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Jurnal Komplikasi Anestesi
Published by Universitas Gadjah Mada
ISSN : 23546514     EISSN : 26155818     DOI : https://doi.org/10.22146/jka.v11i2.12773
Core Subject : Health,
Medicine & Pharmacology
JURNAL KOMPLIKASI ANESTESI (e-ISSN 2354-6514) is a scientific and original journal which published as a forum for various scientific articles including research, literature reviews, case reports and recent book reviews. The presence of this journal, it is hoped that it can provide input of knowledge and knowledge in the field of Anesthesiology and Intensive Therapy for medical personnel.
Arjuna Subject : Kedokteran - Anesthesiology and Pain Medicine
Articles 10 Documents
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Search results for , issue "Vol 7 No 2 (2020): Volume 7 Number 2 (2020)" : 10 Documents clear
Hubungan Antara Neutrophyl-Lymphocyte Ratio dan Kadar Prokalsitonin Plasma pada Pasien Sepsis yang Dirawat di Ruang Intensif RSUP Dr Sardjito Wibowo, Erry Alamsyah Asjhuri; Kurniawaty, Juni; Jufan, Akhmad Yun
Jurnal Komplikasi Anestesi Vol 7 No 2 (2020): Volume 7 Number 2 (2020)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v7i2.7446

Abstract

Background: The immune response of leukocytes to physiological stresses such as tissue damage, severe trauma, major surgery and sepsis is characterized by increased neutrophil levels and decreased lymphocyte levels. In pathological conditions due to severe infection or systemic inflammation, the NLR will increase, so that NLR can be used for clinical evaluation in patients with systemic inflammation. This study aims to determine whether there is a correlation between alteration of Neutrophyl-lymphocyte ratio and plasma procalcitonin as a parameter of infection severity in sepsis patients treated in intensive care RSUP Dr Sardjito. Methods: Prospective observational correlation study. The study was conducted in Intensive care RSUP Dr. Sardjito Yogyakarta for 5 months (starting June 2019). Subject: 29 patients of sepsis admitted to intensive care RSUP dr. Sardjito on June-October 2019. Results: Positive correlations between Neutrophil-lymphocyte ratio and plasma procalcitonin on day 0, day 1 and day 3 of observations, r=0,220 (very weak), r=0,389 (moderate), and 0,065 (very weak). Positive significant correlation was found on day 1 of observation. Meanwhile, on analysis between Neutrophillymphocyte ratio and plasma procalcitonin, Positive correlations were obtained on day 0-1, day 1-3 and day 0-3 of observations, r = 0.159 (very weak), r = 0,450 (moderate) and 0,235 (very weak). The significant positive correlation (p<0.05) was found in alterations between day 1-3. Conclusion: There were no strong correlations between Neutrophyl-lymphocyte ratio and plasma procalcitonin in sepsis patients treated at ICU RSUP Dr Sardjito on day 1 of observation.><0.05) was found in alterations between day 1-3. Conclusion: There were no strong correlations between Neutrophyl-lymphocyte ratio and plasma procalcitonin in sepsis patients treated at ICU RSUP Dr Sardjito on day 1 of observation.
Efek Pemberian Premedikasi Deksametason Terhadap Durasi Rokuronium Dibanding Placebo pada Anestesi Umum Intubasi Adi, Danis Woro Kuncoro; Uyun, Yusmein; Apsari, Ratih Kumala Fajar
Jurnal Komplikasi Anestesi Vol 7 No 2 (2020): Volume 7 Number 2 (2020)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v7i2.7447

