Sendhi Putra, T. Senapathi, I. G. Hartawan, C. Ryalino, A. Pradhana
Background: Successful intubation with the correct endotracheal tube (ETT) size is more difficult to achieve in pediatric patients. Several estimation methods exist, including ultrasonography and several conventional methods, but it is unclear which would be the most accurate method. Thus, this study aimed to compare the accuracy between several ETT diameter estimation methods. Materials and Methods: This was an observational study with a cross-sectional design. The sample includes pediatric patients (0–6 years) at a tertiary hospital recruited from January 2022 to March 2022. Primary data evaluated included age, gender, height, weight, actual ETT size used in the procedure, and the estimation of ETT size obtained by four different methods: ultrasonography, little finger diameter, little fingernail width, and age-based formula. Primary analysis was linear regression test between estimated diameter and the actual ETT diameter used in the procedure, controlling for potential confounders. The accuracy of each ETT size estimation method was seen from the values of the B and R2 coefficients from the linear regression test results. Results: Ultrasonography was found as the most accurate method, with B and R2 coefficients of 0.963 and 0.991, respectively. Among conventional methods, the diameter of the little finger was the most accurate (B = 0.918, R2 = 0.772). The age-based formula method was found to be the least accurate (B = 0.797, R2 = 0.735). Conclusion: Linear regression tests confirmed that the ultrasonography was the estimation method with the highest accuracy. For healthcare facilities with limited resources, the estimation method with little finger diameter should be considered.
{"title":"Accuracy Comparison between Four Methods of Endotracheal Tube Diameter Estimation for Pediatric Patients: An Observational, Cross-sectional Study","authors":"Sendhi Putra, T. Senapathi, I. G. Hartawan, C. Ryalino, A. Pradhana","doi":"10.4103/bjoa.bjoa_69_22","DOIUrl":"https://doi.org/10.4103/bjoa.bjoa_69_22","url":null,"abstract":"Background: Successful intubation with the correct endotracheal tube (ETT) size is more difficult to achieve in pediatric patients. Several estimation methods exist, including ultrasonography and several conventional methods, but it is unclear which would be the most accurate method. Thus, this study aimed to compare the accuracy between several ETT diameter estimation methods. Materials and Methods: This was an observational study with a cross-sectional design. The sample includes pediatric patients (0–6 years) at a tertiary hospital recruited from January 2022 to March 2022. Primary data evaluated included age, gender, height, weight, actual ETT size used in the procedure, and the estimation of ETT size obtained by four different methods: ultrasonography, little finger diameter, little fingernail width, and age-based formula. Primary analysis was linear regression test between estimated diameter and the actual ETT diameter used in the procedure, controlling for potential confounders. The accuracy of each ETT size estimation method was seen from the values of the B and R2 coefficients from the linear regression test results. Results: Ultrasonography was found as the most accurate method, with B and R2 coefficients of 0.963 and 0.991, respectively. Among conventional methods, the diameter of the little finger was the most accurate (B = 0.918, R2 = 0.772). The age-based formula method was found to be the least accurate (B = 0.797, R2 = 0.735). Conclusion: Linear regression tests confirmed that the ultrasonography was the estimation method with the highest accuracy. For healthcare facilities with limited resources, the estimation method with little finger diameter should be considered.","PeriodicalId":8691,"journal":{"name":"Bali Journal of Anesthesiology","volume":"6 1","pages":"177 - 181"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44701927","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 : 2022-07-01DOI: 10.4103/bjoa.bjoa_122_22
A. Tantri, D. Satoto, Stesy Natassa
Background: The anatomical marker used in spinal anesthesia is L4-L5 interspace. The L4-L5 interspace is thought to be right on the Tuffier’s line, which connects the two highest points on the iliac crest. The location of L4-L5 interspace from the Tuffier’s line varies greatly because of the influence of several factors such as differences in race, sex, age, and anthropometric factors. This study aimed to examine the relationship between age, sex, and anthropometry factors with the distance of L4-L5 interspace from the Tuffier’s line using ultrasound guidance at Cipto Mangunkusumo National General Hospital. Materials and Methods: This was an observational analytic study with a cross-sectional design in 93 subjects at Cipto Mangunkusumo National General Hospital recruited for the study. Statistical analysis was performed to find the relationship between age, sex, and anthropometry factors with the distance of L4-L5 interspace from the Tuffier’s line and to continue with multivariate analysis to obtain the prediction formula of the distance between L4-L5 interspace and the Tuffier’s line. Results: This study found that the distance of L4-L5 interspace to the Tuffier’s line is −2.59 ± 1.58 cm. Correlation analysis showed a significant relationship between height and sex to the distance of L4-L5 interspace and the Tuffier’s line. The distance prediction formula obtained in this study is 4.921 + [0.536 × (1 for male or 2 for female)] + (−0.052 × height in cm). Conclusion: There was a significant relationship between height and sex to the distance of L4-L5 interspace from the Tuffier’s line.
