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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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Acute Myocardial Infarction in Severe Acute Exacerbations of Chronic Obstructive Pulmonary Disease: A Surviving Case Cempakadewi, Ade Ajeng; Puspita Sari, Putu Ayu Diah; Budiana, I Putu Gede
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.v44i2.565

Abstract

Background: COPD is characterized by chronic respiratory symptoms with progressive, irreversible structural abnormalities and impaired lung function. Previously, COPD was known as a condition that only affected the airways and lungs, but recent studies have revealed the incidence of cardiovascular disease in this population as the prevalence increased.Case: A 68-year-old male came to the emergency room fully conscious, complaining of shortness of breath since the afternoon. A physical examination detected tachypnea, desaturation of oxygen, and additional breath sounds in both lungs. Blood gas analysis with the result of respiratory acidosis supported the diagnosis of AECOPD (acute exacerbations of chronic obstructive pulmonary disease), impending type II respiratory failure, cor-pulmonale. During the treatment in the intensive unit, the physicians recognized deteriorating conditions as unconsciousness, unstable vital signs, and ST-T segment changes on the ECG with an elevated cardiac marker. Other medications (antiplatelet, LMWH, and statin) were given immediately. The patient’s condition improved. On the ninth day of the treatments, the patient was discharged home.Discussion: Acute exacerbations of COPD have a higher risk of developing ischemic heart disease with varying underlying mechanisms (atherosclerosis process and oxygen supply-demand imbalance). Understanding the numerous pathways that contribute to AMI (acute myocardial infarction) in COPD will help physicians determine the therapy.Conclusion: Based on this case, the ECG and cardiac enzymes warrant immediate evaluation, as must symptoms, vital signs, clinical findings, and other changes. Delays in case finding and treatment can worsen the prognosis.
The Overview Side Effects of MDR TB Short Term Regimen for Heart and Kidney Function in MDR TB Patients at H. Adam Malik General Hospital Medan, North Sumatra Santy, Diana; Siagian, Parluhutan; Sinaga, Bintang YM; Eyanoer, Putri C
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.v44i1.573

Abstract

Background: World Health Organization issued a recommendation for the use of standard 9–11 month Shorter Multidrug-Drug Resistant Tuberculosis (MDR TB) regimen. It will impact the number of patients treated and improve obedience because of the shorter, low cost, and well-tolerated. However, MDR TB drugs allow side effects both mild, moderate and severe. If severe side effects occur, the patient will stop treatment and close monitoring required. An optimal and adequate care of side effects is the key of the successful of MDR TB treatment. The aim of this study was to determine the side effects that occured in the treatment of MDR TB patients with short term regimen (STR) on heart and kidney function at H. Adam Malik General Hospital Medan, North Sumatra.Methods: A case series design with a total of 76 MDR TB patients who underwent a shorter regimen. Samples were obtained from the medical record in the pulmonary isolation inward and MDR TB polyclinic at Adam Malik Hospital, Indonesia. Data were analyzed descriptively to identify changes in heart (Prolong QTc) and kidney function of the nine months treatment.Results: 76 data were collected, the number of male samples was 68.4% and 31.6% were women with the age group of the study subjects being mostly followed by 41-50 years of age. There was a significant increase in value occurred in 4-6 months of treatment related to the side effects of treatment on heart (Prolong QTc) and kidney function.Conclusion: There was a trend to increase the value of heart (Prolong QTc) and kidney function significantly occurred 4-6 months after the patient underwent MDR TB treatment with STR.
The 4T Approach for Smoking Cessation Compliance for Pulmonary Tuberculosis Patients in Persahabatan Referral Hospital Septauli, Kolanda Maria; Susanto, Agus Dwi; Agustin, Heidy; Ginting, Tribowo Tuahta; Taufik, Feni Fitriani
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.v44i1.578

Abstract

Background: Smoking increases the risk of tuberculosis infection and affects its treatment success rate and mortality. Most TB patients who smoke quit at the initial diagnosis, but may continue to smoke if the clinical symptoms improve. Studies show that the 4T approach (Tanya, Telaah, Tolong nasehati, and Tindak lanjut) helps smokers quit. The 4T approach was applied in Indonesia as a smoking cessation program for TB patients.Methods: We conducted a randomized controlled trial on 43 male TB patients who smoke. The trial group received a 4T approach consisting of education, counseling, and motivation to quit smoking for three months. The control group received a self-help leaflet. Smoking status, Fagerström nicotine dependence scale, exhaled carbon monoxide level, and peak expiratory flow rate were collected. We observed the subjects at months 1, 2, and 3 after quitting smoking and reported on the Motivation and Minnesota Withdrawal Scale.Results: Smoking cessation levels during months I, II, and III (Continuous Abstinence Rate I, II, and III) were higher in the trial group than in the control group. The trial group had a higher percentage of smoking cessation than the control group: until 4 weeks (66.7% vs. 54.5%), until 8 weeks (57.1% vs. 45.5%), and until 12 weeks (52.4% vs. 45.5%). The control group had higher numbers of smoking relapses (18.2% vs. 14.3%) and still smokers (18.2% vs. 9.5%) after the study. Withdrawal symptoms included an increase in appetite (44.1%), cigarette cravings (6.9%), agitation (2.3%), insomnia (2.3%), and irritability (2.3%). There were no significant differences in the withdrawal scale between groups (P=0.788), but the trial group showed better motivation to stop smoking during CAR II (P=0.043).Conclusion: The 4T approach is effective in maintaining abstinence from smoking among lung tuberculosis patients until months 1, 2, and 3 after quitting. Smoking cessation programs during tuberculosis treatment can help patients quit smoking and reduce relapse.
Bacterial Profile and Antimicrobial Resistance Patterns of Pleural Empyema in Pekanbaru Hospitals Yovi, Indra; Safari, Dodi; Syah, Nur Afrainin; Anggraini, Dewi; Hanifah, Zulfa Nur; Shapira, Vanesya Zahrani; Elliyanti, Aisyah
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.v44i1.590

