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INDONESIA
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
 1 
Search results for , issue "Vol 9 No 2 (2021)" : 10 Documents clear
Weaning Ventilator pada Pasien Tetraparese Neglecteed Cervical Spondiloptosis dengan Dislokasi Faset Bilateral Cervical 5-6 dan Spinal Cord Injury Inkomplet Level Cervical 6 Sudadi; Rahardjo, Sri; Suharso, Pamungkas Hary
Jurnal Komplikasi Anestesi Vol 9 No 2 (2021)
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.v9i2.8340

Abstract

The patient is a 16 year old male who suffered a cervical injury due to a slipping fall. Pain was felt in the neck, followed by weakness in the limbs, but did not immediately go to the hospital. The patient was referred to Sardjito Hospital about 1 month after the incident, with examination at the previous hospital the patient had a cervical injury with tetraparesis.The patient underwent corpectomy, decompression, and stabilization surgery on the second day. Postoperatively the patient was admitted to the ICU. On the second day of treatment, extubation was carried out, but was later re-intubated because the patient had respiratory distress. The next therapy was physiotherapy, nebulizer and mucolytic, ventilator weaning with pressure support mode and progressive ventilator free breathing (PVFB), Percutaneous Dilatation Tracheostomy (PDT), nutritional therapy, analgesics and antibiotics. On the way, the patient experienced pulmonary atelectasis, sepsis, and several failures in the ventilator weaning trial, so PDT was performed. The patient then experienced an improvement in his condition which was characterized by an increase in lung capacity, extremity muscle strength, and improvement in the condition of sepsis. Until finally the patient was able to be released from the use of the ventilator on the 15th day of treatment by using a T-piece through atracheostomy tube.
Manajemen Ekstubasi pada Pasien dengan Jalan Nafas Sulit Perioperatif Adiyanto, Bowo; Jufan, Akhmad Yun; Adiyatma, Krisna Hario
Jurnal Komplikasi Anestesi Vol 9 No 2 (2021)
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.v9i2.8341

Abstract

Tracheal extubation is a critical step during emergence from general anesthesia. Good management of extubation is needed to prevent undesired complication including laryngospasm, hypoxia, airway injury. Patient with difficult airway is at risk during intubation and extubation period, so the knowledge about it is necessary.
Konsiderasi Teknik Anestesi pada Crash Ponek Fetal Distress Apsari, Ratih Kumala Fajar; Uyun, Yusmein; Adrin, Olga Elenska
Jurnal Komplikasi Anestesi Vol 9 No 2 (2021)
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.v9i2.8342

Abstract

Neonatal and infants’ mortality rate in Indonesia is still high. Emergency case in comprehensive obstetric and neonatal emergency care is one of the causes related to high mortality rate in pregnancy and neonates. There is a thin line between true emergency which may need emergency surgery, previously known as crash-C-section and emergency that could be optimized before surgery is performed. A true emergency may need considerable anesthesia technique which could be done quickly yet also emphasizes on patient’s safety.
Glasgow Coma Scale (GCS) Sebagai Prediktor Kematian dan Kualitas Hidup Pasien Cedera Otak Traumatik di RSUP Dr. Sardjito Taneo, Desy Chery Marlyn; Sudadi; Wisudarti, Calcarina Fitriani Retno
Jurnal Komplikasi Anestesi Vol 9 No 2 (2021)
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.v9i2.8343

Abstract

Background: Glasgow Coma Scale (GCS) as one of the most important predictors and a key measure in neurological assessment after brain injury. Apart from mortality, GCS is also a predictor of quality of life that can be measured using the Extended Glasgow Outcome Scale (GOSE). GOSE is a global assessment of independent living and social reintegration that is widely used as an outcome measure in brain injury research, to analyze long-term functional outcomes. Methods: This study used a retrospective cohort observational study design that aimed to predict mortality and quality of life using the Glasgow Coma Scale. This research has been conducted at the Medical Record Installation of Dr. Sardjito Hospital Yogyakarta using data from patients whom are treated with a diagnosis of traumatic brain injury at Dr. Sardjito Hospital from January 1, 2020 to December 31, 2020 retrospectively. Quality of life was calculated using the GOSE interview questionnaire. The relationship of GCS variables to mortality and quality of life was tested by the unpaired correlative hypothesis test followed by multivariate analysis with logistic regression methods. Results: There were 174 research subjects with a mean age of 37.51 (± 14.17) years, 124 male (71,3%) and 50 female (28.7%). Subjects GCS score < 8 had a higher risk of death than those with GCS score 13-15 (p<0.001, RR=18.3). Subjects with GCS score 9-12 had a higher risk of death than those with GCS score 13-15 (p<0.001, RR=9.71). Subjects with GCS score < 8 had a higher risk of unfavourable outcome than those with GCS score 13-15 (p<0.001, RR=9.49). Subjects with GCS score 9-12 had a higher risk of unfavourable outcome than those with GCS score 13-15 (p=0.001, RR=4.93). Conclusion: GCS on admission can be a predictor of mortality and quality of life for traumatic brain injury patients
Angka Kematian Terkait Anestesi RSUP Dr. Sardjito 2017-2021 Gunawan, Fanny; Sudadi; Mahmud
Jurnal Komplikasi Anestesi Vol 9 No 2 (2021)
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.v9i2.8344

