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Indonesian Journal of Anesthesiology and Reanimation (IJAR)

IJAR
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Published by Universitas Airlangga

ISSN : 27224554 EISSN : 2686021X DOI : 10.20473/ijar.V2I12020.1-7

Core Subject : Health,

Medicine & Pharmacology

IJAR is a scientific journal published by Department of Anesthesiology and Reanimation, Faculty of Medicine Universitas Airlangga. IJAR is an English language journal. IJAR FOCUSES original research, review article, case report, and correspondence, on anesthesiology; pain management; intensive care; emergency medicine; disaster management; pharmacology; physiology; clinical practice research; and palliative medicine. This journal is a peer-reviewed journal established to improve the understanding of factors involved in anesthesiology and emergency medicine.

Arjuna Subject : Kedokteran - Anesthesiology and Pain Medicine

Articles 97 Documents

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Electrolytes Profile of Critically Ill Patients Admitted To Pediatric Intensive Care Unit (PICU) Dr. Soetomo General Hospital Amalia Citra Octavia; Arina Setyaningtyas; Pesta Parulian Maurid Edwar
Indonesian Journal of Anesthesiology and Reanimation Vol. 2 No. 1 (2020): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Introduction: Fluid and electrolyte disorders can be affected by various conditions or diseases. Electrolyte disorders are often found in pediatric patients with critically ill conditions and are associated with increased morbidity also mortality that requires extra care in the Pediatric Intensive Care Unit (PICU). Objective: To describe the electrolyte profile of critically ill patients with electrolyte disorders admitted to the Pediatric Intensive Care Unit (PICU) Dr. Soetomo General Hospital. Materials and Methods: The study was conducted prospectively with a descriptive method in patients with electrolyte disorders aged 1 month – 18 years old admitted to PICU Dr. Soetomo General Hospital, Surabaya in a period from August to November 2018. Data on patient age, gender, electrolyte profile (sodium, potassium, calcium, chloride), and origin before PICU admission were recorded. Results and Discussion: From 37 patients with electrolyte disorders showed that patients were dominated by the male in 56.8% (n=21), in the age group of infants or 1-12 months old in 45.9% (n=17). Common main diagnosis in most patients were digestive system disorders in 27% (n=10), followed by central nervous system, respiratory system, kidney and cardiovascular disorders, and the origin before PICU admission were from Emergency Room (ER) in 62.2% (n=23). There were found 97 incidences of electrolyte disorders. Most frequent electrolyte disorders were hypocalcemia in 59.5% (n=22), hypokalemia in 54.1% (n=20), hyponatremia in 40.5% (n=15) and the least was hypochloremia in 35.1% (n=13). Mean serum sodium level was 138.18 ± 12.071, serum potassium level was 3.608 ± 1.2247, serum calcium level was 8.057 ± 1.9473 and serum chloride level was 101.45 ± 13.266. Conclusions: Critically ill patients admitted in PICU tend to experience low electrolyte levels.

Fluid Resuscitation in Trauma Kun Arifi Abbas
Indonesian Journal of Anesthesiology and Reanimation Vol. 1 No. 2 (2019): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Introduction: Trauma is a problem faced everyday in the emergency room of the hospital where the researcher works. The degree of trauma from the mildest to life threatening can be found in sufferers. The cause of death in trauma sufferers is hypovolemic shock due to bleeding. The amount of blood loss volume from the patient can be estimated by looking at the clinical signs of the patient. Literature Review: In the condition of tissue hypoperfusion, it will cause a chain process which will eventually lead to cell death. Hypoperfusion causes anaerobic metabolism, lactic acidosis (coagulopathy, enzyme dysfunction), Na-K pump malfunction (cellular swelling and cell death), there is hypothermia (increase of oxygen demand, coagulopathy). Hypoperfusion will cause a vicious circle, in which processes that aggravate one another will occur. With the administration of fluids (crystalloid, colloid, transfusion) will improve the hypoperfusion that occurs in the body. Conclusion: The management of hypovolemic shock due to bleeding requires an understanding of the physiology and pathophysiology that occurs due to bleeding. To get maximum results and improve outcome from sufferers, it needs solid team work. Treatment can be different depending on the conditions, equipment and facilities of the hospital / emergency room as well as the policies of each place.

