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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 389 Documents
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Evaluating CRP and Oxygen Requirements as Predictors of Poor Outcomes in COVID-19 Patients with Bacterial Pneumonia Moulid Hidayat; Rina Lestari; Indana Eva Ajmala; Prima Belia Fathana; Indah Sapta Wardani
Jurnal Respirologi Indonesia Vol 46 No 2 (2026)
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.v46i2.1198

Abstract

Background: The COVID-19 pandemic has presented significant challenges in the management of bacterial pneumonia co-infections, particularly among elderly populations. These co-infections, most commonly caused by pathogens such as Streptococcus pneumoniae and Staphylococcus aureus, are associated with increased disease severity, higher mortality rate, and poorer outcomes. Data on bacterial co-infections and their impact on patient recovery remain limited, especially in Indonesia. Therefore, this study investigated the associations of age, oxygen supplementation, oxygen saturation, and clinical markers (procalcitonin and CRP) with outcomes in COVID-19 patients with bacterial pneumonia co-infections. Methods: This cross-sectional predictive study utilized secondary data from medical records of COVID-19 patients with bacterial pneumonia co-infection at the Regional General Hospital of West Nusa Tenggara Province and Universitas Mataram Hospital. Consecutive sampling was used to include patients with confirmed COVID-19 and bacterial pneumonia. Bivariate and multivariate analyses were conducted to assess the association between age, oxygen supplementation, procalcitonin levels, CRP levels, and recovery outcomes. Results: The study analyzed data from 77 COVID-19 patients with bacterial pneumonia co-infection. Significant predictors of poor outcomes included elevated C-reactive protein (CRP) levels (>75 mg/L) and high oxygen supplementation (>6 L/min). Patients with elevated CRP had a sixfold higher risk of death, and higher oxygen requirements were strongly associated with increased mortality. Lower oxygen saturation was also linked to worse outcomes. Findings highlight CRP levels and oxygen needs as critical factors in predicting mortality. Elevated CRP and higher oxygen supplementation were significantly associated with death, providing insights into the management of co-infected COVID-19 patients. Conclusion: CRP levels and oxygen requirements are key predictors of poor outcomes in COVID-19 patients with bacterial pneumonia.
Successful Lobectomy for Lung Aspergilloma Post–Tuberculosis Infection with Recurrent Hemoptysis Gregorio Satrio Pinunggul; Christian Surya Eka Putra; Rezki Tantular; Dini Rachma Erawati; Nurima Diyah; Koernia Kusuma Wardhana
Jurnal Respirologi Indonesia Vol 46 No 3 (2026)
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.v46i3.1061

Abstract

Background: Aspergilloma is a colonization of a lung cavity by the fungus Aspergillus, which often occurs as a result of a prior tuberculous lesion. Thus, a multimodal approach is needed to be more effective at reducing recurrence and mortality. Case: A 45-year-old male smoker came with complaints of recurrent hemoptysis for one year, followed by shortness of breath. The patient was diagnosed with tuberculosis twice, both diagnoses confirmed bacteriologically and declared cured. The CT scan of the thorax with contrast concluded that the pulmonary tuberculosis was inactive, displaying a fungus ball at the apex of the left lung accompanied by multiple subpleural blebs. Lobectomy was performed to remove the fungus ball. The results of the biopsy showed pieces of aspergillosis fungal tissue with a fungus ball appearance accompanied by necrosis. Oral voriconazole was given as postoperative treatment for 7 days and continued with itraconazole for 6 months. The patient experienced clinical improvement and was able to return to activities during follow-up. Discussion: Lobectomy is often optimal despite its morbidity risks. The X-ray that reveals a residual space or hydropneumothorax also mandates prolonged water-seal drainage and strict observation according to protocol. Additionally, postoperative triazoles completely eradicated the disease. Conclusion: Surgery is a fairly effective treatment in cases of aspergilloma with recurrent hemoptysis. Surgical intervention allows for the complete removal of the fungal ball, its enclosing cavity, and the adjacent unhealthy lung tissue. Multidisciplinary and comprehensive treatment needs to be carried out to increase life expectancy and reduce the recurring symptoms.
Analysis of TGF-β1 Levels in Bronchoalveolar Lavage Fluid among Lung Cancer, Suspected, and Non-Cancer Patients Muhammad Khairul Afif; Herry Priyanto; Teuku Zulfikar
Jurnal Respirologi Indonesia Vol 46 No 3 (2026)
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.v46i3.1112

