Pub Date : 2022-01-26DOI: 10.20473/ijar.v4i12022.22-36
Inge Andriani, Arie Utariani, H. Hamzah
Introduction: IL-1β and IL-6 are cytokines that have major roles in cytokine storms and endogenous pyrogens. Several studies have also displayed the effectiveness of IL-1β inhibitors in COVID-19 patients in minimizing severity and mortality. Objective: This study aims to analyze the correlation between IL-1β and body temperature with ARDS severity and mortality in COVID-19 patients. Materials and Methods: This is an analytical observational study with a prospective cohort design. A total of 54 patients have met the inclusion criteria from July to September 2020. This study mainly applied the Spearman-Rho, Mann Whitney, free sample T2 test, and Chi-Square test. Results and Discussion: The correlation between body temperature and IL-1β levels in COVID-19 patients with ARDS did not show a statistically significant difference towards mortality and ARDS severity, as shown by the p-value > 0.05 in the analysis tests of each of the variables studied. Nonetheless, the occurrence of ARDS (p = 0.022), the severity of ARDS (p = 0.001), application of mechanical ventilation (p = 0.00), secondary infection (p = 0.00), and length of stay (p = 0.042) were found to be statistically significant towards COVID-19 patients’ mortality. Conclusion: Body temperature does not correlate with the occurrence of ARDS, the severity of ARDS, mortality, and IL-1β levels. IL-1β levels and transformation in IL-1β levels also do not correlate with mortality as well as the occurrence and severity of ARDS, but the use of mechanical ventilation, secondary infection, and length of stay were correlated with mortality in COVID-19 patients.
{"title":"Correlation of IL-1β Level and Body Temperature to the Severity of Acute Respiratory Distress Syndrome (ARDS) and Mortality in COVID-19 Patients","authors":"Inge Andriani, Arie Utariani, H. Hamzah","doi":"10.20473/ijar.v4i12022.22-36","DOIUrl":"https://doi.org/10.20473/ijar.v4i12022.22-36","url":null,"abstract":"Introduction: IL-1β and IL-6 are cytokines that have major roles in cytokine storms and endogenous pyrogens. Several studies have also displayed the effectiveness of IL-1β inhibitors in COVID-19 patients in minimizing severity and mortality. Objective: This study aims to analyze the correlation between IL-1β and body temperature with ARDS severity and mortality in COVID-19 patients. Materials and Methods: This is an analytical observational study with a prospective cohort design. A total of 54 patients have met the inclusion criteria from July to September 2020. This study mainly applied the Spearman-Rho, Mann Whitney, free sample T2 test, and Chi-Square test. Results and Discussion: The correlation between body temperature and IL-1β levels in COVID-19 patients with ARDS did not show a statistically significant difference towards mortality and ARDS severity, as shown by the p-value > 0.05 in the analysis tests of each of the variables studied. Nonetheless, the occurrence of ARDS (p = 0.022), the severity of ARDS (p = 0.001), application of mechanical ventilation (p = 0.00), secondary infection (p = 0.00), and length of stay (p = 0.042) were found to be statistically significant towards COVID-19 patients’ mortality. Conclusion: Body temperature does not correlate with the occurrence of ARDS, the severity of ARDS, mortality, and IL-1β levels. IL-1β levels and transformation in IL-1β levels also do not correlate with mortality as well as the occurrence and severity of ARDS, but the use of mechanical ventilation, secondary infection, and length of stay were correlated with mortality in COVID-19 patients.","PeriodicalId":117902,"journal":{"name":"Indonesian Journal of Anesthesiology and Reanimation","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125797243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-26DOI: 10.20473/ijar.v4i12022.55-61
A. Wardhana, J. Nugroho
Introduction: General anesthesia in experimental animals is not limited in the field of anesthesia research. In Indonesia, ventilators and breathing circuit systems utilized in research involving anesthesia in rats are not widely available. The limitations in using ventilators and breathing circuit systems in research are one of the reasons why Indonesia is lacking complex and advanced animal experimental studies. Objective: This study aimed to examine a general anesthesia procedure for intubation in rats using tools and materials commonly discovered in clinical settings. Method: A search on the PubMed database using keywords consisting of animal study, rats, anesthesia, breathing circuit was performed. Review and Discussion: An endotracheal tube insertion procedure may utilize a Miller size 0 laryngoscope, while the endotracheal tube may use a 16 G intravenous cannula in which the needle is replaced by a small wire. The 3-way stopcock system may be considered as a replacement for the Mapleson E system for the breathing circuit system. The Fresh Gas Flow (FGF) source needs to be connected to the angled port, while the other two ports are connected to the reservoir and the intravenous cannula which would be delivered to the experimental animals. FGF three to five times as much as the minute ventilation may be used and the use of a reservoir capacity is similar to the tidal volume of spontaneous ventilation. Therefore, the oxygen flow rate is set to approximately 1-1.5 L per minute. A reservoir is not required for controlled ventilation. Conclusion: The use of a 3-way stopcock as a non-rebreathing circuit system is effective because it utilizes the similar principle as Mapleson E. The ability to use common tools and materials for general anesthesia procedures would significantly boost research of animal models in Indonesia to a further level.
