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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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Perbandingan Pengukuran Cardiac Output, Cardiac Index, dan Systemic Vascular Resistance Antara Menggunakan Non-Invasive Cardiometry (Icon®) dan Pressure-Recording Analytic Method (MOST- CARE®) pada Pasien Pascaoperasi Mayor di RSUP Dr. Sardjito Yogyakarta Daniswara; Wisudarti, Calcarina Fitriani Retno; Kurniawaty, Juni
Jurnal Komplikasi Anestesi Vol 8 No 3 (2021): Volume 8 Number 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.v8i3.8372

Abstract

Background: Pulmonary Artery Catheter (PAC) is the gold standard for examining cardiac output (CO), cardiac index (CI), and systemic vascular resistance (SVR), however, PAC insertion is very invasive, causing complications. A less invasive method is currently being developed in the form of Most-Care® (pressure recording analytical method (PRAM)) and non-invasive ICON® (electrical cardiometry (EC)). Methods: The study sample was adult patients who were treated in the ICU Dr. Sardjito with age ≥ 18 years,post major surgery with an arterial line and central venous catheter (CVC). CO, CI, and SVR values were measured at the first hour after the patient arrived at the ICU using ICON® and Most-Care®. Collected data were processed and analyzed to compare between two of them using paired ttest. Results: From a total population of 49 patients, 23 subjects met the inclusion criteria, and the remaining 26 subjects were eliminated due to CHF, obesity, atrial fibrillation, tachycardia, bradycardia, and thoracic surgery. CO and CI of ICON® and Most-Care® are not significantly different (p>0.05). High SVR of ICON® and Most-Care® are not significantly different (p=0.667), but showed a significant difference in normal SVRp=0.015. Conclusion: The measurement of CO and CI between ICON® and Most-Care® showed no significant difference (p>0.05), but showed a significant difference (p=0.015) in the normal SVR category
Panduan Pemeriksaan Analisis Gas Darah Menggunakan Bedside Poct (I‐STAT®) dan Laboratorium Sentral (NOVA PHOX®) dI RSUP Dr. Sardjito Nurdiansyah, Elba; Pratomo, Bhirowo Yudo; Kurniawaty, Juni
Jurnal Komplikasi Anestesi Vol 8 No 3 (2021): Volume 8 Number 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.v8i3.8373

Abstract

Background: Proper postoperative ventilator weaning requires regular monitoring of the patient's blood gas analysis (BGA). Delays in getting the results of the BGA test will be an obstacle in guiding the weaning procedure and affect the length of use of the ventilator. The central laboratory examination (NOVA pHOx®) requires more blood samples, a longer examination time and process compared to POCT which uses fewer blood samples and processes faster results. Methods: This study used a prospective observational design, cohort study, and unpaired comparative analytics. The samples were divided into 2 groups for blood gas analysis i-STAT® and a central laboratory (Nova pHOx®). The inclusion criteria were patients aged 5-60 years who underwent post-open heart surgicaltreatment with a ventilator and a EURO Score <5, The exclusion criteria were patients with ventilator problems, acquired pneumonia, and adult patients with severe chest restriction spirometry. Results: The number of samples was 46 people (POCT: n = 23, Central Laboratory (Nova pHOx®): n = 23).The length of time using the ventilator in the i-STAT group was 1122.8 minutes while the central laboratory group (Nova pHOx®) was 1291.4 minutes with a mean difference of 168.8 minutes but both showed no significant difference with p = 0.303 (p> 0.05). Conclusion: The length of time of using the ventilator in post-cardiac surgery patients with the guidance of blood gas analysis in the i-STAT group and central laboratory (Nova pHOx®). showed no evidence of interaction and no significant effect on the two test modalities
Panjang Tulang Belakang dan Indeks Massa Tubuh sebagai Prediktor Terjadinya Hipotensi Pascaanestesi Spinal pada Ibu Hamil yang Menjalani Seksio Sesarea Wirawan, Angga Aditya; Uyun, Yusmein; Apsari, Ratih Kumala Fajar
Jurnal Komplikasi Anestesi Vol 8 No 3 (2021): Volume 8 Number 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.v8i3.8374