Abstract

Background: Lung cancer remains the leading cause of cancer-related mortality worldwide and is often diagnosed at an advanced stage. TGF-β1 plays a pivotal role in carcinogenesis and may serve as a diagnostic biomarker. BALF represents a relevant medium for assessing biomarkers that reflect the tumor microenvironment. This study aimed to evaluate TGF-β1 levels in BALF and determine its diagnostic performance and optimal cut-off value for lung cancer. Methods: This cross-sectional analytical study was conducted at Dr. Zainoel Abidin General Hospital, Banda Aceh, from April to June 2025, involving 64 patients (34 lung cancer patients, 9 suspected lung cancer patients, and 21 non-cancer patients). BALF samples were obtained via bronchoscopy, and TGF-β1 levels were measured using ELISA. Statistical analyses included the Mann-Whitney U test and ROC curve analysis. Results: Median TGF-β1 levels were 66.24 pg/mL in the non-cancer group, 136.93 pg/mL in the suspected lung cancer group, and 200.25 pg/mL in the lung cancer group. The combined suspected/lung cancer group showed significantly higher levels than the non-cancer group (P=0.025). ROC analysis yielded an area under the curve (AUC) of 0.674 (95% CI=0.529-0.819; P=0.025). The optimal cut-off value was 105.63 pg/mL, with a sensitivity of 67.44%, specificity of 61.90%, positive predictive value of 78.38%, and negative predictive value of 48.15%. Conclusion: TGF-β1 levels in BALF demonstrate potential as a diagnostic biomarker for lung cancer with moderate performance. It may serve as a supportive “rule-in” test to strengthen clinical suspicion but is insufficient as a stand-alone diagnostic tool. Combining TGF-β1 with other biomarkers in a multiparametric diagnostic panel is recommended to improve diagnostic accuracy.
The Impact of Self-Management on the Quality of Life Among COPD Patients Scholastica Fina Puspasari; Margaretha Kurniastuti; Margareta Hesti Rahayu
Jurnal Respirologi Indonesia Vol 46 No 3 (2026)
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.v46i3.1120

Abstract

Background: Chronic obstructive pulmonary disease (COPD) patients report progressive, persistent shortness of breath that worsens with activity. Progressive shortness of breath affects the quality of life of patients with COPD. Patients with good self-management are expected to have greater independence, which will impact their quality of life. This study aimed to examine the relationship between self-management and quality of life among patients with COPD at a respiratory referral hospital in Yogyakarta. Methods: This study used descriptive correlational research with a cross-sectional design to examine the impact of self-management on quality of life among COPD patients. The sample comprised 100 COPD patients at the respiratory referral hospital polyclinic. The sampling technique was a non-random accidental technique, with sampling continued until the quota was fulfilled. The questionnaires used in this research were the Self-Management Scale (CSMS) to measure self-management and the St. George’s Respiratory Questionnaire (SGRQ) to measure quality of life. Both have been tested for validity and reliability in their Indonesian versions. Spearman's rho was used to examine the impact of self-management on the quality of life among COPD patients. Results: The majority of the respondents were female (56%), aged 55–65 years (54%), had a low level of education (70%), had suffered from COPD for 1–5 years (61%), were passive smokers (34%), took bronchodilators regularly (97%), and had no comorbidities (71%). In the Spearman test, self-management had a significant correlation (P=0.01) with quality of life, with a correlation coefficient of 0.613 and a positive direction of relationship. Conclusion: Self-management has a significant and strong correlation with quality of life, and good self-management means better quality of life.
Supraventricular Arrhythmias in Idiopathic Pulmonary Fibrosis: Clinical Links and Implications I Wayan Pande Adhyaksa; Fanny Fachrucha; Sunu Budhi Raharjo; Henda Ageng Rasena; Kevin Aristyo
Jurnal Respirologi Indonesia Vol 46 No 3 (2026)
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.v46i3.1126