Abstract

Background: Anesthesia service is a complex part of health care and has the potential to be dangerous. Anesthesia services can be improved by knowing the death rate related to anesthesia. This study aims to determine the death rate related to anesthesia in RSUP Dr. Sardjito. Methods: A retrospective review of the patient database under anesthesia from January 2017 to May 2021 was carried out by taking data from the medical record installation of RSUP Dr. Sardjito. Data on patients who died related to anesthesia were determined by 3 anesthesiologists. We assessed the patient's preoperative, intraoperative, and postoperative variables such as age, sex, ASA physical status, anesthetic technique, type of surgery, size of surgery, and patient comorbidities associated with anesthesia-related death and place of death. Results: There were 39,965 patients undergoing anesthesia. Thirty patients died related to anesthesia. Characteristics of patients who died related to anesthesia in January 2017 to May 2021 at Dr. Sardjito was a patient with male gender (n=14 (46.6%)), ASA III physical status (n=20 (66.7%)), type of emergency surgery (n=12 (40%)), general anesthetic technique (n=25 (83.3%)), and underwent major surgery (n=25 (83.3%)). The mean age of patients who died related to anesthesia was 46.53 with a standard deviation SD of ±26.31. There were 9 patients (30%) who died with comorbid hypertension. There were twenty six patients (86.6%) died outside the operating room. Conclusion: The death rate related to anesthesia within 24 hours at RSUP Dr. Sardjito is 7.5 per 10,000 anesthetic actions.
Identifikasi Faktor Risiko Kematian di ICU RSUP Dr. Sardjito Ardiansyah, Firman; Widyastuti, Yunita; Jufan, Akhmad Yun
Jurnal Komplikasi Anestesi Vol 9 No 2 (2021)
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.v9i2.8345

Abstract

Background: ICU is one of patients care unit that is costly and have limited capacity. Thus, time spending, man resources and tools should be allocated wisely based on the needs of the patients that would be admitted to ICU. One of the means that can be used to increase care quality of the ICU is creating a risk prediction system to assess and analyze risk factors that associated with mortality in ICU. This system makes comparative assessment and intensive care evaluation can be done. For the first step, we need to identify risk factors that affect mortality in ICU, that can be used as a new scoring models. Methods: This study based on 356 patients that admitted to ICU RSUP dr. Sardjito from 1 January to 31 December 2019. In this cohort retrospective study, variables will be tested with regression logistics test, with univariable and multivariable approach. From this test, we achieved variables that identified as risk factors of mortality in ICU. Those identified variable undergo assessment of strength as a predictor with Area Under The Curve (AUC) method. If we find that, the discrimination strength is quite strong, we continue the test with calibration test using Hosmer-Lemeshow to achieve compoarative value within observed and expected mortality. The whole statistic process use SPSS application version 26.0. Results: Factors that identified as risk factors for mortality in the ICU Dr.Sardjito Hospital were intraoperative use of vasopressor/inotropic drugs drugs, respiratory failure, GCS (Glasgow Coma Scale) decrease, kidney failure and intraoperative PRC transfusion with p < 0.005 in both univariable and multivariable tests. The AUC for mortality prediction in this study was 0.896 (95% CI; 85,3-94%). This value is classified as strong as a predictor factors, so it is continued to the calibration test with Hosmer-Lemeshow test and showed a p value of 0.53 (p > 0.05) which means that this risk prediction factors has a good fit between the observed and the expected. Conclusion: The intraoperative use of vasopressor/inotropic drugs, respiratory failure, GCS decrease, kidney failure and intraoperative PRC transfusion are predictive factors for mortality in the ICU Dr.Sardjito Hospital. The discrimination ability of these factors is strong and also have a good fit in predicting the incidence of mortality in the ICU Dr.Sardjito Hospital.
Pengaruh Fisioterapi Terhadap Parameter Hemodinamik pada Pasien Kritis Di ICU RSUP Dr. Sardjito Hanafi, Irham; Sari, Djayanti; Jufan, Akhmad Yun
Jurnal Komplikasi Anestesi Vol 9 No 2 (2021)
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.v9i2.8346