Effectivity of 5% Dextrose-Diluted and Ringer Lactate-Diluted Propofol to Reduce Intravenous Injection Pain in Pediatric Patient Dian Raseka Parna; Arie Utariani; Elizeus Hanindito
Indonesian Journal of Anesthesiology and Reanimation Vol. 2 No. 1 (2020): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Introduction: Propofol has been known as one out of many inductive drugs which, can cause pain during intravenous injection. There has been a high prevalence of injection pain in pediatric patients. The mechanism of injection pain has not been known. Some therapeutic methods have been tested to reduce the pain, with several success rates. Objective: To compare the effectivity of 5% dextrose-diluted propofol and ringer lactate-diluted propofol, with dilution comparison of 1:1, in their role to reduce intravenous injection pain in pediatric patients, from age 2-15 years old during elective surgery in the Integrated Surgical Building Center of Dr. Soetomo General Hospital Surabaya. Method and Material: Forty-five patients PS ASA I-II, which fulfill inclusion criteria, were induced with general anesthesia. Patients had been selected randomly into three groups. Group I (control group) were injected with propofol without dilution. Group II was injected with propofol with a dilution of 5% dextrose, into 5 mg/ml liquid. Group III was injected with propofol with a dilution of ringer lactate, into 5 mg/ml liquid. Result and Discussion: The level of pain was evaluated afterward, with responding to the four-point scale and spontaneous expression. Patients' blood pressure, mean arterial pressure, heart rate, and oxygen saturation were also examined after injection. Compared to the control group, those in groups with 5% dextrose-diluted and ringer lactate-diluted propofol are not effective in reducing intravenous injection pain, with analytical statistics p=0.503 (p > 0.05). Also, the dilution of propofol has no significant difference to the hemodynamic measurement of patients. Systolic and diastolic blood pressure, and mean arterial pressure were declined after the induction, but statistically insignificant. The heart rate of patients was inclined but also not significant. Conclusion: 5% dextrose-diluted and ringer lactate-diluted propofol with a comparison of 1:1 were not significantly effective in reducing intravenous injection pain in pediatric patients.

Albumin, Leukosit, And Protrombin As Predictors Of Sepsis Mortality Among Adult Patients In Soetomo General Hospital, Surabaya, Indonesia Rahmat Sayyid Zharfan; Ahmad Lukman Hakim; Abdul Khairul Rizki Purba; Soni Sunarso Sulistiawan; Bambang Pujo Semedi
Indonesian Journal of Anesthesiology and Reanimation Vol. 1 No. 1 (2019): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Introduction: Sepsis is presented as acomplex and multifactorial syndrome where the morbidity and mortality rates still high around the world. Strong evidencewith regard to early predictive factors for mortality and morbidity is rare to be provided. Objective: The aim of this study was to analyse the prominent predictors from the values of laboratory findings among patients with sepsis. Method and Material: The study was aan analytic observational study with a case-control approach. The data were extracted from patients's medical records between 2014 and 2015. This study involved 50 septic patients admitted to Dr. Soetomo General Hospital, Surabaya, Indonesia. Blood urea nitrogen (BUN), creatinine serum, albumin, leukocytes count, haemoglobin, hematocrite, platelets, sodium, potassium, chloride, prothrombin time (PT), and activated partial thromboplastin time (APTT) were collected from blood samples. Logistic regression was used to estimate sepsis related mortalities frequencies and the relationship between laboratory findings and under 28-days mortality. Result and Discussion: From 50 patients, 22 patients were died (44%). The regression model was intially conducted using all three biomarkers as covariates, then using backward elimination, the covariate with the highest p-value was eliminated. The process was repeated until covariates with statistically significant remained. Multivariate analysis showed that albumin, leukocytes count, and prothrombin time (PT) were the findings associated with high mortality. The independent predictors of mortality identified by further multivariate regression analysis were taken into account as a lower than 3.5 g/dL of albumin, above12.000/µL of leukocytes count, and prolonged more than 14 seconds of prothrombin time; with p value <0,05 respectively (0.029; 0.049; 0.027). Conclusion: Notably, low albumin level, elevated levels of leukocytes, and prolonged prothrombin time were clinically considered as independent predictors of mortality among adult patients with sepsis.