Abstract

Idiopathic pulmonary fibrosis (IPF) and supraventricular arrhythmias (SVAs) share a profound pathophysiological connection beyond incidental comorbidity. This review synthesizes current evidence demonstrating how progressive pulmonary fibrosis creates an arrhythmogenic cardiac substrate through three interdependent pathways. Pulmonary hypertension imposes chronic pressure overload on the right heart, leading to right atrial dilation, interstitial fibrosis, gap junction dysfunction, and electrical remodeling, creating conditions for re-entrant circuits. Chronic hypoxemia induces intracellular calcium overload, after-depolarizations, and sympathetic overactivity, providing functional arrhythmogenic triggers independent of structural remodeling. These mechanisms collectively transform the atrial myocardium into a vulnerable environment where re-entrant circuits and triggered activity persist. The resulting SVAs, particularly atrial fibrillation and flutter, are strongly associated with IPF's cardiopulmonary pathophysiology. This integrated perspective challenges clinicians to view IPF not as an isolated lung disease but as a systemic syndrome with significant cardiac implications. However, current evidence is largely observational, and further prospective studies are needed to establish screening and management guidelines.
Effects of Adding Sustained Maximum Inspiration to Deep Breathing Exercise on Short-Term Oxygen Saturation in COPD: A Quasi-Experimental Study Suci Amanati; Boki Jaleha; Irawan Wibisono; Rakhmad Rosadi; Aditya Herman Eko Margono
Jurnal Respirologi Indonesia Vol 46 No 3 (2026)
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.v46i3.1137

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is characterized by airflow obstruction that impairs oxygenation and alters vital signs. Pulmonary rehabilitation commonly includes Deep Breathing Exercise (DBE), while Sustained Maximum Inspiration (SMI) may further enhance lung expansion and oxygen diffusion. This study aimed to compare the effects of DBE alone and DBE combined with SMI on vital signs in patients with COPD. Methods: A quasi-experimental study was conducted over four weeks at Balai Kesehatan Masyarakat (Balkesmas) Semarang, involving 22 eligible patients with COPD. Participants were divided into two groups: DBE only (n=11) and DBE with SMI (n=11). Both groups performed daily breathing exercises for 10 minutes. Vital signs measured before and after the intervention included blood pressure, heart rate, respiratory rate, and oxygen saturation. Data were analyzed using paired t-tests. Results: The DBE group showed no significant changes in systolic or diastolic blood pressure, pulse rate, respiratory rate, or oxygen saturation (P>0.05). Similarly, the DBE with SMI group demonstrated no significant changes in blood pressure, pulse rate, or respiratory rate (P>0.05); however, oxygen saturation improved significantly (P=0.042). Conclusion: Both DBE and DBE combined with SMI positively influence vital signs in patients with COPD. However, incorporating SMI into DBE provides additional benefits, particularly in improving oxygen saturation.
Analysis of CXCL11 Levels and Chest X-Ray Findings In Drug-Sensitive and Drug-Resistant Tuberculosis Patients Rahma Djamaludin; Iin Noor Chozin; Rezki Tantular; Ani Nudi Astuti
Jurnal Respirologi Indonesia Vol 46 No 3 (2026)
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.v46i3.1174

Abstract

Background: Tuberculosis (TB) remains a major global health problem, with an increasing incidence of drug-resistant tuberculosis (DR-TB) contributing to low treatment success rates. This study aimed to evaluate the association between serum CXCL11 levels and chest X-ray severity in pulmonary tuberculosis and to compare CXCL11 levels between drug-sensitive and drug-resistant tuberculosis patients. Methods: This was an observational analytic study with a cross-sectional design. The study subjects were patients with drug-sensitive tuberculosis (DS-TB) and DR-TB who were hospitalized or followed up. Serum CXCL11 levels were measured using the enzyme-linked immunosorbent assay (ELISA) method. Chest X-ray findings were assessed based on the severity of pulmonary lesions. Statistical analysis was performed to compare CXCL11 levels and chest X-ray severity between the two groups and to evaluate the correlation between them. Results: CXCL11 levels were higher in patients with DR-TB compared to those with DS-TB. Chest X-ray findings in DR-TB patients showed greater severity, with more extensive lesions and multiple cavitations. A significant correlation was found between CXCL11 levels and the severity of radiological findings in both DS-TB and DR-TB patients (r = 0.477; P<0.05). Conclusion: CXCL11 levels are higher in patients with DR-TB than in those with DS-TB and are associated with the severity of chest X-ray findings. CXCL11 has the potential to be used as an inflammatory biomarker to assist in stratifying drug sensitivity in tuberculosis patients.
Association of Pleural Fluid Glucose, Pleural Fluid CYFRA 21-1, and Radiographic Pleural Effusion Size with Recurrent Malignant Pleural Effusion Fibrianti Ratnasari; Ngakan Putu Parsama Putra; Fitri Indah Sari; Nanik Setijowatirandi Putra Pratomo
Jurnal Respirologi Indonesia Vol 46 No 3 (2026)
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.v46i3.1181