{"title":"Relationship between age, sex, and anthropometric factors with the distance of L4-L5 interspace from Tuffier’s line: Observational study with ultrasonography guidance","authors":"A. Tantri, D. Satoto, Stesy Natassa","doi":"10.4103/bjoa.bjoa_122_22","DOIUrl":"https://doi.org/10.4103/bjoa.bjoa_122_22","url":null,"abstract":"Background: The anatomical marker used in spinal anesthesia is L4-L5 interspace. The L4-L5 interspace is thought to be right on the Tuffier’s line, which connects the two highest points on the iliac crest. The location of L4-L5 interspace from the Tuffier’s line varies greatly because of the influence of several factors such as differences in race, sex, age, and anthropometric factors. This study aimed to examine the relationship between age, sex, and anthropometry factors with the distance of L4-L5 interspace from the Tuffier’s line using ultrasound guidance at Cipto Mangunkusumo National General Hospital. Materials and Methods: This was an observational analytic study with a cross-sectional design in 93 subjects at Cipto Mangunkusumo National General Hospital recruited for the study. Statistical analysis was performed to find the relationship between age, sex, and anthropometry factors with the distance of L4-L5 interspace from the Tuffier’s line and to continue with multivariate analysis to obtain the prediction formula of the distance between L4-L5 interspace and the Tuffier’s line. Results: This study found that the distance of L4-L5 interspace to the Tuffier’s line is −2.59 ± 1.58 cm. Correlation analysis showed a significant relationship between height and sex to the distance of L4-L5 interspace and the Tuffier’s line. The distance prediction formula obtained in this study is 4.921 + [0.536 × (1 for male or 2 for female)] + (−0.052 × height in cm). Conclusion: There was a significant relationship between height and sex to the distance of L4-L5 interspace from the Tuffier’s line.","PeriodicalId":8691,"journal":{"name":"Bali Journal of Anesthesiology","volume":"6 1","pages":"162 - 166"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47251168","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}
B. Putro, Purwoko Purwoko, R. Supraptomo, Eka Putra, A. Sunjoyo
Myocardial ischemia can occur due to hypotension, shock, coronary heart disease, and aortic cross-clamping during open-heart surgery using a cardiopulmonary bypass machine. Cardioplegia is classified into the blood or crystalloid base as a cardioprotective method. This systematic review and meta-analysis aimed to describe the effectiveness of blood and crystalloids cardioplegic solutions in adult open-heart surgery by focusing on their effects on cardiac enzymes. This study investigated the effect of blood and crystalloid cardioplegia on troponin (cTn) and creatinine kinase myocardial bound (CKMB). The literature search was carried out on several Cochrane, PubMed, PMC, and Google Scholar databases from January 2014 to August 2020 using the medical subject heading keywords and Boolean operator. We obtained 346 articles and identified nine prospective randomized studies from five countries that met the eligibility criteria. The majority discussed the comparison of blood cardioplegia and crystalloids in coronary revascularization cardiac surgery (CABG). The cTn values (weighted mean difference [WMD] –2.67, confidence interval [CI] –4.18 to 1.17, P = 0.0005) and CKMB values (WMD –2.67, CI –4.18 to 1.17, P = 0.0005) 24 h operatively showed that the level of the cardiac enzymes increased in the crystalloids cardioplegia group more than the blood cardioplegia group. Overall, the articles used have a low risk of bias despite their high level of homogenicity. The current literature on cardioplegia in adults does not provide adequate advanced-phase trials. Both types of cardioplegia provide reasonable protection for the myocardium. However, several studies reveal that crystalloid cardioplegia increases cardiac enzymes more significantly than blood cardioplegia.
