literature and images of the mucosa of patients with a history of smoking who were treated at the hospital. The data is divided into a training, validation, and testing set and then using the PyTorch framework and the UltraLytics library.Results: This study created a prototype of an endoscope that can detect lesions on the oral mucosa-related airway obstruction disease. Sixty-three percent of the respondents who underwent prototype testing were between the ages of twenty-one and thirty. Of those who smoked, 86% had done so for five to ten years. Sixty percent of the respondents had no COPD diagnosis. The sensitivity of the prototype demonstrated a high rate of 84%. However, the specificity exhibited 57.14%.Conclusion: Endoscopic detection of the oral mucosa can be used for early screening of suspected obstructive airway disorders in smokers. This tool could enhance screening for smoking's effects on the mouth and prevent early obstructive airway diseases.
Silicosis: Mechanisms, Clinical Aspects, and Impacts due to Silica Exposure Esha, Indi; Afdi, Tania Libristina Ambun Suri; Simatupang, Elvando Tunggul Mauliate
Jurnal Respirologi Indonesia Vol 44 No 3 (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.v44i3.644

Abstract

Silicosis, an occupational lung disease, has significant mortality rates in Indonesia, as reported by Global Health Grove in 2013. The death rate for silicosis stands at 69.3%, with the typical age at death ranging from 40 to 44 years for men and approximately 80 years for women. The pathogenesis of silicosis begins when respirable crystalline silica (RCS) particles enter the airways. These RCS particles bypass the mucociliary defense mechanisms of the respiratory tract and reach the alveoli. Workers frequently exposed to silica are at high risk of developing silicosis, which significantly impacts morbidity and mortality. The diagnosis of silicosis can follow the seven-step principle for determining occupational diseases. Although silicosis is linked to serious conditions such as tuberculosis, autoimmune diseases, and lung cancer, no effective therapy exists. Treatment remains symptomatic, adjuvant, and supportive. To prevent occupational lung diseases, it is essential to involve the government in policy-making for industrial management and workers.
Hypoxemia During Bronchoscopy and The Risk Factors Related Putri, Chyntia Triana; Indriani, Sri Indah; Yovi, Indra
Jurnal Respirologi Indonesia Vol 45 No 1 (2025)
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.v45i1.651

Abstract

Background: Hypoxemia, a common complication of bronchoscopy, often occurs even with oxygen supplementation, particularly during procedures performed under sedation, with reported incidences ranging from 2.5% to 69%. Hypoxemia during bronchoscopy which is defined as desaturation under 90% or more than 5% decreasing of basal SpO2, becomes a concern due to possible fatal complications. This study aims to determine the incidence of hypoxemia during bronchoscopy and identify its predisposing risk factors. Methods: An analytic observational study with a cross-sectional design was held in our center from October 2022 until June 2023. As many as 100 consecutive patients who underwent bronchoscopy and met inclusion criteria were evaluated prospectively. The patient’s oxygen saturation was monitored by finger pulse oximetry during the procedure. Demographic characteristics, comorbidities, lung function, PaO2 value, ASA score, types of intervention, sedative agents, duration of sedation and procedure were recorded. The risk factors for hypoxemia during bronchoscopy were evaluated. Results: The incidence of hypoxemia during bronchoscopy in our center was 15%. Bivariate analysis showed pleural effusion as a comorbidity (9 patients; 60%), restrictive-obstructive lung function test (10 patients; 66.7%) and PaO2 value (76.87±8.219) were statistically significant (P<0.05) related to the existence of hypoxemia during bronchoscopy. Three other factors such as age, ASA score and duration of procedure with P<0.25 were included in multivariate analysis and found that the most influencing factor was the restrictive-obstructive lung function test (P=0.001; OR=13.845). Conclusion: Comorbidity (pleural effusion), lung function (restrictive-obstructive) and PaO2 value were some factors significantly related to hypoxemia during bronchoscopy with lung function being the most influencing factor.
Type-A Thymoma: A Case Report Hermawan, Yosua Kevin; Yaniswari, Ni Made Dwita
Jurnal Respirologi Indonesia Vol 44 No 3 (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.v44i3.677

