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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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Manajemen Pasien dengan Hoarseness Paskatiroidektomi Total Dipacu Kusuma, Danur Adi; Pratomo, Bhirowo Yudo; Jufan, Akhmad Yun
Jurnal Komplikasi Anestesi Vol 10 No 1 (2022)
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.v10i1.8324

Abstract

look at the clinical appearance of the patient who appears hoarse after extubation, thevoice becomes softer, the ability to cough is not strong but the respiration rate is stillnormal 18 times/minute with a saturation of 98% then The probability of injury isunilateral. Pathophysiologically hoarseness can mean there is a possibility of injury toeither the bilateral superior laryngeal nerve or unilateral recurrent laryngeal nerve (RLN).Then the possibility of injury is unilateral RLN unilateral in this patient. Ideally thedifferential diagnosis of postoperative hoarseness requires examination such as simplelaryngoscopy, stroboscopy or intra and extralaryngeal electromyography. In practice it isdifficult to distinguish between damage caused by thyroid surgery and anaestheticfactors. There are a number of anesthetic-related factors that may predispose to hoarseness in these patients such as the risk of doubling in patients who are intubated for3-6 hours (in patients 3.5 hours). This could be ruled out if we could measure the ET cuffpressure during surgery. While from the surgical factor there are several risk factors suchas surgery on the neck area (thyroid surgery), excessive neck extension during surgery,pulling the RLN causing injury. In the last operation the position of the neck extended, forRLN in the operation report has been identified. It is better to assess vocal cord functionprior to extubation, such as a cuff leak test or insertion of a flexible intubation scopethrough the lumen of the ET tube.
Hubungan Kadar Awal D-Dimer Terhadap Mortalitas pada Pasien COVID-19 Di RSUP Dr. Sardjito Alqustar, Adam; Kurniawaty, Juni; Widyastuti, Yunita
Jurnal Komplikasi Anestesi Vol 10 No 1 (2022)
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.v10i1.8325

Abstract

In severe COVID-19 infection, the immune response can be exaggerated andcause a systemic cytokine storm that triggers systemic inflammatory responsesyndrome (SIRS). Excessive systemic inflammatory response can lead to systemicendothelial injury (endotheliopathy) and a hypercoagulable state that increasesthe risk of systemic macrothrombosis and microthrombosis. D-dimers arereleased when plasmin, a fibrinolytic enzyme, breaks down fibrin and is areflection of the endovascular thrombosis process. Assessment of circulating Ddimer concentrations is a sensitive test for diagnosing thrombotic status(including pulmonary embolism and DIC) and predicting mortality event inpatient contracted with COVID- 19
Hubungan Neutrophil-Lymphocyte Ratio (NLR) Terhadap Mortalitas dan Lama Rawat Inap Pasien COVID-19 Di RSUP Dr. Sardjito Khoeri, Fatkhur Roofi; Sari, Djayanti; Widyastuti, Yunita
Jurnal Komplikasi Anestesi Vol 10 No 1 (2022)
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.v10i1.8326

Abstract

Background: COVID-19 is a viral-caused disease which has become pandemic disease with broad clinical manifestation. Neutrophyl Lymphocyte Ratio (NLR) may represent immune system dysregulation, a warning sign in mild COVID-19 patient and was predicted to have relation to mortality and length of stay. NLR is a simple blood test and applicable in daily clinical practice. Method: This study is an observational, cohort retrospective by taking secondary data from confirmed COVID-19 patient’s medical record during April 2020 – Maret 2021. NLR cut-off point was concluded using ROC and Youden’s Index. Survival Kaplan Meier analysis was used to determine the relation between NLR, mortality, and length of stay (LOS). This relation was analyzed using univariat and Cox regression multivariat analysis Method: This study is an observational, cohort retrospective by taking secondary data from confirmed COVID-19 patient’s medical record during April 2020 – Maret 2021. NLR cut-off point was concluded using ROC and Youden’s Index. Survival Kaplan Meier analysis was used to determine the relation between NLR, mortality, and length of stay (LOS). This relation was analyzed using univariat and Cox regression multivariat analysis. Result: 273 samples was included in the study. With 7,62 cut-off point, it was found that 190 samples had NLR <7,62 and 83 samples had NLR >7,623. Multivariat analysis shown that samples with higher NLR independently and significantly had higher mortality risk (HR 3,345, p<0,001). Samples with NLR > 7,62 significantly had longer LOS (23 vs 19 days, respectively). However, multivariat analysis shown that NLR did not correlate with LOS (p=0,090). Summary: High NLR >7,62 independently and significantly correlate with higher mortality risk. Univariat analysis shown that higher NLR correlate with LOS in COVID-19 patients, but did not affect LOS.
Hubungan Indeks ROX dengan Mortalitas Pasien COVID-19 di RSUP Dr. Sardjito Naomi, Diah Anis; Wisudarti, Calcarina Fitriani Retno; Widodo, Untung
Jurnal Komplikasi Anestesi Vol 10 No 1 (2022)
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.v10i1.8327

