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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 317 Documents
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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.
Perbandingan Chlorhexidine 0,5% dan Povidone Iodine 10% dalam Mencegah Kolonisasi Bakteri pada Kateter Epidural Harianto, Widi Yuli; Mahmud; Widodo, Untung
Jurnal Komplikasi Anestesi Vol 7 No 3 (2020): Volume 7 Number 3 (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.v7i3.7468

Abstract

Background: Infection in the epidural space is rare but if it occurs it is a serious complication of epidural catheter placement. Aromaa et al reported 8 cases of bacterial infection in the spinal or central nervous system (CNS) after 170,000 epidurals and 550.00 spinal anesthesia, with an overall frequency of 1.1 per 100,000 blocks. The purpose of this study was to compare chlorhexidine 0.5% with 10% povidone iodine in preventing bacterial colonization of epidural catheters in patients treated at the Central General Hospital (RSUP) Dr. Sardjito. Methods: The study design was a single-blind randomized controlled trial in 52 patients who had epidural anesthesia or a combination of general and epidural anesthesia at RSUP Dr. Sardjito Yogyakarta in JanuaryApril 2019. The research subjects were divided into two groups, namely clorhexidine 0.5% in 70% alcohol and povidone iodine 10%. Examination of the epidural catheter (3-4 cm) tip culture on the 3rd day after installation. The research data was tested using the Chi-Square test. Results: This study found positive bacterial cultures on chlorhexidine 0.5% and povidone iodine 10% each in 13% of 23 epidural catheters (p> 0.05). Risk factors for the incidence of spinal needle bacterial colonization which include age, sex, history of diabetes, autoimmune diseases, cytostatica therapy, HIV / AIDS infection, steroid use more than 2 weeks and type of surgery, antibiotic use and irritation events, and complications between the two groups there was no significant difference (p.0,05). Conclusion: The effectiveness of chlorhexidine 0.5% in 70% alcohol compared to povidone iodine 10% did not differ significantly in preventing bacterial colonization in epidural catheters, there was a growth of 13% (3/23) in the chlorhexidine 0.5% group in 70% alcohol and 13 % (3/23) in the povidone iodine 10% group
Sistem Revised Trauma Score (RTS) sebagai Prediktor Mortalitas Pasien Cedera Otak Traumatik di RSUP Dr. Sardjito Wikantama, Aswin; Sudadi; Widyastuti, Yunita
Jurnal Komplikasi Anestesi Vol 7 No 3 (2020): Volume 7 Number 3 (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.v7i3.7469

Abstract

Background: Mortality predictor scores are important as prognosis tool for patients and families and to improve the quality of patient services in hospitals. RTS is easy to use and has been studied in several centers to estimate the prognosis of mortality in traumatic brain injury patients. Dr. Sardjito Hospital has never been investigated regarding the use of RTS mortality predictions in cases of traumatic brain injury. Objective: To validate the Revised Trauma Score (RTS) to predict mortality rates of traumatic brain injury patients in Dr. Sardjito General Hospital. Method: The study was conducted in the Medical Records Installation of Dr. Sardjito General Hospital Yogyakarta by searching the data of patients who were admitted to treatment at the Dr. Sardjito with a diagnosis of traumatic brain injury from 1 January 2018 to 31 December 2018 retrospectively. The RTS prediction number used to predict the number of deaths compared to the actual death rate of the sufferer group (observed death) with the Hosmer and Lemeshow (HL) test. Results: The number of inclusion samples in this study was 325 patients. Discrimination in this study obtained an AUC value of 0.030 (CI 95%: 0.012-0.048)]. The ability of RTS discrimination on the mortality of traumatic brain injury patients is 1-0.030 = 0.970 or 97%. With youden index, a cut of point for a significant RTS value with a mortality outcome for traumatic brain injury patients at Sardjito General Hospital 6.43 with a sensitivity value of 87% and a specificity of 94,6% and RR value of 32,73. HL test obtained p value = 0.976 (p> 0.05). Conclusion: The Revised Trauma Score (RTS) system has a very high discrimination ability and good calibration so that the Revised Trauma Score (RTS) has a high prognosis ability in predicting the mortality of patients with traumatic brain injury at RSUP Dr. Sardjito.
Perbandingan Antara Nilai Indeks Variasi Gelombang Plethysmography dengan Nilai Variasi Tekanan Pulsasi Arteri pada Pasien dengan Ventilasi Tekanan Positif di ICU RSUP Dr. Sardjito Bhaktiyar, Agung; Widodo, Untung; Jufan, Akhmad Yun
Jurnal Komplikasi Anestesi Vol 7 No 3 (2020): Volume 7 Number 3 (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.v7i3.7470

Abstract

Background: Pulse pressure variations (PPV) provide a good assessment of fluid status but require the installation of arterial line with high cost, difficult installation, and the risk of complications in the form of tissue death as well as infection. Meanwhile, the plethysmography variation index which has similarities to the pulse pressure variation that arises due to arteriolar pulses and is influenced by the breathing cycle, but is non-invasive, easy to apply, cheaper material, and without the risk of tissue death or infection. Methods: This study uses a prospective observational study design. We measured pulse pressure variation and plethysmography variability index (PVi) in 22 patients mechanically ventilated with preexisting radial artery catheter in intensive care unit (ICU). PPV was obtained by installing radial arterial line connected to Mostcare®. PVi was obtained by installing an oximetry probe on fourth finger and connected to the Masimo® monitor. We compared PPV and PVi using Mann-whitney test and looked for correlations with the spearman coefficient. Result: Twenty-two patients (SAPS II = 1.74 (0.4-75) had PPV values of 11.7 (7.03) and PVi 13.29 (7.76) different but were not statistically significant p = 0.405 (p> 0.05). There was a moderate correlation between PPV and PVi (r = 0.55). Four of the 22 patients receiving noreepinephiren (dose = 0.125 mcg / kg / min (0.1- 0.15)) showed no correlation between PPV and PVi (r = 0.40 p = 0.60). Conclusion: There was no significant difference between the value of the pulse pressure variation and the plethysmography variability index (PVi). There was a moderate correlation between the pulse pressure variation with the plethysmography variability index. There was no correlation between PVi and PPV in patients receiving norepinephrine.
Penatalaksanaan Perioperatif Atresia Esofagus dengan Fistula Trakeoesofageal Sari, Djayanti; Widyastuti, Yunita; Fauzi, Rizqi Ahmad
Jurnal Komplikasi Anestesi Vol 7 No 3 (2020): Volume 7 Number 3 (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.v7i3.7471

Abstract

Esophageal atresia with trachheoesophageal fistula occurs in 1 in 3,000 to 5,000 births. Esophageal atresia is often associated with other congenital anomalies like ventricular septal defects, patent ductus arteriosus or tetralogy of fallot. We reported a neonatal patient with esophageal atresia. Surgery was performed 2 days after being treated at the NICU. The operation lasted for 2 hours 25 minutes. The anesthetic technique is GA, semi open with Jackson Reese, ETT number 3, controlled breathing. The premedication was 0.1 mg atropine sulphate and 5 µg fentanyl, induction and maintenance were sevoflurane and O2, and with 1mg atracurium muscle relaxant. Postoperatively, patient was transported to the NICU in an intubated condition. The problems of anesthesia management on patients with esophageal atresia are evaluation of aspiration pneumonia, gastric overdistence, difficulty in ventilating the patient, the presence of other congenital abnormalities, and postoperative intensive care. Early recognition, prevention of aspiration, and immediate delivery to tertiary health care center will improve infant morbidity and mortality significantly.

Page 19 of 32 | Total Record : 317

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