{"title":"The use of blood versus crystalloid cardioplegia in adult open heart surgery: A systematic review","authors":"B. Putro, Purwoko Purwoko, R. Supraptomo, Eka Putra, A. Sunjoyo","doi":"10.4103/bjoa.bjoa_62_22","DOIUrl":"https://doi.org/10.4103/bjoa.bjoa_62_22","url":null,"abstract":"Myocardial ischemia can occur due to hypotension, shock, coronary heart disease, and aortic cross-clamping during open-heart surgery using a cardiopulmonary bypass machine. Cardioplegia is classified into the blood or crystalloid base as a cardioprotective method. This systematic review and meta-analysis aimed to describe the effectiveness of blood and crystalloids cardioplegic solutions in adult open-heart surgery by focusing on their effects on cardiac enzymes. This study investigated the effect of blood and crystalloid cardioplegia on troponin (cTn) and creatinine kinase myocardial bound (CKMB). The literature search was carried out on several Cochrane, PubMed, PMC, and Google Scholar databases from January 2014 to August 2020 using the medical subject heading keywords and Boolean operator. We obtained 346 articles and identified nine prospective randomized studies from five countries that met the eligibility criteria. The majority discussed the comparison of blood cardioplegia and crystalloids in coronary revascularization cardiac surgery (CABG). The cTn values (weighted mean difference [WMD] –2.67, confidence interval [CI] –4.18 to 1.17, P = 0.0005) and CKMB values (WMD –2.67, CI –4.18 to 1.17, P = 0.0005) 24 h operatively showed that the level of the cardiac enzymes increased in the crystalloids cardioplegia group more than the blood cardioplegia group. Overall, the articles used have a low risk of bias despite their high level of homogenicity. The current literature on cardioplegia in adults does not provide adequate advanced-phase trials. Both types of cardioplegia provide reasonable protection for the myocardium. However, several studies reveal that crystalloid cardioplegia increases cardiac enzymes more significantly than blood cardioplegia.","PeriodicalId":8691,"journal":{"name":"Bali Journal of Anesthesiology","volume":"6 1","pages":"133 - 144"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46499546","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}
Amniotic fluid embolism (AFE) is a rare but potentially fatal condition of pregnancy. It is a diagnosis of exclusion and its management largely supportive. We present a case of a 36-year-old patient who was admitted at 32 weeks gestational age with an acute abdomen. She underwent an emergency Cesarean section for fetal distress secondary to possible placental abruption. This was complicated by post-delivery cardiac arrest and respiratory failure from suspected AFE, disseminated intravascular coagulation and severe postpartum hemorrhage. She was managed with vasopressors, point-of-care coagulation testing, massive transfusion, anti-fibrinolytics, fibrinogen concentrate and eventual hysterectomy. Post-operatively, she was treated for acute respiratory distress syndrome in the intensive care unit. She and her neonate survived with good outcome. We discuss the practical constraints faced in the diagnosis and management of AFE, due to a lack of specific diagnostic tests and the need for prompt high-quality resuscitation, simultaneous management of coagulopathy and massive hemorrhage, timely activation of senior personnel and the involvement of a multi-disciplinary team in a crisis situation.