Abstract

Background: In December 2019, a new infectious disease caused by a corona virus named SARS-CoV-2 emerged. COVID-19 disease causes multi-organ failure that occurs in the lungs and extra-pulmonary, sepsis, and even death. Pulmonary disorders that often occur in COVID-19 patients are ARDS. Early recognition of ARDS can be done by assessing the clinical condition of the patient and the parameters of RR and SpO2. ROX is a calculation of Index (SpO2/FiO2)/RR. The ROX index may be one of the predictors of mortality in COVID-19 patients. Methods: An observational study with a retrospective cohort approach to COVID19 patients who were hospitalized at Sardjito General Hospital in July 2020 to June 2021. Patients with COVID-19 without oxygen therapy or with nasal cannula oxygen therapy, NRM, or HFNC who were hospitalized, the ROX Index were calculated on the first day of treatment and then assessed for patient mortality and length of stay. The data was taken from medical records at the Medical Records Installation at Sardjito General Hospital. Results: There were 953 research subjects with average age of 51 (± 15.5) years old, 479 women (50.3%) and 474 men (49.7%). There was a significant relationship between the ROX index 15.06 and the mortality of COVID-19 patients (p < 0.001, HR = 2.15, 95% CI 1.57-2.94). Other factors related to mortality in COVID-19 patients were age, oxygen therapy with HFNC, hypertension, diabetes mellitus, chronic kidney failure, and cardiovascular disease. The survival time of subjects with an ROX index of 15.06 was 24 days, shorter than the index group > 15.06, which was 31 days (p < 0.001). The ROX index did not have a significant relationship with the length of stay in the hospital. The average length of stay in the ROX 15.06 index group was 17 days, longer than the > 15.06 index group, which was 14 days (p=0.002). Factors related to length of stay were age ³ 65 years, history of hypertension and diabetes mellitus. Conclusion: There was a significant association of ROX index and mortality of COVID-19 patients at Sardjito General Hospital.
Diagnosis dan Tata Laksana Sepsis Maternal Jufan, Akhmad Yun; Wisudarti, Calcarina Fitriani Retno; Atmanagara, Dikho
Jurnal Komplikasi Anestesi Vol 10 No 1 (2022)
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.v10i1.8328

Abstract

Maternal sepsis is a common and potentially preventable cause of direct maternal death globally. A barrierto further progress has been the lack of consensus on the definition of maternal sepsis. Recognition and treatment of maternal sepsis are often delayed due to the physiological adaptations of pregnancy and vague or absent signs and symptoms during its initial presentation. Over the past decade, our understanding of sepsis has evolved and maternal early warning systems have been developed in an effort to help providers promptly identify and stratify parturients who are at risk. In addition, new consensus definitions and care bundles have recently been published by the World Health Organization and the Surviving Sepsis Campaign to facilitate earlier recognition and timely management of sepsis. Standardizing the criteria for maternal sepsis optimizes clinical finding. It may facilitate the evaluation of the role of different clinical parameters and biomarkers in the diagnosis, earlier recognition and management of maternal infection and sepsis. Further work is required to develop an international consensus on the criteria for diagnosing maternal sepsis and any associated organ dysfunction. In this narrative review, we summarize the available evidence about sepsis and provide an overview of the research efforts focused on maternal sepsis to date.
An Ultrasonography Guidance Lumbar Epidural Anaesthesia in Patient with Difficult Landmarks Wisudarti, Calcarina Fitriani Retno; Mahmud; Mi’raj, Geza Getar
Jurnal Komplikasi Anestesi Vol 10 No 1 (2022)
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.v10i1.8329

Abstract

Anestesi epidural banyak digunakan dalam praktik klinis. Namun, keberhasilan metode anestesi ini bergantung pada kemampuan untuk memperkirakan penempatan dengan benar dari ruang epidural untuk menusuk dan mengateterisasinya. Saat ini, metode paling umum untuk menentukan level tusukan dan arah jarum yang benar didasarkan pada landmark anatomis dan kedalaman ruang epidural penempatan dinilai dengan tes ''kehilangan resistensi''. Kompleksitas teknis dari metode tusukan epidural dapat meningkatkan risiko komplikasi neurologis, blok yang tidak berhasil, dan ketidakpuasan pasien. Panduan ultrasonografi pada blok saraf banyak digunakan dalam praktik klinis. Namun, penerapan suara ultra selama anestesi neuraksial masih terbatas karena kesulitan memvisualisasikan padat struktur yang mengelilingi ruang epidural dan tulang belakang kanal.
Konsiderasi Analgesi Opioid pada Pasien Geriatri Mahmud; Sudadi; Adityo, Galang Martin
Jurnal Komplikasi Anestesi Vol 9 No 3 (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.v9i3.8330