Abstract

Background: Empyema is a problem worldwide due to its high incidence, mortality, and morbidity rates. So, administering antibiotics is mandatory to treat the disease. It should be sensitive to the causal microorganisms and avoid resistant ones for treatment efficacy. This research aimed to determine bacterial profile and antimicrobial resistance, which can be fundamental foundations for clinical practices in the treatment of patients, especially in Pekanbaru.Methods: This was a cross-sectional study from medical records at Arifin Achmad and Eka Hospitals from January 1, 2015, to December 31, 2022, including culture and antibiotic resistance test results with samples from pleural fluid and antibiotic susceptibility test using VITEK 2.0.Results: A total of 197 pleural fluid specimens were obtained. Gram-negative bacteria were found to be the most prevalent at 79.7%, namely Klebsiella pneumoniae (18.5%), Escherichia coli (12.0%), and Pseudomonas aeruginosa (11.0%). Gram-positive bacteria were found at 12.2%, the most common being Staphylococcus aureus (6.1%) and Enterococcus faecalis (2.0%). Antibiotic sensitivity tests for Gram-negative bacteria showed that amikacin and tigecycline were the most sensitive, and Gram-positive bacteria showed the most sensitivity to linezolid, tigecycline, and vancomycin. The resistance of Klebsiella pneumoniae and Escherichia coli to cephalosporins was 18.5% and 75.0%, respectively. The resistance of Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa to carbapenems was 8.0%, 13.0%, and 53.0%, respectively.Conclusion: Gram-negative is the most common microorganism found in pleural empyema. The resistance of multiresistant bacteria to antibiotics is high and requires supervision to apply appropriate antibiotic administration based on local antimicrobial patterns and the need to strengthen antimicrobial stewardship programs. 
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 Smoking Habits and Outcomes of COVID-19 Patients in Persahabatan Hospital, Jakarta Lestari, Ayesya Nasta; Taufik, Feni Fitriani; Susanto, Agus Dwi
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.
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.
Proportions of Hypertension in Stable COPD Patients at the National Respiratory Center Persahabatan Hospital Dewantoro, Luhur; Wiyono, Wiwien Heru; Yunus, Faisal; Agustin, Heidy; Damayanti, Triya; Antariksa, Budhi; Fachrucha, Fanny; Samoedro, Erlang; Elhidsi, Mia
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.v44i3.774

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. Most of these deaths are related to cardiovascular disease. This is due to systemic inflammation that causes increased vascular stiffness and hypertension. These comorbidities lead to poor quality of life, low exercise tolerance, and an increased risk of hospitalization. This study aims to report the proportion of hypertension among stable COPD patients in the Indonesian population.Methods: This cross-sectional study was conducted at the National Respiratory Center Persahabatan Hospital between February and March 2023. Stable COPD patients admitted to the Asthma and COPD Polyclinic who met the criteria were enrolled. Clinical information, vital signs, spirometry results, and DLCO measurements were collected.Results: There were 84 subjects participating in this study. The result of this study shows a 60.7% proportion of hypertension in stable COPD patients. Hypertension has a significant correlation with pulmonary functional values (P=0.021), severity degree of clinical COPD (P=0.004), Brinkman index (P=0.008), and age (P=0.0001). However, hypertension association with COPD duration (P=0.505) and DLCO (P=0.122) were not significant.Conclusion: The hypertension proportion in stable COPD Indonesian patients is 60.7%. Hypertension shows a significant association with pulmonary function values, severity degree of clinical COPD, Brinkman index, and age. 
Medication Adherence among Drug-Resistant Tuberculosis (DR-TB) Patients at Universitas Indonesia Hospital Harahap, Daimah Wirdatus Sanaun; Andrajati, Retnosari; Sari, Santi Purna; Handayani, Diah
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.v44i3.775

Abstract

Background: Drug-resistant tuberculosis (TB-DR) is a deadly disease caused by infectious agents. Indonesia is one of the countries with the highest drug-resistant tuberculosis (TB-DR) rates in the world. The prevalence of tuberculosis cases in Depok City between 2019-2022 showed an increase in cases every year. This study aims to measure the level of adherence of drug-resistant tuberculosis (TB-DR) patients to their treatment using the Eight-Item Morisky Medication Adherence Scale (MMAS-8) questionnaire.Methods: This study is an observational study using a cross-sectional study design, conducted from February 2024 to March 2024 at the University of Indonesia Hospital. Eighty-seven respondents participated in this study. Respondents completed the validated Indonesian version of the MMAS-8 questionnaire after signing informed consent forms.Results: The results of the study showed that 50.6% of respondents had low adherence levels, 47.1% had moderate adherence levels, and 2.3% had high adherence levels. The data was then statistically analyzed using the SPSS version 29 statistical package with Chi-Square analysis, which resulted in a significant correlation (P<0.05) between adherence levels and gender.Conclusion: There was a significant correlation between gender and respondent adherence. More than 50% of drug-resistant tuberculosis (TB-DR) patients at the University of Indonesia Hospital still have low adherence levels to their treatment.

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