Systematic Review Comparison of Endotracheal Intubation Success Rate Using McGrath® Mac Videolaryngoscope with Direct Laryngoscope (Macintosh): A Manikin Studies Dicha Niswansyah Auliyah; Lilik Herawati; Prananda Surya Airlangga
Indonesian Journal of Anesthesiology and Reanimation Vol. 3 No. 1 (2021): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Introduction: McGrath® MAC videolaryngoscope is a single-handed device designed to facilitate intubation in patients both in patients with normal airway conditions (without any complications) or airway conditions with complications such as cervical spine and/or anatomic abnormalities. Objective: This study aims to compare McGrath® MAC videolaryngoscope and direct laryngoscope using Macintosh blades as learning material or study simulators for medical personnel (including anesthesiologist and paramedics) and novice operator (medical students). Method: this study is a systematic review using the PRISMA method which was carried out systematically. Data was collected through Pubmed, direct science, EBSCOHost, and Proquest using the keywords ‘airway management ', ‘laryngoscopy', and 'manikin'. Journal included based on published publication time between 2008 and 2020, a study using SimMan Laerdal Airway manikin, a journal discussing intubation using McGrath® MAC videolaryngoscope and direct laryngoscope with Macintosh blades here, where it is normal airway (without complications) and difficult airway. Results: 1556 journals were collected through 4 journal search sites and then carried out a screening process for the publication year approved in 2008 to 2020. Four studies use adult manikin SimMan Laerdal Airway including 247 participants were included in this systematic review. Conclusion: Based on journals that have been reviewed, McGrath® MAC videolaryngoscope provides better and superior results compared to Macintosh in terms of the success rate and visualization of glottis. Also, the intubation time using McGrath® MAC videolaryngoscope is shorten compared to Macintosh both on the normal airway (without complication) and difficult airway. The participants (medical personnel and novice operators) in all studies that reviewed prefer to use McGrath® Mac videolaryngoscope instead of using direct laryngoscope with Macintosh blade for Endotracheal Intubation mainly used for learning or study simulators.

Comparing Alteration of MMSE (Mini-Mental State Examination) Scores as Cognitive Function Test in Geriatrics After General and Regional Anesthesia Budianto, Ferrie; Setiawan, Philia; Hamzah, Hamzah; Yulianti, Erikavitri
Indonesian Journal of Anesthesiology and Reanimation Vol. 2 No. 2 (2020): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Introduction: An alteration of cognitive function in geriatrics often occurred after a surgery procedure. To do a surgery, patients would go through the process with anesthesia, whether it is general or regional anesthesia. We aimed to identify the effect of general and regional anesthesia in increasing the risk of alteration in cognitive function from geriatrics who underwent elective surgery followed by other risks. Methods: This observational analytic study has a total sample of 60 patients who aged 60 years or more, and half of the total sample underwent an elective surgery with general anesthesia, whereas the other half with regional anesthesia at Gedung Bedah Pusat Terpadu Dr. Soetomo General Hospital in a range of October – November 2016. The cognitive function of patients was assessed with MMSE which is done in approximately 10 – 15 minutes. Results: There was a statistically significant correlation between age and both preoperative MMSE score also the alteration of MMSE score after 3 days in patients with regional anesthesia (P-value = 0.032; 0.044). Also, the correlation between educational status and preoperative MMSE score (P-value = 0.001). There was also a statistically significant difference in alteration of the MMSE score after 3 days between patients with general and regional anesthesia which went through the hypotension phase (P-value = 0.022; 0.003). We identified that both general and regional anesthesia could lead to alteration of MMSE score (P-value = 0.001; 0.02) and there was a statistically significant difference between both of them (P-value = 0.001). Conclusion: Both general and regional anesthesia could lower the cognitive function of geriatrics, especially general anesthesia which happened to have a higher risk to occur. Other factors such as age, educational status, and hemodynamic condition during surgery, had their impacts toward lowering cognitive function in geriatrics.