Abstract

Background: Thymoma is a neoplasm that arises from the thymus gland. Around one-third of the patients are asymptomatic. Five subtypes of thymoma differentiate from the cell’s morphology based on the World Health Organization (WHO). Type-A thymoma comprises oval or spindle epithelial cells.Case: We presented a 49-year-old woman with a persistent cough and shortness of breath when performing heavy tasks. Chest radiography showed opacity on the mediastinum. Chest computed tomography with contrast revealed a tumor in the anterior part of the mediastinum and pericardial effusion. The patient underwent an Ultrasonography (USG) guided transthoracic needle aspiration (TTNA) and the histopathology examination showed a type-A thymoma. The patient was referred to a cardiothoracic surgeon for further management.Discussion: Type-A thymoma has a good prognosis and is rarely associated with myasthenia gravis. It has a less malignant nature compared to type B2 thymoma. However, it still can cause respiratory problems through the mass effect of the tumor itself. Surgery is usually the treatment of choice. Radiotherapy and chemotherapy can also be considered if complete resection is hard to achieve.Conclusion: Type-A thymoma has a less malignant nature and has a good prognosis. In this case, the tumor caused compression into the right lung resulting in the partial collapse of the right middle lobe and pericardial invasion were taken into consideration due to pericardial effusion.
Current Lung Asbestosis Approach for Diagnosis, Not Just Histopathology: A Literature Review Purnama, Nori; Esha, Indi; Adrianison, Adrianison; Simanjuntak, Arya Marganda
Jurnal Respirologi Indonesia Vol 45 No 1 (2025)
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.v45i1.678

Abstract

Asbestosis is characterized by diffuse interstitial fibrosis in the lungs, which is caused by breathing asbestos fibers from the crystalline or amphibole groups. The diagnosis of asbestosis, a form of pneumoconiosis, is one of the seven steps in identifying an occupational lung disease. Because there is no known cure for this condition, early detection, prevention, and education of workers and anybody in their proximity who has a risk of asbestos fiber exposure is critical. Clinical symptoms of asbestosis include weight loss, decreased appetite, and dyspnea during exertion. Clubbing fingers, cyanosis, and tachypnea are all symptoms of severe asbestosis. Bronchoalveolar lavage (BAL), histology, CT scans, HRCT, and respirometry can all help with the diagnosis. The "shaggy heart border sign" on a chest X-ray, along with the asbestos body observed in the BAL, is a reliable indicator of asbestosis. Because of the dismal prognosis and lifelong consequences, prevention is essential.
Profile of Pulmonary Tuberculosis After COVID-19 at Toba District, North Sumatra Province Simatupang, Elvando Tunggul Mauliate; Simanjuntak, Arya Marganda; Yovi, Indra; Simbolon, Rohani Lasmaria; Fauzi, Zarfiardy Aksa
Jurnal Respirologi Indonesia Vol 44 No 4 (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.v44i4.716

Abstract

Background: Worldwide cases of pulmonary tuberculosis (PTB) have significantly increased since the COVID-19 pandemic. Indonesia accounted for 6,811,818 of the 767,518,723 cases reported by the World Health Organization. While the Indonesian Ministry of Health reported 824,000 cases, the Global Tuberculosis Report in 2022 reported 10.6 million cases. The pandemic has hampered the goal of eliminating PTB globally, with cases diagnosed after COVID-19 having a 7.15-fold increased risk of contracting the illness.Methods: This cross-sectional study was conducted using total sampling to identify the profile of patients with PTB after having COVID-19 based on age, gender, classification, and type of PTB, as well as the duration of occurrence of PTB after COVID-19. The data collected were from COVID-19 patients from 2020 to 2022, then compared with PTB data. All data were compared to ensure that COVID-19 and PTB patient data were the same.Results: Of the 2544 patients recorded, 29 (1.1%) were infected with PTB after COVID-19 infection. The mean age of patients was 34±18.9 and was dominated by men (68.9%). Most of the cases were drug-sensitive TB (96.6%) and clinically diagnosed TB (55.2%). Age had a statistically significant association with the occurrence of TB cases after COVID-19 infection (P<0.0001). The mean time from the initial diagnosis of COVID-19 to the diagnosis of confirmed TB was approximately 203±34.3 days (6.7 months).Conclusion: After COVID-19, patients have the potential to be infected with TB. Screening former COVID-19 patients can be one solution to finding early cases of PTB.
Factors that Affected the Mortality Rate of Chronic Obstructive Pulmonary Disease Patients with Respiratory Failure Nahrisyah, Putri; Syarani, Fajrinur; Tarigan, Amira P; Ashar, Taufik
Jurnal Respirologi Indonesia Vol 45 No 1 (2025)
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.v45i1.805