Abstract

Background: Recurrent malignant pleural effusion (MPE) remains a significant clinical problem that often necessitates repeated interventions and negatively affects patients' quality of life. This study evaluated the association of pleural fluid glucose, pleural fluid CYFRA 21-1, and radiographic pleural effusion size with recurrent malignant pleural effusion. Methods: A single-center observational analytic study was conducted in 60 patients with malignant pleural effusion. Patients were classified into recurrent and non-recurrent groups based on pleural fluid reaccumulation requiring repeat thoracentesis within 30 days. Pleural glucose and CYFRA 21-1 levels were measured using enzyme-linked immunosorbent assay. One radiologist and one pulmonologist independently interpreted chest radiographs. Pleural effusion size was categorized according to the hilar level. Statistical analyses included the Chi-square test, Mann–Whitney U test, and receiver operating characteristic (ROC) curve analysis. Results: Recurrent pleural effusion occurred in 55% of patients. Effusion extending above the hilar level was observed in all recurrent cases and was significantly associated with recurrence (P<0.001). Patients with recurrent pleural effusion had significantly lower pleural glucose levels (39.53 vs 107.46 mg/dL; P<0.001) and higher pleural CYFRA 21-1 levels (58.61 vs 27.26 ng/mL; P<0.001) than those in the non-recurrent group. ROC analysis demonstrated excellent discriminative performance for pleural glucose (AUC=0.905) and pleural CYFRA 21-1 (AUC=0.933), with optimal cut-off values of <85.85 mg/dL and ≥44.02 ng/mL, respectively. Chest pain was the only clinical symptom significantly associated with recurrent pleural effusion (P<0.001). Conclusion: Lower pleural glucose levels, higher pleural CYFRA 21-1 levels, and radiographic pleural effusion extending above the hilar level were significantly associated with recurrent malignant pleural effusion. These parameters may serve as useful clinical markers to complement the evaluation of patients with recurrent MPE.
Association Between Mobile-Based Remote Monitoring and Chemotherapy Adherence Among Lung Cancer Patients in Aceh Province Ferry Dwi Kurniawan; Fajar Tara Winanda; Teuku Zulfikar; Budi Yanti; Irmaini Irmaini; Liza Salawati
Jurnal Respirologi Indonesia Vol 46 No 3 (2026)
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.v46i3.1217

Abstract

Background: Chemotherapy adherence is essential for optimizing treatment outcomes in patients with lung cancer, yet maintaining adherence remains challenging because of treatment-related adverse effects and limited opportunities for continuous monitoring. Mobile-based remote monitoring applications may improve adherence by facilitating symptom reporting, treatment reminders, and communication between patients and healthcare providers. This study aimed to evaluate the association between the use of a mobile-based remote monitoring application and chemotherapy adherence among patients with lung cancer. Methods: A case-control study was conducted at the Pulmonology Clinic of Dr. Zainoel Abidin Hospital between October 2025 and January 2026. A total of 62 patients with lung cancer undergoing chemotherapy were enrolled, including 31 patients who used a mobile-based remote monitoring application (case group) and 31 patients who received standard care (control group). Chemotherapy adherence was assessed using the Indonesian version of the 8-item Morisky Medication Adherence Scale (MMAS-8). Data analysis used the chi-square test, with P<0.05 is significantly statistic. Results: Baseline demographic and clinical characteristics, including age, sex, smoking history, histopathological subtype, and disease stage, showed no association between the two groups (P>0.05). High chemotherapy adherence was observed in 22 patients (71.0%) in the application group compared with 7 patients (22.6%) in the control group, whereas low adherence was more frequent in the control group (61.3% vs. 12.9%). The use of the mobile-based remote monitoring application was significantly associated with improved chemotherapy adherence (P=0.001). Conclusion: The use of a mobile-based remote monitoring application was significantly associated with higher chemotherapy adherence among patients with lung cancer. By integrating treatment reminders, symptom monitoring, laboratory follow-up, and direct communication with healthcare providers, the application may improve patient engagement and support continuity of care. Mobile-based remote monitoring represents a promising strategy for enhancing chemotherapy adherence and should be further evaluated in larger multicenter studies with longer follow-up.

Page 39 of 39 | Total Record : 389

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