The Effect of Basic Life Support (BLS) Training in The Knowledge and Skill Level of Community in Sidodadi Village, Lawang, Indonesia Maria Arni Stella; Prima Hapsari Wulandari; Tantri Adhiatama Lukitaningrum Subianto; Farah Adiba Binti Mohamad Jahari; Aida Nur Aisyah; Isna Mahmudah; Steven Sandjaja; Septian Dwi Prabowo; Djohar Nuswantoro; Heri S Widodo
Indonesian Journal of Anesthesiology and Reanimation Vol. 2 No. 1 (2020): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Introduction: About 300.000 – 350.000 Indonesian people suffer from cardiac arrest each year. Basic Life Support (BLS) is the first immediate response needed by cardiac arrest people, especially the out of hospital cardiac arrest (OHCA) patient. BLS that given from public to OHCA could increase the survival rate up to 2 – 3x higher. Unfortunately, the Indonesian still did not know what is cardiac arrest, how to recognize it, and how to do BLS. Objective: The objective of this study was to identify the effect of BLS training in the knowledge and skill level of community in Sidodadi Village, Lawang, Indonesia. Method and Material: This experiment used a quasi-experimental design with 102 of the random sampling of people age 20-40 in Sidodadi Village, Lawang, Indonesia. The sample was given pre-test and post-test knowledge questioner before and after joining BLS training. The sample's skill was scored by an assistant doctor using a skill checklist. The data then analysed with a t-paired sample test, Wilcoxon sum rank test, and Pearson correlation. Result and Discussion: The score of women is higher than men both in pre-test and post-test, with the significance of p=0,039 for pre-test and p=0,001. 99% who joined BLS training have a significant increase in knowledge with p=0,001. Conclusion: The increase in knowledge and skill is correlated for an excellent and good level of the score, but not correlated in a bad level. About 99% of people who have joined BLS training have a significant increase in knowledge and skill. These trained people have the willingness to be a bystander for cardiac arrest people near them.

Transportation and The Use of Oxygen Kun Arifi Abbas
Indonesian Journal of Anesthesiology and Reanimation Vol. 1 No. 2 (2019): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Introduction: All living things need a certain amount of oxygen which is obtained from free air, which is continuous throughout life, but cannot be stored in the body as a reserve. Oxygen is distributed throughout the body to the mitochondria of cells which are used in metabolic processes along with glucose to produce ATP (energy source for cell activity) and remove carbon dioxide (CO2). Literature Review: The exchange of oxygen as a metabolic material for the body and carbon dioxide as the end product of the body's metabolism is done through a process called respiration. Blood pumped by the heart carries oxygen from the lungs to all body tissues and brings back the blood containing carbon dioxide from the tissues back to the lungs for gas exchange. Oxygen transport in the blood takes two forms, namely bound to hemoglobin/Hb (the largest) and dissolved. Meanwhile, the transportation of carbon dioxide in the blood takes 3 forms, namely: carbonic ion (the largest), dissolved, and binds to Hb. Conclusion: The consumption of oxygen in the body requires processes and is associated with several organ systems. If one of the systems is not functioning properly, it can cause oxygen deficiency, thus the cells do not consume enough oxygen, which can cause anaerobic metabolism and if it becomes severe it will cause the death of cells, organs, and the individual.

Myasthenia Crisis Vs Cholinergic Crisis: Challenges in Crisis Management Without Plasmapheresis or Intravenous Immunoglobulin (IVIG) Lila Tri Harjana; Hardiono Hardiono
Indonesian Journal of Anesthesiology and Reanimation Vol. 2 No. 2 (2020): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Introduction: Myasthenia gravis (MG) is an acquired autoimmune disorder clinically characterized by skeletal muscle weakness & fatigability on exertion with prevalence as high as 2–7 in 10,000 and women are affected more frequently than men (~3:2). Over 12-16% of generalized MG patients experience crisis once in their lifetime. A serious complication of myasthenia gravis is respiratory failure. This may be secondary to an exacerbation of myasthenia (myasthenia crisis) or to treatment with excess doses of a cholinesterase inhibitor (cholinergic crisis). Case Report: Thirty-two years old woman refereed from a private hospital to ED for further treatment with myasthenia in crisis, after nine days of treatment in the previous ICU. Patient already in intubation with mechanical ventilation and history of the treatment of a high dose of multiple anticholinesterase drugs and steroids without plasmapheresis or immunoglobulin intravenous. During admission, diarrhea was present, with no sign of GI infection. On the third day of admission, the patient performed a Spontaneous Breathing Trial and was a success then extubated. Then two day after extubation, the patient falls to respiratory failure and need mechanical ventilation. Anticholinesterase test was performed, and it shows no improvement in clinical signs, and diagnose as Cholinergic Crisis. After re-adjustment of anticholinesterase drug with a lower dose, clinically, the respiratory condition improved, and on the 10th day of admission, the patient was succeed extubated. At 12nd days of ICU admission, patient discharge from ICU. Discussion: Myasthenia and Cholinergic Crisis is a severe and life-threatening condition characterized by generalized muscle weakness with a respiratory compromise that requires ventilatory support. Respiratory failure may be present in the cholinergic crisis without cholinergic symptoms (miosis, diarrhea, urinary incontinence, bradycardia, emesis, lacrimation, or salivation). The most important management aspect of Myasthenia patients in crisis is the recognition and treatment of myasthenia vs cholinergic crisis.