{"title":"Three-Way Stopcock as Breathing Circuit in Anesthetic Procedures on Wistar Rats as Animal Models in Research","authors":"A. Wardhana, J. Nugroho","doi":"10.20473/ijar.v4i12022.55-61","DOIUrl":"https://doi.org/10.20473/ijar.v4i12022.55-61","url":null,"abstract":"Introduction: General anesthesia in experimental animals is not limited in the field of anesthesia research. In Indonesia, ventilators and breathing circuit systems utilized in research involving anesthesia in rats are not widely available. The limitations in using ventilators and breathing circuit systems in research are one of the reasons why Indonesia is lacking complex and advanced animal experimental studies. Objective: This study aimed to examine a general anesthesia procedure for intubation in rats using tools and materials commonly discovered in clinical settings. Method: A search on the PubMed database using keywords consisting of animal study, rats, anesthesia, breathing circuit was performed. Review and Discussion: An endotracheal tube insertion procedure may utilize a Miller size 0 laryngoscope, while the endotracheal tube may use a 16 G intravenous cannula in which the needle is replaced by a small wire. The 3-way stopcock system may be considered as a replacement for the Mapleson E system for the breathing circuit system. The Fresh Gas Flow (FGF) source needs to be connected to the angled port, while the other two ports are connected to the reservoir and the intravenous cannula which would be delivered to the experimental animals. FGF three to five times as much as the minute ventilation may be used and the use of a reservoir capacity is similar to the tidal volume of spontaneous ventilation. Therefore, the oxygen flow rate is set to approximately 1-1.5 L per minute. A reservoir is not required for controlled ventilation. Conclusion: The use of a 3-way stopcock as a non-rebreathing circuit system is effective because it utilizes the similar principle as Mapleson E. The ability to use common tools and materials for general anesthesia procedures would significantly boost research of animal models in Indonesia to a further level.","PeriodicalId":117902,"journal":{"name":"Indonesian Journal of Anesthesiology and Reanimation","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129699359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-26DOI: 10.20473/ijar.v4i12022.47-54
Mirza Koeshardiandi, Zulfikar Loka Wicaksana, B. Semedi, Y. Avidar
Introduction: Coronavirus disease-19 (COVID-19) has become a pandemic that is still ongoing today. This is a new challenge for health workers in handling emergency cases. Several COVID-19 patients arrived at the hospital with severe respiratory problems. Meanwhile, other pathological conditions causing respiratory failure must also be considered, such as pneumothorax. Objective: This study aimed to examine the effective emergency procedures to treat COVID-19 cases with tension pneumothorax. Case report: A 45-year-old male patient arrived with a referral letter from a pulmonologist with a diagnosis of simple pneumothorax and pneumonia. The patient also presented a positive SARS COV-2 PCR test result. The patient complained about a worsening of shortness of breath. A symptom of dry cough for 14 days was also reported. Chest radiograph examination subsequently indicated right tension pneumothorax. In the emergency ward, needle decompression procedure connected to the vial containing sterile intravenous fluids was performed. Re-examination of the chest x-ray demonstrated right pulmonary re-expansion. The patient was monitored and after four days, needle decompression was removed and no chest tube was inserted because complete resolution of the lungs had occurred. Discussion: This case illustrates that tension pneumothorax causes worsening of the patient's condition with COVID-19 diagnosis. In another case of tension pneumothorax in a COVID-19 patient, needle decompression of the 2nd intercostal space and the mid-clavicular line was performed as initial treatment followed by chest tube insertion as definitive treatment. However, in this case, chest tube approach was not carried out because the patient had demonstrated clinical and radiological improvement and a worsening condition had not occurred. Conclusion: Prolonged needle decompression connected to a vial containing sterile intravenous fluids as deep as 2 cm from the water surface is an effective procedure in the management of tension pneumothorax even without the installation of a chest tube.
