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The Journal of Society Medicine (JSOCMED)
Published by PT. CoinReads Media Prima
ISSN : -     EISSN : 29645565     DOI : https://doi.org/10.47353/jsocmed.v2i1
Core Subject : Health, Science,
Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience
The Journal of Society Medicine (JSOCMED) | ISSN (e): 2964-5565 is a leading voice in the Indonesia and internationally for medicine and healthcare. Published continuously, JSOCMED features scholarly comment and clinical research. JSOCMED is editorially independent from and its The Editor-in-Chief (EIC) is Prof. dr. Aznan Lelo, PhD, SpFK. JSOCMED offers many attractive features for authors, including free online access to all research articles, online publication ahead of print, and online responses to articles published as Quick Comments. In addition, as befitting a publication of the Journal of Society Medicine, JSOCMED implements best practice in scientific publishing with an open peer review process, declarations of competing interests and funding, full requirements for patient consent and ethical review, and statements of guarantorship, contributorship, and provenance.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 5 Documents
 1 
Search results for , issue "Vol. 4 No. 7 (2025): July" : 5 Documents clear
Management of Acute Hypercapnic Respiratory Failure (AHRF) in Patients with Obesity Hypoventilation Syndrome (OHS) in the Intensive Care Unit (ICU) Ningsih, Diana Fitria; Indriasari, Indriasari
Journal of Society Medicine Vol. 4 No. 7 (2025): July
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i7.222

Abstract

Introduction: Acute hypercapnic respiratory failure (AHRF) in patients with obesity hypoventilation syndrome (OHS) presents significant challenges in the intensive care unit (ICU), particularly when complicated by comorbidities such as community-acquired pneumonia and heart failure. Effective management requires a tailored approach addressing altered lung mechanics, infection control, and fluid balance. This case report highlights the multidisciplinary management of AHRF in a complex clinical scenario. Case Description: A 35-year-old female with OHS presented with progressive dyspnea for one month, worsening over the last two days. Initial assessment revealed type II respiratory failure with a pCO2 of 89 mmHg. Management included intubation and mechanical ventilation, initially with pressure control-assist control (PC-AC) mode, gradually transitioned to pressure support ventilation (PSV). Empirical antibiotics were administered, later adjusted based on sputum culture results. Fluid management involved furosemide to address concurrent heart failure. Adequate positive end-expiratory pressure (PEEP) was crucial to optimize lung mechanics. Despite an initial failed extubation, the patient was successfully extubated on day 7 with high-flow nasal cannula support and subsequently transferred to a step-down unit with nasal cannula oxygen therapy. Conclusion: This case underscores the importance of a multidisciplinary approach and dynamic therapy adjustments based on clinical response in managing AHRF in OHS patients with complex comorbidities. Early broad-spectrum antibiotics, careful fluid management, and gradual weaning from mechanical ventilation are critical for successful outcomes.
Management of Acute Respiratory Distress Syndrome Due to Transfusion-Related Acute Lung Injury and Pulmonary Contusion in a Patient with Moderate Head Injury Post-Craniotomy Decompression, Epidural Hematoma, and Posterolateral Rib Fractures 2-6 Hendro, Rachmad Try; Pison, Osmond Muftilov
Journal of Society Medicine Vol. 4 No. 7 (2025): July
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i7.223

Abstract

Introduction: Acute Respiratory Distress Syndrome (ARDS) is characterized by acute onset within seven days of an insult, leading to impaired gas exchange, respiratory distress not attributed to cardiac pump dysfunction, and diffuse bilateral opacities on chest X-ray (CXR). ARDS can result from direct lung parenchymal injury, such as pulmonary contusion, or indirect mechanisms, such as transfusion-related acute lung injury (TRALI), which triggers inflammatory mediator release, causing capillary leakage and damage to type I and II pneumocytes. Case Description: A 50-year-old male was admitted to the Intensive Care Unit (ICU) following a craniotomy evacuation. On the second day of ICU care, after receiving four units of packed red cell (PRC) transfusion and subsequent extubation, the patient developed dyspnea, increased respiratory rate, elevated work of breathing, and desaturation. Clinical examination revealed decreased consciousness, tachycardia, tachypnea, and desaturation. Diagnostic imaging showed diffuse bilateral opacities without cardiac abnormalities. The patient was re-intubated and connected to a ventilator using a lung protective strategy. Broad-spectrum antibiotics and adequate tissue perfusion support were administered. The patient showed improvement and was discharged from the ICU. Conclusion: ARDS, whether caused by direct insults like pulmonary contusion or indirect mechanisms like TRALI, requires a lung protective strategy to preserve healthy lung tissue. Early recognition and appropriate ventilatory management are critical for improving outcomes in such cases.
Management of a P3A0 Postpartum Patient with Peripartum Cardiomyopathy (PPCM), Acute Decompensated Heart Failure (ADHF), Respiratory Failure Due to Acute Pulmonary Edema, and Community-Acquired Pneumonia (CAP) in the ICU Sulistiono, Paulus; Budipratama, Dhany
Journal of Society Medicine Vol. 4 No. 7 (2025): July
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i7.224