{"title":"Amniotic fluid embolism with cardiac arrest and coagulopathy during Cesarean section: A case report","authors":"L. Lim, Xiu Sim, B. Sng","doi":"10.4103/bjoa.bjoa_96_22","DOIUrl":"https://doi.org/10.4103/bjoa.bjoa_96_22","url":null,"abstract":"Amniotic fluid embolism (AFE) is a rare but potentially fatal condition of pregnancy. It is a diagnosis of exclusion and its management largely supportive. We present a case of a 36-year-old patient who was admitted at 32 weeks gestational age with an acute abdomen. She underwent an emergency Cesarean section for fetal distress secondary to possible placental abruption. This was complicated by post-delivery cardiac arrest and respiratory failure from suspected AFE, disseminated intravascular coagulation and severe postpartum hemorrhage. She was managed with vasopressors, point-of-care coagulation testing, massive transfusion, anti-fibrinolytics, fibrinogen concentrate and eventual hysterectomy. Post-operatively, she was treated for acute respiratory distress syndrome in the intensive care unit. She and her neonate survived with good outcome. We discuss the practical constraints faced in the diagnosis and management of AFE, due to a lack of specific diagnostic tests and the need for prompt high-quality resuscitation, simultaneous management of coagulopathy and massive hemorrhage, timely activation of senior personnel and the involvement of a multi-disciplinary team in a crisis situation.","PeriodicalId":8691,"journal":{"name":"Bali Journal of Anesthesiology","volume":"6 1","pages":"191 - 195"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43739707","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 : 2022-07-01DOI: 10.4103/bjoa.bjoa_157_21
M. Lestari, Zulkifli, R. Zainal, Muhammad Mulia
Background: Medication error is one of the barriers to achieving sustainable patient safety. We aim to determine the efficacy and reliability of a smartphone dosage calculator application (AnesthCalc™) when compared with the manual calculation of various anesthetic drugs to prevent medication error. Materials and Methods: This is a pre-test–post-test intervention study. There are 52 participants who included residents in anesthesiology, which is divided into two groups. Each group performed two simulation cases in which they had to calculate drugs dosage in anesthesia settings. One set of cases was performed with the app and the other set was performed manually. The order of drugs and simulation patients was randomized. The accuracy and the deviation of administered drug doses were recorded. Accuracy of dosage was categorized as either accurate (80–100% of target dose) or inaccurate (less than 80%), whereas the deviation of dosage was categorized as either deviant (<50% or >200% of target dose) or safe (between the range). Results: There is a significant increase in the accuracy of calculation between the manual group and that using the app group (from 46% to 92%, a mean increase of 18.29%, P < 0.005). There is a significant decrease in the duration of calculation between without using the app group and with using the app group (from 32.92 to 18.79 s, a mean decrease of 30.55 s, P = 0.001). Conclusion: AnesthCalc™ is a valid and reliable instrument as it increases users’ accuracy and shortens calculating time. AnesthCalc™ may be the potential to reduce calculation errors and may increase patients’ safety.
{"title":"AnesthCalc™ is associated with superior accuracy and faster accomplishment in simulation-based anesthesia drugs dosage calculation","authors":"M. Lestari, Zulkifli, R. Zainal, Muhammad Mulia","doi":"10.4103/bjoa.bjoa_157_21","DOIUrl":"https://doi.org/10.4103/bjoa.bjoa_157_21","url":null,"abstract":"Background: Medication error is one of the barriers to achieving sustainable patient safety. We aim to determine the efficacy and reliability of a smartphone dosage calculator application (AnesthCalc™) when compared with the manual calculation of various anesthetic drugs to prevent medication error. Materials and Methods: This is a pre-test–post-test intervention study. There are 52 participants who included residents in anesthesiology, which is divided into two groups. Each group performed two simulation cases in which they had to calculate drugs dosage in anesthesia settings. One set of cases was performed with the app and the other set was performed manually. The order of drugs and simulation patients was randomized. The accuracy and the deviation of administered drug doses were recorded. Accuracy of dosage was categorized as either accurate (80–100% of target dose) or inaccurate (less than 80%), whereas the deviation of dosage was categorized as either deviant (<50% or >200% of target dose) or safe (between the range). Results: There is a significant increase in the accuracy of calculation between the manual group and that using the app group (from 46% to 92%, a mean increase of 18.29%, P < 0.005). There is a significant decrease in the duration of calculation between without using the app group and with using the app group (from 32.92 to 18.79 s, a mean decrease of 30.55 s, P = 0.001). Conclusion: AnesthCalc™ is a valid and reliable instrument as it increases users’ accuracy and shortens calculating time. AnesthCalc™ may be the potential to reduce calculation errors and may increase patients’ safety.","PeriodicalId":8691,"journal":{"name":"Bali Journal of Anesthesiology","volume":"6 1","pages":"182 - 186"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45362771","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 : 2022-07-01DOI: 10.4103/bjoa.bjoa_128_22