{"title":"Effectiveness and Safety of Prolonged Needle Decompression Procedures in Tension Pneumothorax Patients with COVID-19","authors":"Mirza Koeshardiandi, Zulfikar Loka Wicaksana, B. Semedi, Y. Avidar","doi":"10.20473/ijar.v4i12022.47-54","DOIUrl":"https://doi.org/10.20473/ijar.v4i12022.47-54","url":null,"abstract":"Introduction: Coronavirus disease-19 (COVID-19) has become a pandemic that is still ongoing today. This is a new challenge for health workers in handling emergency cases. Several COVID-19 patients arrived at the hospital with severe respiratory problems. Meanwhile, other pathological conditions causing respiratory failure must also be considered, such as pneumothorax. Objective: This study aimed to examine the effective emergency procedures to treat COVID-19 cases with tension pneumothorax. Case report: A 45-year-old male patient arrived with a referral letter from a pulmonologist with a diagnosis of simple pneumothorax and pneumonia. The patient also presented a positive SARS COV-2 PCR test result. The patient complained about a worsening of shortness of breath. A symptom of dry cough for 14 days was also reported. Chest radiograph examination subsequently indicated right tension pneumothorax. In the emergency ward, needle decompression procedure connected to the vial containing sterile intravenous fluids was performed. Re-examination of the chest x-ray demonstrated right pulmonary re-expansion. The patient was monitored and after four days, needle decompression was removed and no chest tube was inserted because complete resolution of the lungs had occurred. Discussion: This case illustrates that tension pneumothorax causes worsening of the patient's condition with COVID-19 diagnosis. In another case of tension pneumothorax in a COVID-19 patient, needle decompression of the 2nd intercostal space and the mid-clavicular line was performed as initial treatment followed by chest tube insertion as definitive treatment. However, in this case, chest tube approach was not carried out because the patient had demonstrated clinical and radiological improvement and a worsening condition had not occurred. Conclusion: Prolonged needle decompression connected to a vial containing sterile intravenous fluids as deep as 2 cm from the water surface is an effective procedure in the management of tension pneumothorax even without the installation of a chest tube.","PeriodicalId":117902,"journal":{"name":"Indonesian Journal of Anesthesiology and Reanimation","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116939210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-26DOI: 10.20473/ijar.v4i12022.6-13
Ghuraba Adi Surya, K. Abbas
Introduction: Acute Kidney Injury (AKI) is a significant cause of morbidity and mortality following common cardiac surgery. The most common cardiac surgery performed at Dr Soetomo General Academic Hospital Surabaya is coronary artery bypass grafting (CABG). Along with the increasing number of these procedures performed on subjects, Cardiopulmonary Bypass (CPB) has also grown in popularity, which is frequently associated with postoperative AKI. Objective: To investigate the incidence of postoperative AKI in subjects who had undergone a CABG procedure using the CPB technique. Materials and Methods: A retrospective study was conducted at Dr. Soetomo General Academic Hospital in Surabaya. All subjects who had CABG with CPB in 2019 were included in the study. The incidence of AKI was determined by comparing the creatinine serum level before and after surgery on days 0, 1, 2, 3, and >3 according to the AKIN criteria. Results and Discussion: The 68 subjects who underwent the CABG with CPB procedure were made up of 53 males (77.9%) and 15 females (22.1%). The average age of the subjects was 58.209.07. This study included 63 subjects (five subjects could not be evaluated due to incomplete data), and AKI was diagnosed in 44 of them using the AKIN criteria (69.8%). Postoperative AKI was reported in 14 subjects (22.2%) on day 0, 18 subjects (28.6%) on day 1 post-operation, and the same number of 6 subjects (9.5%) on day 2 and day 3 post-operation. None of them had AKI after the third post-operative day. Conclusion: More than 50 % of cases of post-CABG Acute Kidney Injury (AKI) occur at Dr. Soetomo General Academic Hospital, with the majority occurring on the first day after surgery.