Abstract

Introduction: Acute dyspnea following pregnancy is a rare condition often accompanied by significant comorbidities. Potential causes include pulmonary embolism, amniotic fluid embolism, pneumonia, aspiration, pulmonary edema, and other critical conditions. Pulmonary edema, in particular, may occur during pregnancy or the postpartum period, associated with preeclampsia, peripartum cardiomyopathy (PPCM), pre-existing cardiac disease, tocolytic therapy, or fluid overload. This case report highlights a complex clinical scenario involving these factors. Case Description: We present the case of a 36-year-old woman, P4A0, who developed progressive acute dyspnea six days postpartum following a normal delivery. Her condition rapidly progressed to respiratory failure, necessitating admission to the intensive care unit (ICU) and mechanical ventilation. Physical examination and diagnostic workup revealed acute pulmonary edema secondary to peripartum cardiomyopathy, complicated by acute decompensated heart failure (ADHF) and community-acquired pneumonia (CAP). Following tailored medical therapy, the patient’s condition improved, and she was discharged from the ICU on the fifth day in a stable condition. Conclusion: This case underscores the importance of early recognition and multidisciplinary management of acute dyspnea in the postpartum period, particularly when linked to PPCM, ADHF, and CAP. Timely intervention with mechanical ventilation and targeted therapy can lead to favorable outcomes, emphasizing the need for heightened awareness among clinicians managing postpartum patients.
Management of a Critically Ill Post-Cesarean Section Patient with Antepartum Hemorrhage Due to Placenta Previa Totalis in a G2P1A0 at 27–28 Weeks Gestation with Severe Preeclampsia, HELLP Syndrome, Pulmonary Edema, Stage 2 Acute Kidney Injury, and Hypoalbuminemia Bernadeth, Bernadeth; Erlangga, Muchammad Erias
Journal of Society Medicine Vol. 4 No. 7 (2025): July
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i7.225

Abstract

Introduction: Massive antepartum hemorrhage in pregnancy, particularly due to placenta previa totalis, poses life-threatening risks requiring intensive care unit (ICU) management. The ROSE (Resuscitation, Optimization, Stabilization, Evacuation) approach is critical in managing critically ill patients with massive bleeding, emphasizing fluid resuscitation, massive transfusion protocols, and coagulopathy management. This case report highlights the complex management of a patient with placenta previa totalis, severe preeclampsia, and HELLP syndrome, complicated by pulmonary edema, acute kidney injury (AKI), and hypoalbuminemia. Case Description: A 35-year-old woman, G2P1A0 at 27–28 weeks gestation, was admitted to the ICU following an emergency cesarean section due to antepartum hemorrhage from placenta previa totalis. She presented with hemorrhagic shock and severe preeclampsia complicated by HELLP syndrome. Initial resuscitation at a referring facility included 2000 cc Ringer’s lactate and 500 cc 0.9% NaCl. In the hospital, damage control surgery and massive transfusion (packed red blood cells, fresh frozen plasma, and platelets) were performed. Postoperatively, the patient required mechanical ventilation and vasopressor support in the ICU. On day 1, she developed volume overload, pulmonary edema, stage 2 AKI, and hypoalbuminemia, managed with furosemide. Extubation was achieved on day 3, and she was transferred to the high-care unit on day 4. Conclusion: In pregnant patients with trauma and massive hemorrhage, early diagnosis, damage control surgery, and appropriate massive transfusion management are critical interventions required to save the patient's life.
Management of Sepsis Patients Due to Community-Acquired Pneumonia in the Intensive Care Unit Ardiayuman , Ardiayuman; Budipratama, Dhany
Journal of Society Medicine Vol. 4 No. 7 (2025): July
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i7.226

Abstract

Introduction: Sepsis, a life-threatening response to infection, remains a critical global health issue, often triggered by community-acquired pneumonia (CAP) in vulnerable populations such as the elderly. This condition frequently requires intensive care unit (ICU) admission, necessitating adherence to evidence-based guidelines like the 2021 Surviving Sepsis Campaign (SSC) and Infectious Diseases Society of America (IDSA) recommendations. This case report highlights the application of these protocols in managing a complex sepsis case, emphasizing the role of early intervention and multidisciplinary care in improving outcomes.  Case Description: A 67-year-old male, Mr. U, presented with a 3-day history of dyspnea and 1-day history of altered consciousness. Initial assessment revealed respiratory distress (respiratory rate 32/min, oxygen saturation 88% on room air, Glasgow Coma Scale 10), with chest radiography confirming CAP. Laboratory results showed a lactate level of 4.2 mmol/L and leukocytosis (18,000/mm³), indicating sepsis. In the ICU, the patient received oxygen therapy, followed by intubation due to worsening respiratory failure. Blood cultures were obtained, and empirical antibiotics (meropenem) were initiated within 1 hour per SSC guidelines. Fluid resuscitation (30 mL/kg crystalloids) and norepinephrine were administered for persistent hypotension. Bronchoscopy revealed purulent secretions, aiding diagnosis and management. After 5 days of ventilatory support and adjusted antibiotics, the patient stabilized and was transferred to a general ward.  Conclusion: This case illustrates successful sepsis management due to CAP using SSC 2021 and IDSA guidelines. The integration of early antibiotics, fluid resuscitation, vasopressors, ventilation, and bronchoscopy underscores the efficacy of a multidisciplinary approach. Timely intervention in the ICU significantly improved survival and recovery, highlighting the need for further research to optimize protocols for such critical cases. 

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