Abstract

Background: Hypotension is one of the neuraxial anesthesia complications, whereas if not properly managed, might diminish the uteroplacental perfusion, cause fetal hypoxia, acidosis, and neonatal injury. Vertebral column length and body mass index are believed to have a role in predicting the incidence of hypotension after spinal anesthesia in parturients undergoing cesarean section because some research wasmentioned the correlation between vertebral column length and body mass index with sensory block height and vasopressor needs. Methods: This research uses prospective observational, cross-sectional as the design. The sample size is 72parturient of physical status ASA 1 and 2 who will undergo caesarean section with spinal anesthesia. Hypotension is defined as a decrease in systolic blood pressure >20% compared with baseline measurement on the table before spinal anesthesia is given up to 20 minutes after spinal anesthesia. Results: The mean vertebral column length in the hypotension group is 36,1 cm and no hypotension group is 33,6 cm. Statistically, this condition doesn’t show a significant difference (p=0,076). While in body mass index, mean body mass index in hypotension group is 32,7 kg/m2 and no hypotension group is 27,6 kg/m2. Statistically, this shows significant difference (p=0,0001). Conclusion: Vertebral column length was not significant in predicting incidence of hypotension after spinal anesthesia in pregnant women undergoing caesarean section. Whereas, body mass index has significant difference so it can be used to predict the incidence of hypotension after spinal anesthesia in pregnant women undergoing caesarean section.
Tata Laksana Badai Tiroid di Instalasi Gawat Darurat Sudadi; Pratomo, Bhirowo Yudo; Utomo, Wandito Gayuh
Jurnal Komplikasi Anestesi Vol 8 No 3 (2021): Volume 8 Number 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.v8i3.8375

Abstract

A thyroid storm is one of endocrinology emergency. Its incidence is very rare but has a very high mortality. Early diagnosis and aggressive treatment must be made in this case so that the patient has a good prognosis. Thyroid storm is often occurring in patients with hyperthyroidism who are not given adequate treatment and are triggered by infection, trauma, thyroid surgery, or uncontrolled diabetes mellitus. Initial treatment in Emergency Department includes assessment and management of the ABCDSs, appropriate intravenous (IV) fluid resuscitation, electrolyte replacement, precipitate factors management, and thyroid-specific therapy (include Anti Thyroid Drugs [ATDs], inorganic iodine, corticosteroid, betaAdrenergic Agonists [beta-AAs]). After getting proper treatment in Emergency Department, the patient must continue his care in the Intensive Care Unit (ICU) for clinical and treatment close monitoring. Therapeutic plasmapheresis (TPE) should be considered if clinical improvement is not noted within 24–48 hours of initial treatment.
Enhanced Recovery After Surgery (ERAS) pada Pediatrik yang Menjalani Operasi Kolorektal Pratomo, Bhirowo Yudo; Widyastuti, Yunita; Ilman, Pesiar
Jurnal Komplikasi Anestesi Vol 8 No 3 (2021): Volume 8 Number 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.v8i3.8376

Abstract

Enhanced recovery after surgery (ERAS) was first described by Henrik Kehlet as a tool for optimizing perioperative care. The general scope of ERAS includes perioperative counseling, limiting the fasting hours before surgery, postoperative enteral intake, early mobilization, use of non-opioid pain medications, and restriction of intravenous fluids, drainage, and catheters. Colorectal surgery in pediatrics has a higher infection rate in the surgical area than in adults, thereby the implementation of ERAS in this operation canhave a big impact. There are few studies on the implementation of ERAS in pediatrics. Despite that, the available data shows the implementation of ERAS in pediatrics undergoing colorectal surgery is positive.
Penggunaan Non-Invasive Ventilation pada Pasien COVID-19 Kurniawaty, Juni; Adiyanto, Bowo; Sadewo, Yuri
Jurnal Komplikasi Anestesi Vol 9 No 1 (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.v9i1.8499