Sarin John, Vijay Adabala, M. Dhar
{"title":"Successful management of Roemheld syndrome: A diagnosis of exclusion","authors":"Sarin John, Vijay Adabala, M. Dhar","doi":"10.4103/bjoa.bjoa_128_22","DOIUrl":"https://doi.org/10.4103/bjoa.bjoa_128_22","url":null,"abstract":"","PeriodicalId":8691,"journal":{"name":"Bali Journal of Anesthesiology","volume":"6 1","pages":"196 - 197"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42540192","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 : 2022-07-01DOI: 10.4103/bjoa.bjoa_101_22
Aldy Heriwardito, S. Manggala, Suryo Widhyanti, Lara Aristya
Background: The incidence of PONV (Postoperative Nausea and Vomiting) and pain are still one of the most common symptoms of post-surgery and prophylaxis to reduce the event is needed. Therefore, we wanted to know the effectiveness of 1 mg intravenous haloperidol compared to 5 mg intravenous dexamethasone to prevent the occurrence of nausea and vomiting and to control pain in adult patients after laparoscopic surgery. Materials and Methods: Eighty subjects (n = 40 for each group) scheduled for laparoscopic-assisted surgery were enrolled in a randomized double-blind clinical trial. One milligram intravenous haloperidol was given one hour before the end of surgery, while 5 mg intravenous dexamethasone was given right after induction. The occurrence of PONV and VAS pain score were recorded. Results: This study showed a significant difference in the incidence of nausea between haloperidol and dexamethasone at 2–6 hours (5% vs 25%, P = 0.012), 6–12 hours (10% vs 24%, P = 0.012), and 12–24 hours (12.5% vs 60%, P < 0.001) after laparoscopic surgery. The incidence of vomiting after laparoscopic surgery between two groups was not significantly different (P > 0,05). However, haloperidol group resulted in lower VAS pain score at every postoperative period with statistically significant result. Conclusion: The administration of 1 mg intravenous haloperidol is significantly better than 5 mg intravenous dexamethasone to prevent the occurrence of nausea and to lower the pain, but not significantly different to prevent the incidence of postoperative vomiting in adult patients after laparoscopic surgery.
{"title":"Haloperidol vs. dexamethasone in lowering postoperative nausea and vomiting and pain in adult after laparoscopy: A randomized, double-blind study","authors":"Aldy Heriwardito, S. Manggala, Suryo Widhyanti, Lara Aristya","doi":"10.4103/bjoa.bjoa_101_22","DOIUrl":"https://doi.org/10.4103/bjoa.bjoa_101_22","url":null,"abstract":"Background: The incidence of PONV (Postoperative Nausea and Vomiting) and pain are still one of the most common symptoms of post-surgery and prophylaxis to reduce the event is needed. Therefore, we wanted to know the effectiveness of 1 mg intravenous haloperidol compared to 5 mg intravenous dexamethasone to prevent the occurrence of nausea and vomiting and to control pain in adult patients after laparoscopic surgery. Materials and Methods: Eighty subjects (n = 40 for each group) scheduled for laparoscopic-assisted surgery were enrolled in a randomized double-blind clinical trial. One milligram intravenous haloperidol was given one hour before the end of surgery, while 5 mg intravenous dexamethasone was given right after induction. The occurrence of PONV and VAS pain score were recorded. Results: This study showed a significant difference in the incidence of nausea between haloperidol and dexamethasone at 2–6 hours (5% vs 25%, P = 0.012), 6–12 hours (10% vs 24%, P = 0.012), and 12–24 hours (12.5% vs 60%, P < 0.001) after laparoscopic surgery. The incidence of vomiting after laparoscopic surgery between two groups was not significantly different (P > 0,05). However, haloperidol group resulted in lower VAS pain score at every postoperative period with statistically significant result. Conclusion: The administration of 1 mg intravenous haloperidol is significantly better than 5 mg intravenous dexamethasone to prevent the occurrence of nausea and to lower the pain, but not significantly different to prevent the incidence of postoperative vomiting in adult patients after laparoscopic surgery.","PeriodicalId":8691,"journal":{"name":"Bali Journal of Anesthesiology","volume":"6 1","pages":"157 - 161"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49439292","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}