Abstract

Based on the changing demographics of geriatrics today, it is expected that there will be an increase in demand for various surgical services, including vascular surgery and general surgery. DI Yogyakarta (14.71 percent) is the city with the largest geriatric population in Indonesia. In the geriatric age group, there are changes related to physiological functions, pharmacokinetics and pharmacodynamics. The use of opioids requires a 25-50% lower initial dose than the adult age group. The administration of opioids in geriatrics needs to consider: the type of opioid group, the level of toxicity, monitoring pharmacological effects and side effects that occur closely after the initial dose, and rotating opioids that allow the use of lower doses.
Gagal Spinal pada Operasi Sectio Caesarea Wisudarti, Calcarina Fitriani Retno; Uyun, Yusmein; Utomo, F uad Cipto
Jurnal Komplikasi Anestesi Vol 9 No 3 (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.v9i3.8331

Abstract

Subarachnoid block is the most convenient and safe anesthesia to undergo cesarean section. It provides excellent anesthesia, avoids risks associated with general anesthesia and increase level of parturients' satisfaction, associated with low occurrence of intra-operative and post-operative morbidities. It's simplicity to institute, rapid onset of sensory blockage, its reliability, ease of mastering and producing optimal surgical conditions are some of the frequent reasons to choose spinal anesthesia over other techniques. Despite this significant move towards spinal anesthesia, it has a risk of failure reported in the range of 1-17%. Failed spinal anesthesia can be defined as partial or incomplete spinal block within 15-20 min after injection and requiring supplemental analgesia or conversion to general anesthesia. Failed spinal leads to maternal discomfort and it is a cumbersome event for the anesthetist. Management of failed spinal during caesarean section by repeat, sedation or conversion to general anesthesia may negatively impact maternal and fetal outcome. This may result in decreased maternal satisfaction, inadequate pain management, fetal sedation (incases of general anesthesia), suboptimal surgical anesthesia and may also pose to risks of general anesthesia on the parturient. Keywords: Caesarean Section; failed spinal anesthesia; management of failed spinal; spinal anesthesia
Manajemen Preoperatif pada Pasien dengan Hipertiroid Pratomo, Bhirowo Yudo; Widodo, Untung; Ferdiansyah, David
Jurnal Komplikasi Anestesi Vol 9 No 3 (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.v9i3.8332

Abstract

Gangguan tiroid adalah kelainan endokrin yang paling sering ditemukan setelah diabetes melitus. Prevalensi kelainan tiroid di wilayah dengan defisiensi iodin lebih tinggi, salah satunya wilayah Asia Tenggara. Hormon tiroid memiliki banyak efek pada beberapa organ di dalam tubuh seperti meningkatkan pertumbuhan, sistem saraf pusat, kardiovaskuler, dan laju metabolisme. Stres, yang salah satunya diakibatkan oleh prosedur operatif, dapat mengeksaserbasi kelainan tiroid sehingga dapat menyebabkan dekompensasi atau bahkan mortalitas. Semua prosedur operasi elektif harus ditunda hingga pasien berada pada kondisi eutiroid dengan terapi medikamentosa. Pasien harus memiliki kadar T3 dan T4 yang normal dan tidak mengalami takikardi pada kondisi istirahat.
Hubungan Antara C-Reactive Protein dengan Mortalitas dan Lama Rawat Pasien COVID-19 di RSUP Dr. Sardjito Ramsi, Irhash Faisal; Widyastuti, Yunita; Widodo, Untung
Jurnal Komplikasi Anestesi Vol 9 No 3 (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.v9i3.8333

Abstract

Background: COVID 19 is an emerging viral infectious disease that is currently spreading around the world, and has become a pandemic. Diverse clinical manifestations also produce extensive morbidity and mortality. C reactive protein (CRP) is a new biomarker that describe the event of inflammation or infection. Serum CRP level reflects the relationship with disease severity and high mortality. Objective: The objective of this study is to analyze the relationship between CRP level and patient’s length of stay and mortality. Method: This study used retrospective observational cohort method at the Medical Records and Accounting Departement, Dr. Sardjito Hospital by reviewing confirmed COVID 19 patient’s medical records examined serum CRP level in the period of April until December 2020. To analyze the relationship between CRP level and mortality, logistic regression was used. And to analyze to relationship between CRP level and hospital length of stay, Kaplan-Meier was used. Result: Total sample population was 285 patients, and 178 patients met inclusion and exclusion criteria. The median of age of the patients was 54 years old (19-89) consist of 60,7% male patients and 39,3% female patients. Subjects with higher CRP level (>72 mg/L) were at higher risk of death (HR 4,726; p< 0,001) than those with lower CRP level. The difference in LOS was significantly different between groups of subjects, with the median LOS for subjects with CRP >72 mg/L was 20 days, while for subjects with CRP ≤72 mg/L was 16 days (p= 0.021). Conclusion: Increased serum CRP level >72 mg/L strongly related with increased risk of mortality and length of hospital stay in COVID-19 patients.

Page 23 of 32 | Total Record : 317

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