Abstract

COVID-19 patients with acute respiratory distress require hospitalization and require invasive and/or non-invasive mechanical ventilation support. NonInvasive Ventilation (NIV) is used in cases requiring escalation of standard oxygen therapy to a higher level. NIV can also reduce early intubation, but long-term use of NIV is not recommended. NIV also does not decrease intubation rates. We report a 52-year-old female patient with a confirmed diagnosis of severe COVID-19. Our patient was admitted to the ICU with the use of HFNC and NIV during treatment. The use of NIV at the right time could determine the patient's prognosis. Persistent weaning of NIV could maintain PO2 and reduce the patient's oxygen fraction requirements. This patient’s condition could improve and become a survivor of COVID-19.
Terapi Opioid pada Kasus COVID-19 Jufan, Akhmad Yun; Kurniawaty, Juni; Dewi, Baiq Dessy Resmana
Jurnal Komplikasi Anestesi Vol 9 No 1 (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.v9i1.8515

Abstract

One-third of COVID-19 patients experience a variety of neurological symptoms involving the central and peripheral nervous systems. These symptoms include headache, dizziness, loss of consciousness, impaired smell, neuralgia, and skeletal muscle damage. Myalgia is the most common symptom in cases of COVID-19. Therefore, adequate pain management isneeded, one of the choices is using opioids. Opioid receptor agonists are a group of drugs that stimulate opioid receptors and produce their effects by mimicking endogenous opioid peptides known as endorphins.
Hubungan Fungsi Absorbsi Gastrointestinal dengan Lama Rawat Inap dan Mortalitas pada Pasien Pascaoperasi Kraniotomi di ICU RSUP Dr. Sardjito Yogyakarta Setiadi, Teguh; Widodo, Untung; Jufan, Akhmad Yun
Jurnal Komplikasi Anestesi Vol 9 No 1 (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.v9i1.8516

Abstract

Background: Nutrition is an important part of patient management in the intensive care unit. Nutritional factors need to be known, whether there is a relationship between nutrition and ICU outcome in post craniotomy patients in ICU. Objective: The aim of this study is to know the relationship between gastrointestinal absorption function with the length of stay (LOS) and mortality in post-operative craniotomy patients in ICU RSUP Dr. Sardjito. Methods: Prospective cohort observational study design with the number of the sample was 60 post craniotomy surgery patients older than 18 years old hospitalized in ICU RSUP Dr. Sardjito. The gastrointestinal absorption function was assessed from the parameters of blood sugar examination before and after the administration of enteral nutrition. The association of gastrointestinal absorption function related to the LOS and mortality in ICU RSUP Dr. Sardjito Yogyakarta was analyzed. Results: There were 60 patients enrolled in this study. GCS values 13-15 were 45 patients (75%), GCS values 9-12 were 6 patients (10%), GCS values 3-8 were 9 patients (15%). The average LOS in the ICU was 3.4±5.13 days. The outcome was 58 patients (96.7%) survived and 2 patients (3.3%) died. The 2002 NRS average score was 3.2 ± 0.4, average APACHE II score was 6.53±4.7. There were 47 patients (78.3%) with good absorption and 13 patients (21.7%) with poor absorption. Vomiting occurred in 14 patients (23.35%), diarrhea 6 patients (10%), constipation 10 patients (16,7%). Spearman's correlation test showed a significant correlation of GCS and APACHE II score with LOS (p<0.05). While age, gender, weight, height, and BMI were not significant (p>0.05). A significant variable in multivariate analysis was the gastrointestinal absorption function(p<0.05) with a regression coefficient of -9.3. Conclusion: There was a significant relationship between gastrointestinal absorption function with length of stay and mortality, If the gastrointestinal absorption function was good the length of stay and mortality were decreased in post craniotomy patients in the ICU RSUP DR. Sardjito. > <0.05) with a regression coefficient of -9.3. Conclusion: There was a significant relationship between gastrointestinal absorption function with length of stay and mortality, If the gastrointestinal absorption function was good the length of stay and mortality were decreased in post craniotomy patients in the ICU RSUP DR. Sardjito.
Identifikasi Faktor Risiko Prediktif Prolonged Length of Stay (PLOS) di ICU RSUP Dr. Sardjito Yogyakarta Fauzi, Rizqi Ahmad; Jufan, Akhmad Yun; Widyastuti, Yunita
Jurnal Komplikasi Anestesi Vol 9 No 1 (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.v9i1.8517