{"title":"Acute Kidney Injury Following Coronary Artery Bypass Grafting with Cardiopulmonary Bypass at Dr. Soetomo General Academic Hospital Surabaya: A Preliminary Study","authors":"Ghuraba Adi Surya, K. Abbas","doi":"10.20473/ijar.v4i12022.6-13","DOIUrl":"https://doi.org/10.20473/ijar.v4i12022.6-13","url":null,"abstract":"Introduction: Acute Kidney Injury (AKI) is a significant cause of morbidity and mortality following common cardiac surgery. The most common cardiac surgery performed at Dr Soetomo General Academic Hospital Surabaya is coronary artery bypass grafting (CABG). Along with the increasing number of these procedures performed on subjects, Cardiopulmonary Bypass (CPB) has also grown in popularity, which is frequently associated with postoperative AKI. Objective: To investigate the incidence of postoperative AKI in subjects who had undergone a CABG procedure using the CPB technique. Materials and Methods: A retrospective study was conducted at Dr. Soetomo General Academic Hospital in Surabaya. All subjects who had CABG with CPB in 2019 were included in the study. The incidence of AKI was determined by comparing the creatinine serum level before and after surgery on days 0, 1, 2, 3, and >3 according to the AKIN criteria. Results and Discussion: The 68 subjects who underwent the CABG with CPB procedure were made up of 53 males (77.9%) and 15 females (22.1%). The average age of the subjects was 58.209.07. This study included 63 subjects (five subjects could not be evaluated due to incomplete data), and AKI was diagnosed in 44 of them using the AKIN criteria (69.8%). Postoperative AKI was reported in 14 subjects (22.2%) on day 0, 18 subjects (28.6%) on day 1 post-operation, and the same number of 6 subjects (9.5%) on day 2 and day 3 post-operation. None of them had AKI after the third post-operative day. Conclusion: More than 50 % of cases of post-CABG Acute Kidney Injury (AKI) occur at Dr. Soetomo General Academic Hospital, with the majority occurring on the first day after surgery.","PeriodicalId":117902,"journal":{"name":"Indonesian Journal of Anesthesiology and Reanimation","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122424322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-28DOI: 10.20473/ijar.v3i22021.39-45
Cindy Aprilia Eka Prasanty, A. Setyaningtyas, Arie Utariani
Introduction: Respiratory failure is the respiratory system’s inability to maintain its gas exchange functions, oxygenation, and carbon dioxide elimination. Infant and children are more susceptible to develop respiratory failure. Respiratory failure can also be caused by several diseases/conditions, which is a common reason for pediatrics to be admitted to the intensive care unit. Objective: This study aims to describe patients’ demographic and clinical profile with respiratory failure at the PICU of Dr. Soetomo General Hospital, Surabaya. Materials and Methods: This is a prospective study with the descriptive method using the medical records of patients with respiratory failure who were admitted to the PICU from September 2019 to February 2020 and had arterial BGA data (PaCO2, PaO2), which were examined in the PICU or resuscitation room before the patients were admitted to the PICU. Results: This study showed that out of 35 patients, 24 (68.6%) were female, 19 (54.3%) were <1 year old, and 20 (57.1%) had normal nutritional status. Type I (hypoxemic) and type II (hypercapnic) respiratory failures were found in 13 patients (37.1%), respectively. The most common clinical signs were fever in 26 patients (74.3%), shortness of breath in 24 patients (68.6%), and chest retraction in 24 patients (68.6%). The primary diagnosis that commonly occurred was respiratory system disorders in 15 patients (42.9%). The other diagnosis that mainly occurred was nutrition and metabolic disorders of 19 patients (54.3%). The patients' outcome was that 24 patients were survived (68.6%), and ten patients died (28.6%). Conclusions: Various clinical signs and diagnoses can be found in patients with respiratory failure at PICU. The most common respiratory failure types are type I (hypoxemic) and type II (hypercapnic) respiratory failure.