Abstract

Background: Critically ill patients undergoing treatment in the ICU experience long-term immobilization. Giving physiotherapy to patients is a recommendation to mobilize critically ill patients early to prevent complications. Monitoring vital signs is important to ensure that physiotherapy is safe and that the patient is protected from the adverse effects of physiotherapy. The recording of hemodynamic changes has never been done in Dr. Sardjito General Hospital. Objective: To determine the effect of passive motion physiotherapy on hemodynamic parameters in critically ill patients admitted to the ICU. Method: This study used a quasi-experimental interventional design. Patients who entered the inclusion criteria were patients who were treated in the ICU and aged over 18 years in June and July 2021. Hemodynamic data were taken from bedside monitors and ICON devices. Results: The number of research subjects was 32 patients. Passive motion physiotherapy resulted in a lower SVV value (10.84 ± 6.19; p = 0.014) than at baseline (12.91 ± 6.19) and after rest (12.25 ± 5.21). Other parameters, HR, RR, SBP, DBP, MAP, SV, SI, CO, CI, SVR, and DO2 did not produce statistically significant changes. Conclusion: Passive motion physiotherapy has no effect on hemodynamic parameters in critically ill patients admitted to the ICU Dr. Sardjito General Hospital. Passive motion physiotherapy resulted in lower SVV compared to baseline and resting conditions.
Manajemen pada Pasien Sindroma Guillain-Barré Di ICU RSUP Dr. Sardjito Jufan, Akhmad Yun; Sudadi; Sunantara, I Gusti Ngurah Putu Mandela
Jurnal Komplikasi Anestesi Vol 9 No 2 (2021)
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.v9i2.8347

Abstract

Guillain-Barré syndrome (GBS) is an autoimmune disorder that affects the peripheral nervous system. Most patients with GBS are clinically characterized by tetraplegia with or without sensory disturbances. In GBS this is due to a hyperreactive immune response including release of antiganglioside antibodies, formation of antibody-dependent immune complexes, and increased macrophages leading to axonal demyelination and degeneration. Severe cases of GBS may present with progressive clinical signs involving respiratory muscle and requiring mechanical ventilation and treatment in an intensive care unit (ICU). We reported a 26-year-old woman with type 2 respiratory failure with suspicion of GBS who was being treated in the ICU of RSUP Dr. Sardjito and undergone plasma exchange as immunomodulator therapy. The patient was treated for 9 days in the ICU of RSUP Dr. Sardjito with the outcome of the patient discharged from ICU to the ward.
Manajemen Sulit Jalan Napas pada Pasien Pediatrik dengan Sindrom Bosman-Arhinia Mikroftalmia Mahmud; Widodo, Untung; Loru, Martha Yuanita
Jurnal Komplikasi Anestesi Vol 9 No 2 (2021)
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.v9i2.8348

Abstract

A 12-months-old boy with Bosman-Arhinia Microphthalmia Syndrome (BAMS) will undergo surgery to replace a nasopharyngeal duct catheter after nasal reconstruction. Patients with ASA physical status 2 with BAMS and prediction of difficult airway. Patient with a history of 2 months ago went on tracheostomy surgery, facilitated by general anesthesia using the Supraglotic Airway Device (SAD) or Laringeal Mask Airway (LMA). After 3 weeks, the tracheostomy cannula was removed and the tracheostomy wound was closed. We used crash induction but found difficulty in ventilation with a facemask or with the LMA so that management was immediately carried out according to the difficult airway algorithm and intubation was successful
Manajemen Intraoperative Nausea and Vomiting (IONV) pada Pasien Seksio Sesarea dengan Anestesi Spinal Apsari, Ratih Kumala Fajar; Jufan, Akhmad Yun; Sari, Dhanty Dwita
Jurnal Komplikasi Anestesi Vol 9 No 2 (2021)
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.v9i2.8350

Abstract

Background: Spinal anesthesia is the most commonly used anesthesia for caesarean section with it being safely, quickly and easy to administer. Current literature indicates a high incidence of intraoperative nausea and vomiting (IONV) during caesarean section under spinal anesthesia up to 80% likely to suffer from nausea and vomiting because of the pregnancy itself. This is applicable not only to the first 3 months of pregnancy but also to the last trimester due to the reduced tone of the esophagogastric junction and an increased intraabdominal pressure. During abdominal surgery under regional anesthesia, nausea may happen due to several contributing factors such as sympathetic blocks followed by parasympathetic dominance with hypotension which is the most important cause of nausea after spinal anesthesia, decreased perfusion of central nervous system, anxiety, and sudden abdominal movements during surgery

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