Pain Treatment On Trauma Patient In Dr.Soetomo General Hospital Emergency Room Khoir Amaliin; Atiya Nurrahmah; Nancy Margarita Rehatta; Choesnan Effendi
Indonesian Journal of Anesthesiology and Reanimation Vol. 1 No. 1 (2019): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Introduction: Uncontrolled pain has many negative effects to the body. The Guideline of Pain Management has been specifically arranged, but assessment and pain treatment in the Emergency Room (ER) have not adequate yet. Integrated pain assessment before and after treatment is very important in monitoring pain management effectiveness. Objective: The aim of this study was to determine pain score of emergency patients before and after treatment. This study was also conducted to record the treatment timing that was given by the paramedics in the emergency room. Method and Material: This study was a description research with 40 trauma patients as samples in the ER at Dr. Soetomo Hospital. Patient's pain level was measured twice, before the treatment and an hour after that. The pain level was measured using Visual Analog Scale (VAS). Patients were given ketorolac 30mg intravenous as the treatment. Result and Discussion: There were2.5% of the patients VAS 1 and the other 12.5% VAS 10. An hour after treatment 20% of the ER patients were free of pain and the rest 7.5% VAS 6. The average of VAS before the treatment were 6.38 ± 2.1and an hour after later they decreased to 2.23 ± 1.7. There were only 67.5% of the ER patients that were treated in the 1st hour, 17.5% of them were treated in the 2nd hour, the other 10% were treated in the 3rd hour, and the last 5% of them were treated in the 4th hour. Conclusion:The average value of pain was decreased when one hour after administration of pain therapy by paramedics, but therapy at different times showed no difference in the level of pain reduction that can be inferred.

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Prihatma Kriswidyatomo

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ijar@fk.unair.ac.id

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+628123008875

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ijar@fk.unair.ac.id

Editorial Address
Departemen Anestesiologi dan Reanimasi Fakultas Kedokteran Universitas Airlangga-RSUD Dr Soetomo Surabaya Gedung Anestesi Baru-RSUD Dr Soetomo Surabaya Jl. Mayjen Prof. Dr. Moestopo No 6-8, Airlangga, Gubeng, Surabaya, 60286, Indonesia

Location
Kota surabaya,

Jawa timur

INDONESIA

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Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name Prihatma Kriswidyatomo

Contact Email ijar@fk.unair.ac.id

Phone +628123008875

Journal Mail Official ijar@fk.unair.ac.id

Editorial Address Departemen Anestesiologi dan Reanimasi Fakultas Kedokteran Universitas Airlangga-RSUD Dr Soetomo Surabaya Gedung Anestesi Baru-RSUD Dr Soetomo Surabaya Jl. Mayjen Prof. Dr. Moestopo No 6-8, Airlangga, Gubeng, Surabaya, 60286, Indonesia

Location Kota surabaya, Jawa timur INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Contact Name
Prihatma Kriswidyatomo

Contact Email
ijar@fk.unair.ac.id

Phone
+628123008875

Journal Mail Official
ijar@fk.unair.ac.id

Editorial Address
Departemen Anestesiologi dan Reanimasi Fakultas Kedokteran Universitas Airlangga-RSUD Dr Soetomo Surabaya Gedung Anestesi Baru-RSUD Dr Soetomo Surabaya Jl. Mayjen Prof. Dr. Moestopo No 6-8, Airlangga, Gubeng, Surabaya, 60286, Indonesia

Location
Kota surabaya,

Jawa timur

INDONESIA