{"title":"Profile of Patients With Respiratory Failure at Pediatric Intensive Care Unit (PICU) Dr. Soetomo General Hospital","authors":"Cindy Aprilia Eka Prasanty, A. Setyaningtyas, Arie Utariani","doi":"10.20473/ijar.v3i22021.39-45","DOIUrl":"https://doi.org/10.20473/ijar.v3i22021.39-45","url":null,"abstract":"Introduction: Respiratory failure is the respiratory system’s inability to maintain its gas exchange functions, oxygenation, and carbon dioxide elimination. Infant and children are more susceptible to develop respiratory failure. Respiratory failure can also be caused by several diseases/conditions, which is a common reason for pediatrics to be admitted to the intensive care unit. Objective: This study aims to describe patients’ demographic and clinical profile with respiratory failure at the PICU of Dr. Soetomo General Hospital, Surabaya. Materials and Methods: This is a prospective study with the descriptive method using the medical records of patients with respiratory failure who were admitted to the PICU from September 2019 to February 2020 and had arterial BGA data (PaCO2, PaO2), which were examined in the PICU or resuscitation room before the patients were admitted to the PICU. Results: This study showed that out of 35 patients, 24 (68.6%) were female, 19 (54.3%) were <1 year old, and 20 (57.1%) had normal nutritional status. Type I (hypoxemic) and type II (hypercapnic) respiratory failures were found in 13 patients (37.1%), respectively. The most common clinical signs were fever in 26 patients (74.3%), shortness of breath in 24 patients (68.6%), and chest retraction in 24 patients (68.6%). The primary diagnosis that commonly occurred was respiratory system disorders in 15 patients (42.9%). The other diagnosis that mainly occurred was nutrition and metabolic disorders of 19 patients (54.3%). The patients' outcome was that 24 patients were survived (68.6%), and ten patients died (28.6%). Conclusions: Various clinical signs and diagnoses can be found in patients with respiratory failure at PICU. The most common respiratory failure types are type I (hypoxemic) and type II (hypercapnic) respiratory failure.","PeriodicalId":117902,"journal":{"name":"Indonesian Journal of Anesthesiology and Reanimation","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124643183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-28DOI: 10.20473/ijar.v3i22021.81-90
Akhyar Nur Uhud, Arie Utariani, Lucky Andriyanto
Introduction: NRSD (Neonatal Respiratory Distress Syndrome) is one of the most frequent causes of newborns in intensive care (NICU). Several NICU centers are now using the High Flow Nasal Cannula (HFNC) in recent years. With the use of HFNC as a breath aid in preterm infants, HFNC had the same efficacy ratio as nasal Continuous Positive Airway Pressure (CPAP) (continuous or intermittent). Case Report: A three-day-old baby boy was admitted to anesthesia with respiratory failure due to grade II HMD with suspicion of congenital heart failure. The initial condition showed that a respiratory rate of 70-80x / minute, breathing of the nostrils and retractions in the intercostals and abdomen with 85% post ductal SpO2 with the help of a CPAP mask (Pinsp 10, Fio2 70%). There was a Ronchi sound in the right and left basal lungs, and hemodynamics obtained a pulse of 180-195x / minute, non-invasive blood pressure 95/34 mmHg (54), heart murmurs were not found. During day 1 - day three, the patient uses a CPAP mask until the patient vomits and being consulted to an Anesthesiologist. On day 3 - day seven, the patient uses HFNC; after day seven until day 10, the patient uses neonatal nasal canularis oxygen. Until day 10, the patient is still being treated at the NICU by administering oxygen 0.5 liters/minute with SpO2 ranging from 93-96% with stable conditions but still needing oxygen. Conclusion: The use of Modified High Flow Nasal Cannula (HFNC) in preterm infants with Neonatal Respiratory Distress Syndrome (NRSD) is more effective and efficient than CPAP. The use of HFNC was associated with a lower incidence of nasal trauma and pneumothorax than nasal CPAP.
{"title":"The Use of Modified High Flow Nasal Cannula (HFNC) In Preterm Infants With Neonatal Respiratory Distress Syndrome (NRSD) In Primary ICU Services","authors":"Akhyar Nur Uhud, Arie Utariani, Lucky Andriyanto","doi":"10.20473/ijar.v3i22021.81-90","DOIUrl":"https://doi.org/10.20473/ijar.v3i22021.81-90","url":null,"abstract":"Introduction: NRSD (Neonatal Respiratory Distress Syndrome) is one of the most frequent causes of newborns in intensive care (NICU). Several NICU centers are now using the High Flow Nasal Cannula (HFNC) in recent years. With the use of HFNC as a breath aid in preterm infants, HFNC had the same efficacy ratio as nasal Continuous Positive Airway Pressure (CPAP) (continuous or intermittent). Case Report: A three-day-old baby boy was admitted to anesthesia with respiratory failure due to grade II HMD with suspicion of congenital heart failure. The initial condition showed that a respiratory rate of 70-80x / minute, breathing of the nostrils and retractions in the intercostals and abdomen with 