Abstract

Background: Dexamethasone is often used as prevention and treatment for postoperative nausea and vomiting, reducing the severity of postoperative pain and analgesic requirements. The study of dexamethasone effects on the rocuronium duration might be beneficial in patients who have contraindications to neostigmine or atropine reversal. Purpose: To evaluate the relation between rocuronium duration with dexamethasone premedication compare with placebo in patient with general anesthesia intubation procedure with rocuronium neuromuscular blocking agent in GBST RSUP Dr. Sardjito. Methods: An experimental research design, randomized clinical trial with double blind. The sample was chosen using the non-probability sampling method in a consecutive manner in 3 months. Sample was divided into two groups: group receiving dexamethasone premedication and group receiving placebo NaCl 0.9%. Time monitoring starts after the TOF shows the number 0 until it reaches TOF 0.9. Results: The study was conducted on 58 research subjects. Numeric data was analysed using independent T test and categorical data was analysed using chi square. Dexamethasone premedication was found to reduce the duration of rocuronium with the time needed to reach TOF 0.9 was 111±14.33 minutes compared with 123±14.57 minutes in the placebo group (P = 0.003). Conclusion: Dexamethasone premedication shortens the duration of rocuronium compared to the administration of placebo under intubation general anesthesia.
Hubungan Nilai “Lung Ultrasound Score (LUS)” dengan P/F Ratio pada Pasien Pneumonia yang Dirawat di ICU RSUP Dr Sardjito Wibowo, Catur Prasetyo; Wisudarti, Calcarina Fitriani Retno; Jufan, Akhmad Yun
Jurnal Komplikasi Anestesi Vol 7 No 2 (2020): Volume 7 Number 2 (2020)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v7i2.7448

Abstract

Background: Respiratory tract disease (about 22.4%) is the frequent reason of admitting patients to the Intensive Care Unit (ICU), with 72.6% of it is caused by infection, such as pneumonia. On patient with pneumonia, there will be impairment in oxygen diffusion from alveoli to the blood flow that can affect the P/F ratio. Lung ultrasonography is directly proportional to the degree of pulmonary aeration or the ratio of air to liquid composition in the lung. Changes in pulmonary aeration can be detected accurately using pulmonary ultrasonography. Objectives: Knowing the relationship of “Lung Ultrasound Score (LUS)” with P/F ratio as a parameter to assess the degree of oxygenation in pneumonia patients treated at ICU Dr. Sardjito General Hospital. Methods: The design of this study was cross sectional study. In this study, every single sample will be examined only one time to obtain Lung Ultrasound Score (LUS) and arterial blood gas analysis (BGA) sampling to get the P/F ratio. LUS measurement was done by performing pulmonary ultrasonography at 12 predetermined examination points (6 in the left hemithorax and 6 in the right hemithorax) then scoring (0-3) per examination point, the total scoring from the 12 examination points is the result of the LUS sample. Inclusion criteria in the subjects of this study were >18 years of age, diagnosed pneumonia (score ≥6 from CPIS score), intubated with mechanical ventilation, and the candidate could be mobilized slightly right and left incline. While exclusion criteria were, patients with unstable hemodynamics (HR <60x / min or>130x / min and MAP <70mmHg or>120mmHg), pulmonary trauma, patients undergoing hemodialysis, there are contraindications to the oblique position (spinal cord injury), patients with wound dressing on the chest, and patients with morbid obese (BMI> 40). Results: There were 60 subjects in this study. Patient observation pointed that have high P/F ratio values tend to have lower Lung Ultrasound Score (LUS) values. Based on the correlation results, the value of p = 0.010 (p <0.05) with the correlation coefficient (r) = -0.332 had a negative sign which means there is a significant negative correlation between the value of Lung Ultrasound Score (LUS) with the P / F ratio with the closer relationship of the category weak (0.2 - 0.399). Conclusion: The higher the P/F ratio, the lower the LUS value in patients with pneumonia who were getting mechanical ventilation in ICU Dr. Sardjito.
Hubungan Rasio Netrofil Limfosit dengan Ketebalan Dinding Diafragma pada Pasien Kritis Haloho, Agustina Br; Sedono, Rudyanto; Sugiarto, Adhrie; Zulkifli
Jurnal Komplikasi Anestesi Vol 7 No 2 (2020): Volume 7 Number 2 (2020)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v7i2.7449