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a significant health issue with high morbidity and mortality rates. However, risk factors for COPD, particularly in cases with type II respiratory failure, are not fully understood. This study analyzes factors influencing the mortality rate of COPD patients with type II respiratory failure. Methods: This observational study used a cross-sectional design, analyzing medical records of COPD patients with type II respiratory failure treated at H. Adam Malik General Hospital, Medan, from November 2021 to September 2022. A total of 42 patients met the inclusion criteria. Data analysis included descriptive statistics and inferential tests using the Chi-Square test and multiple logistic regression to identify the most dominant factors. Results: Among the 42 patients, the mortality rate was 50%. Variables such as gender, age, number of comorbidities, smoking habits, and history of exacerbations were not significantly associated with mortality. Patients who did not regularly use inhalers had a 19-fold higher mortality risk than those who did (P=0.004; OR=19.79; 95% CI=2.67-146.99). Length of stay was inversely associated with mortality, with each additional day reducing the risk by 0.77 times (P=0.011; OR=0.77; 95% CI=0.63-0.94). Conclusion: Routine inhaler use and length of stay are significant factors influencing the mortality rate in COPD patients with type II respiratory failure.
Analysis of Monocyte to Lymphocyte Ratio and Clinical Symptoms of Clinically Confirmed Pulmonary Tuberculosis New Case Patients Before Treatment and After Intensive Phase Handoko, Basti; Arliny, Yunita; Priyanto, Herry; Andayani, Novita; Yanifitri, Dewi Behtri
Jurnal Respirologi Indonesia Vol 45 No 1 (2025)
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.v45i1.533

Abstract

Background: Treatment evaluation of clinically confirmed pulmonary tuberculosis (TB) is limited to clinical symptoms and chest X-rays that tend to be subjective and no better than bacteriological examination. Monocytes and lymphocytes mediate the immunopathology of TB infection as a form of host defense that affects the systemic concentration of the body’s defense cells. The study assesses the monocyte-to-lymphocyte ratio (MLR) to evaluate TB treatment. Methods: Longitudinal prospective paired t-test with characteristics of clinically confirmed pulmonary TB new cases then compared to monocytes, lymphocytes, and monocyte-lymphocyte ratio (MLR) before administration of anti-tuberculosis drugs (ATD) and the end of the intensive phase. Results: In thirty clinically confirmed pulmonary TB patients before and after the anti-tuberculosis drug (ATD) there was no difference in monocytes pre 8.3 - post 8.5 (P=0.82), there was a difference in lymphocytes pre 17.8 - post 25.6 (P<0.05) that affected the MLR ratio value pre 0.57 - post 0.39 (P<0.05). Conclusion: This study identifies there is a significant difference in MLR before treatment and after the intensive phase of clinically confirmed pulmonary TB.
Correlation of Zinc Levels on C-Reactive Protein Among Advanced-Stage Non-Small Cell Lung Cancer Patients Prasetyo, Nugroho Eko; Haryati, Haryati
Jurnal Respirologi Indonesia Vol 45 No 1 (2025)
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.v45i1.603

Abstract

Background: Lung cancer is a leading cause of malignancy and mortality. Zinc and C-reactive proteins are known to affect lung cancer progression. However, inconsistent findings between zinc levels on plasma CRP levels were reported. This study aimed to determine the correlation between serum zinc and CRP levels in patients with advanced-stage non-small cell lung cancer (NSCLC) Methods: A cross-sectional study was conducted in the Regional Hospital of Doris Sylvanus Palangkaraya between January and April 2023. Thirty-five lung cancer patients were included. The blood specimen was analyzed for serum Zinc and CRP. Spearman's correlation test was used to analyze the data. Results: The zinc level was dominantly normal or low (71.4%), with a mean of 65.57 ug/dL. Most subjects have elevated CRP, with higher CRP in the deficiency zinc group (96.64 vs. 68.89 mg/L). However, no significant correlation was found between serum zinc and CRP levels (P=0.160; r=0.173). Conclusion: Serum zinc levels were not proven statistically correlated with inflammatory markers (CRP), particularly in non-small lung cancer patients.

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