85% post ductal SpO2 with the help of a CPAP mask (Pinsp 10, Fio2 70%). There was a Ronchi sound in the right and left basal lungs, and hemodynamics obtained a pulse of 180-195x / minute, non-invasive blood pressure 95/34 mmHg (54), heart murmurs were not found. During day 1 - day three, the patient uses a CPAP mask until the patient vomits and being consulted to an Anesthesiologist. On day 3 - day seven, the patient uses HFNC; after day seven until day 10, the patient uses neonatal nasal canularis oxygen. Until day 10, the patient is still being treated at the NICU by administering oxygen 0.5 liters/minute with SpO2 ranging from 93-96% with stable conditions but still needing oxygen. Conclusion: The use of Modified High Flow Nasal Cannula (HFNC) in preterm infants with Neonatal Respiratory Distress Syndrome (NRSD) is more effective and efficient than CPAP. The use of HFNC was associated with a lower incidence of nasal trauma and pneumothorax than nasal CPAP.","PeriodicalId":117902,"journal":{"name":"Indonesian Journal of Anesthesiology and Reanimation","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115292766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-28DOI: 10.20473/ijar.v3i22021.46-53
Christya Lorena, Agustina Salinding, P. Airlangga
Introduction: Laryngoscopy is one of the critical points in the intubation process and a mechanical trauma that provides noxious stimulation, affecting cardiovascular, respiratory, and intracranial changes. Practitioner competence is a significant factor that supports laryngoscope intubation procedures. That can influence the intubation duration and amount of mechanical trauma besides caused by laryngoscope type. Objective: To analyze the effectiveness of using Macintosh blade compared to McCoy blade in intubation laryngoscopy by Anesthesia Residents. Materials and Methods: This research is an experimental study in adult patients who underwent elective surgery at GBPT Dr. Soetomo Hospital. Intubation did by Anesthesia Residents at levels 5-9 using Macintosh or McCoy Laryngoscope and chosen randomly. The data of laryngeal visualization (Cormack Lehane), hemodynamics (blood pressure, pulse), pain scale (qNOX), intubation time length, and pain scale data (VAS) after extubation were taken during intubation laryngoscope. Result and Discussion: The study was conducted on 28 samples that met the criteria. Anesthesia Resident's competence levels based on the semester in both groups laryngoscopes were not different (p 0.868). Based on laryngeal visualization data laryngoscopy, the McCoy's blade had better visualization with CL 1 at 85.7% of the samples and p-value 0.020. This good visualization makes it possible to speed up the laryngoscope-intubation in the McCoy blade group with a significant difference of time compared to the Macintosh blade group. Hemodynamic parameters, there were significant differences for hemodynamics increase. In the Macintosh blade group, the blood pressure and pulse were significantly increased after laryngoscopy intubation. The pain scale during the intubation procedure, which was rated based on the qNOx score, showed a significant increase in the Macintosh blade group with a p-value of 0.003. The postoperative pain scale (VAS) was smaller in the McCoy blade group compared to the Macintosh group (p-value <0.001). Conclusion: The ability to use both laryngoscopes at some levels of Anesthesia residents was equally good, and the use of McCoy Blade is more effective than Macintosh Blade in the intubation laryngoscopy procedure.
{"title":"Effectiveness Comparison of Using Macintosh Blade and Mccoy Blade For Endotracheal Intubation In Anesthesia Residents","authors":"Christya Lorena, Agustina Salinding, P. Airlangga","doi":"10.20473/ijar.v3i22021.46-53","DOIUrl":"https://doi.org/10.20473/ijar.v3i22021.46-53","url":null,"abstract":"Introduction: Laryngoscopy is one of the critical points in the intubation process and a mechanical trauma that provides noxious stimulation, affecting cardiovascular, respiratory, and intracranial changes. Practitioner competence is a significant factor that supports laryngoscope intubation procedures. That can influence the intubation duration and amount of mechanical trauma besides caused by laryngoscope type. Objective: To analyze the effectiveness of using Macintosh blade compared to McCoy blade in intubation laryngoscopy by Anesthesia Residents. Materials and Methods: This research is an experimental study in adult patients who underwent elective surgery at GBPT Dr. Soetomo Hospital. Intubation did by Anesthesia Residents at levels 5-9 using Macintosh or McCoy Laryngoscope and chosen randomly. The data of laryngeal visualization (Cormack Lehane), hemodynamics (blood pressure, pulse), pain scale (qNOX), intubation time length, and pain scale data (VAS) after extubation were taken during intubation laryngoscope. Result and Discussion: The study was conducted on 28 samples that met the criteria. Anesthesia Resident's competence levels based on the semester in both groups laryngoscopes were not different (p 0.868). Based on laryngeal visualization data laryngoscopy, the