Abstract

Background: The cause of weaning failure is multifactorial. One of the causes was Ventilator Induced Diaphragm Dysfunction (VIDD) due to thinning process of the diaphragm thickness. Decreased diaphragm muscle mass might occur due to inflammatory process. This study was aimed to find the relationship between neutrophil to lymphocyte ratio (NLR) with diaphragm thickness of critical patients in ICU. Methods: This was an observational analytic study from September 2018 to January 2019 in Mohammad Hoesin Hospital, Palembang – Indonesia. Ethical appoval for the study was obtained from Ethics Committee and subjects were recruited after signing the informed consents. Only 30 subjects were involved in the end of the study. About 6 mL of blood sample from cubital vein was withdrawn from each subject to measure neutrophils and lymphocytes. Patients’ diaphragm thickness was measured by using ultrasonography on 0th, 3rd, 5th day. Collected data were then analyzed with Stata 15. Results: The chi-square test showed that the relationship of NLR (neutophil to lymphocyte ratio) of the 0th day to the decrease in diaphragm thickness on the 3rd day was not significant (p = 0.254), while the decrease in diaphragm thickness on the 5th day was significant (p = 0.015). Subjects with initial NLR values >7 had a significant higher risk of having decreased diaphragm thickness compared to subjects with initial NLR values ≤7 (RR = 1.62 (0.99-2.64); p-value = 0.003). Conclusion: Neutrophil to lymphocyte ratio affected the decrease of diaphragm thickness in patients using mechanical ventilation.
Regional Anestesi Subarachnoid Block pada Wanita 34 Tahun G2P1A0 Hamil Preterm, Pre Eklamsia Berat, Ketuban Pecah Dini 18 Jam, Pro SCTP dengan Status Fisik Asa II E Soepraptomo, RTH
Jurnal Komplikasi Anestesi Vol 7 No 2 (2020): Volume 7 Number 2 (2020)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v7i2.7455

Abstract

Preeclampsia is still one of the leading causes of maternal and fetal death worldwide with an incidence of 5-14% of all pregnancies. Sectio caesarea is generally performed if there are certain medical indications, as an act of ending a pregnancy with complications. One indication of a caesarean section is severe preeclampsia. Many delivery procedures in health services have used regional anesthesia in its implementation, both epidural and spinal, because in addition to the mother being able to consciously experience the birth process, it also has lower morbidity and mortality rates than general anesthesia. On February 14, 2019, a 34-year-old woman came to the emergency room of RSDM with a gestational age of 34 + 6 weeks, G2P1A0 referral to Pandan Arang Hospital, Boyolali with information on PEB and Premature rupture of membrane (PROM) (18 hours) in preterm pregnant secundigravida with renal insufficiency + hypoalbumin not yet in labor. In this patient, cesarean section was performed with subarachnoid regional anesthesia technique.
Mengenali Medical Error dan Optimalisasi Patient Safety di Intensive Care Unit (ICU) Adiyanto, Bowo; Suwarman
Jurnal Komplikasi Anestesi Vol 7 No 2 (2020): Volume 7 Number 2 (2020)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v7i2.7458

Abstract

Characteristics of patients treated in the ICU are patients with critical conditions, acute, with many comorbidities, the number of actions and medications and treatments by multidisciplinary and multi-specialist. This condition is a challenge to be able to develop safety culture in the ICU. The safety culture in the ICU must be aware of and have high vigilance that the potential for medical errors is quite high in the ICU and has a severe impact on patients. Systematic strategies and multifactorial approaches are needed to improve patient safety and reduce medical errors at the ICU. Improving safety culture, ensuring commitment to national patient safety regulations, investing in safe infrastructure, optimizing the role of units in identifying potential errors and standardizing services according to the latest evidence base are the basic factors needed to support safe and quality patient care at ICU . It is important for the next stage to manage and measure the processes and outcomes in the service, and ensure that patients receive optimal therapy in accordance with evidence base practice. In addition to focusing on patient safety areas that have been regulated by national regulations, focus on areas with an appropriate evidence base to be applied in ICU care such as protocol development, checklists, care bundles, simulation-based education, and CUSP programs to optimize the role of units in the program patient safety. The efforts mentioned above to be able to succeed certainly require organization, leadership, multidisciplinary and multi-specialist cooperation, as well as individual service ends who are committed and consistent to the development of safety culture in the ICU.
Penggunaan Rumus Holliday Segar pada Pasien Pediatrik yang Dilakukan Anestesi Sari, Djayanti; Widyastuti, Yunita; Gunawan, Fanny
Jurnal Komplikasi Anestesi Vol 7 No 2 (2020): Volume 7 Number 2 (2020)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v7i2.7459