Abstract

Background: One method to improve the service quality in the Intensive Care Unit (ICU) is to develop a risk prediction system to assess and analyze associated risk factors that cause the prolonged length of stay (PLOS) at the ICU. In Indonesia, there is no risk prediction system developed from the population of Indonesians themselves who have different disease characteristics and patterns from European countries that have developed risk prediction such as APACHE IV and SAPS II. Objective: This study aims to identify the predictive factors of PLOS in ICU RSUP Dr. Sardjito. The long-term goal of this research is to develop a PLOS risk prediction model in the ICU based on the patient population treated at RSUP Dr. Sardjito. Methods: A retrospective cohort study was conducted on 451 patients in the ICU RSUP Dr. Sardjito. Variables that are thought to have a relationship with PLOS were tested using bivariate and multivariable logistic regression tests. After that, an assessment of the power of discrimination and calibration of the new PLOS predictive risk scoring system was carried out using the Area Under the Curve (AUC) method. A calibration test with Hosmer-Lameshow was done to get a comparison value between the observed and expected PLOS. Results: Factors identified as risk factors for PLOS in the ICU RSUP Dr.Sardjito were the medical cases, GCS value <8, use of vasoactive or inotropic drugs, sepsis, respiratory failure, and renal failure in both univariate and multivariate tests. Factors that have passed the multivariable test were used as predictors of PLOS in the ICU and a discrimination test was performed with the AUC. The discriminatory ability of the PLOS predictive model was 0,878 (95% CI). This value is classified as strong as a predictor model. The calibration test with Hosmer-Lameshow obtained a p-value of 0.547 (p>0.05) which means that this model was good. Conclusion: The medical cases, GCS value <8, use of vasoactive or inotropic drugs, sepsis, respiratory failure, and renal failure are predictive factors for PLOS in the ICU RSUP Dr. Sardjito. The discriminatory ability of these factors is strong and is able to predict the incidence of PLOS in the ICU RSUP Dr.Sardjito.
Hubungan Kadar Interleukin-6 terhadap Luaran Mortalitas dan Hari Rawat serta Hari Penggunaan Oksigenasi Tekanan Positif Pasien COVID-19 di RSUP Dr. Sardjito Kuncoro, Kusuma Edhi; Sudadi; Sari, Djayanti; Wisudarti, Calcarina Fitriani Retno
Jurnal Komplikasi Anestesi Vol 9 No 1 (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.v9i1.8518

Abstract

Background: COVID-19 is a disease caused by the SARS-CoV-2 virus with the main clinical manifestations of respiratory disorders. Patients with severe and critical symptoms require oxygenation therapy during treatment. Interleukin-6 (IL-6) plays a role in the course of the disease and is associated with the clinical severity of COVID-19. IL-6 has the potential as one of the test parameters to estimate the outcome of COVID-19 patients. Objective: To know the relationship between IL-6 levels and the outcome of mortality, length of stay (LOS) and positive pressure oxygenation days of COVID-19 patients during hospitalization at Dr. Sardjito hospital. Methods: The study design was a retrospective observational cohort by taking secondary data from the medical records of hospitalized COVID-19 confirmed patients who were examined for serum IL-6 during April 2020- March 2021 at dr.Sardjito Hospital. Data collection was carried out at the Medical Records Instalation of Dr. Sardjito Hospital. The relationship of the IL-6 variable to the outcome was tested by logistic regression method and further analyzed with Kaplan-Meier and Cox regression analysis of survival. Results: There were 302 research subjects with a mean age of 55.45 (+14.79) years, 183 male (60.6%) and 119 female (39.4%). Subjects with IL-6 >80 pg/mL had a higher risk of death than those with IL-6 <80 (p=0.000, HR=4.68). As many as 87.4% of the subject required oxygenation therapies during hospitalization. Group of subjects with an IL-6 value >80 was significantly required more positive pressure oxygenation therapy (p=0.000) and require longer (p=0.005) duration of positive pressure oxygenation (9.36(+5,9) days) compared to the group of subjects with IL-6 <80 (6(+2,98) days). The difference in LOS was significantly different between groups of subjects, with the median LOS for subjects with IL-6 >80 was 25 days, while for subjects with IL-6 <80 was 13 days (p= 0.000). Conclusion: There was a significant relationship of IL-6 levels >80 pg/mL with increased risk of mortality, LOS and the requirement of positive pressure oxygenation therapies in COVID-19 patients.

Page 27 of 32 | Total Record : 317

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