McCoy's blade had better visualization with CL 1 at 85.7% of the samples and p-value 0.020. This good visualization makes it possible to speed up the laryngoscope-intubation in the McCoy blade group with a significant difference of time compared to the Macintosh blade group. Hemodynamic parameters, there were significant differences for hemodynamics increase. In the Macintosh blade group, the blood pressure and pulse were significantly increased after laryngoscopy intubation. The pain scale during the intubation procedure, which was rated based on the qNOx score, showed a significant increase in the Macintosh blade group with a p-value of 0.003. The postoperative pain scale (VAS) was smaller in the McCoy blade group compared to the Macintosh group (p-value <0.001). Conclusion: The ability to use both laryngoscopes at some levels of Anesthesia residents was equally good, and the use of McCoy Blade is more effective than Macintosh Blade in the intubation laryngoscopy procedure.","PeriodicalId":117902,"journal":{"name":"Indonesian Journal of Anesthesiology and Reanimation","volume":"217 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122860977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-15DOI: 10.20473/IJAR.V3I12021.34-38
A. Veterini, B. Semedi, C. Prakoeswa, D. Tinduh
Providing expertise in the care of critically ill patients is one of the main needs of critical care medicine, especially in the COVID-19 pandemic era. This goal is particularly challenging, given the acknowledged shortage of intensive care specialists. We need the bedside nurse to have real-time access to get continuous reporting monitoring. The intensivist also has access to bed site examination at some time when they are not possible for coming to the intensive care unit (ICU). The big problems during COVID-19 are the limited personal protective equipment, the limited number of intensivist doctors, and the nature of the disease was very contagious and deadly. It is necessary to find a solution so as not to cause new problems, namely the death of medical staff and nurses due to frequent contact with Covid-19 patients. In this article, the author wants to open a view to getting solutions to problems in the field by presenting human replacement technology.
{"title":"The Role of “Robotic Assisted Intensivist” As Solution Of Resources Management In Covid-19 Pandemic Era","authors":"A. Veterini, B. Semedi, C. Prakoeswa, D. Tinduh","doi":"10.20473/IJAR.V3I12021.34-38","DOIUrl":"https://doi.org/10.20473/IJAR.V3I12021.34-38","url":null,"abstract":"Providing expertise in the care of critically ill patients is one of the main needs of critical care medicine, especially in the COVID-19 pandemic era. This goal is particularly challenging, given the acknowledged shortage of intensive care specialists. We need the bedside nurse to have real-time access to get continuous reporting monitoring. The intensivist also has access to bed site examination at some time when they are not possible for coming to the intensive care unit (ICU). The big problems during COVID-19 are the limited personal protective equipment, the limited number of intensivist doctors, and the nature of the disease was very contagious and deadly. It is necessary to find a solution so as not to cause new problems, namely the death of medical staff and nurses due to frequent contact with Covid-19 patients. In this article, the author wants to open a view to getting solutions to problems in the field by presenting human replacement technology.","PeriodicalId":117902,"journal":{"name":"Indonesian Journal of Anesthesiology and Reanimation","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124922013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-06DOI: 10.20473/ijar.v1i22019.52-57
K. Abbas
Introduction: Trauma is a problem faced everyday in the emergency room of the hospital where the researcher works. The degree of trauma from the mildest to life threatening can be found in sufferers. The cause of death in trauma sufferers is hypovolemic shock due to bleeding. The amount of blood loss volume from the patient can be estimated by looking at the clinical signs of the patient. Literature Review: In the condition of tissue hypoperfusion, it will cause a chain process which will eventually lead to cell death. Hypoperfusion causes anaerobic metabolism, lactic acidosis (coagulopathy, enzyme dysfunction), Na-K pump malfunction (cellular swelling and cell death), there is hypothermia (increase of oxygen demand, coagulopathy). Hypoperfusion will cause a vicious circle, in which processes that aggravate one another will occur. With the administration of fluids (crystalloid, colloid, transfusion) will improve the hypoperfusion that occurs in the body. Conclusion: The management of hypovolemic shock due to bleeding requires an understanding of the physiology and pathophysiology that occurs due to bleeding. To get maximum results and improve outcome from sufferers, it needs solid team work. Treatment can be different depending on the conditions, equipment and facilities of the hospital / emergency room as well as the policies of each place.