Abstract

Intravenous fluid theraphy in acute ill patient has been the subject of health practices for more than 50 years. The development of knowledge in dealing with patients and illness has raised questions about the validity of Holliday Segar formula. Many researchers found hyponatremia in pediatric patient who were hospitalized and received intravenous fluid theraphy using the Holliday Segar formula. This thread tries to review the use of the Holliday Segar formula based on research studies that have been conducted.
Eras pada Lower Abdominal Surgery Pratomo, Bhirowo Y.; Sudadi; Gentong, Metia Gledis G.
Jurnal Komplikasi Anestesi Vol 7 No 2 (2020): Volume 7 Number 2 (2020)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v7i2.7460

Abstract

Enhanced Recovery After Surgery (ERAS) also known as fast track surgery or Enhanced Recovery Protocol (ERP) is a multimodal-based perioperative management designed to reduce morbidity, length of hospitalization, improve postoperative recovery time and minimize postoperative complications. Key elements of the ERAS protocol include pre-operative counseling, nutrition optimization, analgesic standards and anaesthesia regimens and early mobilization. Lower abdominal surgery and colorectal resection have traditionally been associated with high morbidity and length of hospital stay. ERAS has been shown to improve postoperative recovery, reduce length of stay and increase early return to normal function when compared to traditional colorectal surgical protocols. Recommendations for anaesthesia treatment in patients undergoing gastrointestinal surgery in the ERAS program are issued in an integrated protocol, which can facilitate the involvement of anesthesiologists in the implementation of the ERAS program.
Terapi Pengganti Ginjal pada Sepsis Disertai dengan Status Hiperosmolar Hiperglikemia dan Cedera Ginjal Akut Mutiara, Gunawan; , Indriasari
Jurnal Komplikasi Anestesi Vol 7 No 2 (2020): Volume 7 Number 2 (2020)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v7i2.7461

Abstract

Acute kidney injury was a complication recently occurred in critical ill patients in ICU. A 64 years old man came to emergency department with chief complain of lump originated at colli dextra accompanying with difficult of breathing symptom. Patient was diagnosed with septic shock due to deep neck abcess complicated with AKI and uremic encephalopathy, diabetes mellitus type 2 with hyperosmolar hyperglycemia state. Patient was treated to manage dehydration, high blood glucose, and source control of infection, then patients was transferred to ICU with support of mechanical ventilator. The major problem of this patients was decrease of consciousness and difficulties in treating AKI stage because there were increase in serum ureic and creatinine level even though urine production was excessive. Patients condition was improved and could be extubated after performing renal replacement therapy on the sixth day. On patients with sepsis with AKI, renal replacement therapy was one of the modalities considered to support management in critical ill patients in ICU.
Manajemen Hemodinamik Menggunakan Electrical Cardiometry (EC) dengan Mempertimbangkan Parameter Makrosirkulasi dan Mikrosirkulasi Sudadi; Mahmud; Rani, Hajar Rafika
Jurnal Komplikasi Anestesi Vol 7 No 2 (2020): Volume 7 Number 2 (2020)
Publisher : This journal is published by the Department of Anesthesiology and Intensive Therapy of Faculty of Medicine, Public Health and Nursing, in collaboration with the Indonesian Society of Anesthesiology and Intensive Therapy , Yogyakarta Special Region Br

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jka.v7i2.7462

Abstract

A 62-year-old woman with peritonitis suspected of intestinal perforation who underwent exploratory laparotomy. Patients with ASA 2 physical status with geriatrics, leukocytosis, hypokalemia, hypoalbuminemia. The patient was under general anesthesia with epidural analgesia. The surgery rans for 5 hours. Postoperative patients were transferred to post-anesthesia care unit (PACU) and EC measurements were carried out before and after postoperative hemodynamic management. Changes in cardiac output seen by EC measurements by considering lactate values as microcirculation parameters can be used to predict hemodynamic responses to fluids.

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