{"title":"Fluid Resuscitation in Trauma","authors":"K. Abbas","doi":"10.20473/ijar.v1i22019.52-57","DOIUrl":"https://doi.org/10.20473/ijar.v1i22019.52-57","url":null,"abstract":"Introduction: Trauma is a problem faced everyday in the emergency room of the hospital where the researcher works. The degree of trauma from the mildest to life threatening can be found in sufferers. The cause of death in trauma sufferers is hypovolemic shock due to bleeding. The amount of blood loss volume from the patient can be estimated by looking at the clinical signs of the patient. Literature Review: In the condition of tissue hypoperfusion, it will cause a chain process which will eventually lead to cell death. Hypoperfusion causes anaerobic metabolism, lactic acidosis (coagulopathy, enzyme dysfunction), Na-K pump malfunction (cellular swelling and cell death), there is hypothermia (increase of oxygen demand, coagulopathy). Hypoperfusion will cause a vicious circle, in which processes that aggravate one another will occur. With the administration of fluids (crystalloid, colloid, transfusion) will improve the hypoperfusion that occurs in the body. Conclusion: The management of hypovolemic shock due to bleeding requires an understanding of the physiology and pathophysiology that occurs due to bleeding. To get maximum results and improve outcome from sufferers, it needs solid team work. Treatment can be different depending on the conditions, equipment and facilities of the hospital / emergency room as well as the policies of each place.","PeriodicalId":117902,"journal":{"name":"Indonesian Journal of Anesthesiology and Reanimation","volume":"79 1-2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116732539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-29DOI: 10.20473/ijar.v2i22020.30-39
Muzaiwirin Muzaiwirin, Arie Utariani
Introduction: Propofol is often used as sedation for a long time in the ICU. The use is at risk of Propofol Infusion Syndrome (PRIS) which is characterized by arrhythmias or decreased heart function, metabolic acidosis, rhabdomyolysis, and acute renal failure. Literature Review: The pathophysiology of PRIS is due to a disturbance in cell metabolism which inhibits the transport of Free Fatty Acid (FFA) into cells and inhibits the mitochondrial respiration chain. The management of PRIS is supportive of every symptom that arises so that screening is needed as a treatment to reduce high mortality rates. Screening using creatine phosphokinase (CPK) and lactate is supporting data as an initial introduction for symptoms of PRIS. Conclusion: PRIS can occur if continuous administration of propofol > 4 mg / kg / hour. CPK levels> 5000 IU / L become a benchmark to stop propofol before the onset symptoms of PRIS. Implementation of screening protocol is very helpful for clinicians to reduce mortality in ICU due to the use of propofol.
简介:异丙酚在ICU常被长期用于镇静。异丙酚输注综合征(PRIS)的危险，其特征是心律失常或心功能下降、代谢性酸中毒、横纹肌溶解和急性肾功能衰竭。文献综述:PRIS的病理生理是由于细胞代谢紊乱，抑制游离脂肪酸(FFA)进入细胞，抑制线粒体呼吸链。PRIS的管理支持出现的每一种症状，因此需要筛查作为一种治疗方法，以降低高死亡率。使用肌酸磷酸激酶(CPK)和乳酸盐进行筛选是作为PRIS症状的初步介绍的支持数据。结论:异丙酚持续给药> 4 mg / kg / h可发生PRIS。CPK水平> 5000 IU / L成为PRIS出现症状前停用异丙酚的基准。筛查方案的实施有助于临床医生降低ICU患者因异丙酚使用而导致的死亡率。
{"title":"Screening Protocol of Propofol Infusion Syndrome","authors":"Muzaiwirin Muzaiwirin, Arie Utariani","doi":"10.20473/ijar.v2i22020.30-39","DOIUrl":"https://doi.org/10.20473/ijar.v2i22020.30-39","url":null,"abstract":"Introduction: Propofol is often used as sedation for a long time in the ICU. The use is at risk of Propofol Infusion Syndrome (PRIS) which is characterized by arrhythmias or decreased heart function, metabolic acidosis, rhabdomyolysis, and acute renal failure. Literature Review: The pathophysiology of PRIS is due to a disturbance in cell metabolism which inhibits the transport of Free Fatty Acid (FFA) into cells and inhibits the mitochondrial respiration chain. The management of PRIS is supportive of every symptom that arises so that screening is needed as a treatment to reduce high mortality rates. Screening using creatine phosphokinase (CPK) and lactate is supporting data as an initial introduction for symptoms of PRIS. Conclusion: PRIS can occur if continuous administration of propofol > 4 mg / kg / hour. CPK levels> 5000 IU / L become a benchmark to stop propofol before the onset symptoms of PRIS. Implementation of screening protocol is very helpful for clinicians to reduce mortality in ICU due to the use of propofol.","PeriodicalId":117902,"journal":{"name":"Indonesian Journal of Anesthesiology and Reanimation","volume":"318 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121242541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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