{"title":"Technological Advances in Cardiac Anesthesia: We Live in Exciting Times Ensuring Better Patient Safety and Care","authors":"Kunal Sarin, Ajay Chandra, A. Garg","doi":"10.4103/bjoa.bjoa_58_22","DOIUrl":"https://doi.org/10.4103/bjoa.bjoa_58_22","url":null,"abstract":"","PeriodicalId":8691,"journal":{"name":"Bali Journal of Anesthesiology","volume":"6 1","pages":"123 - 124"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70698528","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}
Background: The severity of COVID-19 infection may depend on severe inflammation and hypercoagulability mechanisms. These processes may be rapidly identified in peripheral blood tests. This study aims to determine whether components of complete blood counts are able to predict the severity of COVID-19 infection. Materials and Methods: This is a prospective, observational analytical study carried out in the Indonesian population. We included all patients admitted to our hospital for COVID-19 during a 3-month period. We obtained blood samples for complete blood count examinations upon hospital admission. Confirmation of COVID-19 infection was based on a polymerase chain reaction test. Severe COVID-19 infection was determined if the patients had a Severe Community-Acquired Pneumonia (SCAP) score of >10. We collected blood samples upon hospital admission for leukocyte, neutrophil, lymphocyte, platelet, and monocyte counts. Results: We included 131 patients consisting of 77 (58.8%) males and 54 (41.2%) females. There were significant associations between neutrophil count and SCAP score (r = 0.28; P = 0.001) and platelet count (r = 0.023; P = 0.007). Upon regression analysis, we found that every 1,000 declines in platelet count was associated with increased risk (0.8%) of severe COVID-19, whereas every 1,000 declines in the neutrophil count was associated with decreased risk (18%) of severe COVID-19. Conclusion: There is a significant, weak positive correlation between neutrophil and platelet counts and the severity of COVID-19 infection as expressed by the SCAP score.
{"title":"Neutrophil and Platelet Count Upon Hospital Admission as Predictors of Severe COVID-19 Infection: An Observational Study","authors":"I. Bagiada, I. Widiana","doi":"10.4103/bjoa.bjoa_48_22","DOIUrl":"https://doi.org/10.4103/bjoa.bjoa_48_22","url":null,"abstract":"Background: The severity of COVID-19 infection may depend on severe inflammation and hypercoagulability mechanisms. These processes may be rapidly identified in peripheral blood tests. This study aims to determine whether components of complete blood counts are able to predict the severity of COVID-19 infection. Materials and Methods: This is a prospective, observational analytical study carried out in the Indonesian population. We included all patients admitted to our hospital for COVID-19 during a 3-month period. We obtained blood samples for complete blood count examinations upon hospital admission. Confirmation of COVID-19 infection was based on a polymerase chain reaction test. Severe COVID-19 infection was determined if the patients had a Severe Community-Acquired Pneumonia (SCAP) score of >10. We collected blood samples upon hospital admission for leukocyte, neutrophil, lymphocyte, platelet, and monocyte counts. Results: We included 131 patients consisting of 77 (58.8%) males and 54 (41.2%) females. There were significant associations between neutrophil count and SCAP score (r = 0.28; P = 0.001) and platelet count (r = 0.023; P = 0.007). Upon regression analysis, we found that every 1,000 declines in platelet count was associated with increased risk (0.8%) of severe COVID-19, whereas every 1,000 declines in the neutrophil count was associated with decreased risk (18%) of severe COVID-19. Conclusion: There is a significant, weak positive correlation between neutrophil and platelet counts and the severity of COVID-19 infection as expressed by the SCAP score.","PeriodicalId":8691,"journal":{"name":"Bali Journal of Anesthesiology","volume":"6 1","pages":"115 - 118"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43199213","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}
Walaa Saber, M. El-Ghannam, Y. Mubarak, H. Mahdy, R. Khorshid
Background: Histidine-tryptophan-ketoglutarate (HTK), Bretschneider’s, or Custodiol is an intracellular crystalloid cardioplegic solution which is claimed to offer single shot cardioplegia for myocardial protection during complex cardiac procedures for up to 3 h. We aimed to compare the clinical outcome of early coronary artery bypass grafting (CABG) using blood cardioplegia vs. Custodiol solution for myocardial protection in patients with recent ST-elevation myocardial infarction (STEMI). Materials and Methods: This prospective comparative study included 100 patients with recent STEMI who underwent early CABG at our institution between January 2019 and December 2020. The patients were divided into two groups: group A (n = 50) received blood cardioplegia and group B (n = 50) received Custodiol-HTK crystalloid cardioplegia. Results: There were non-significant differences in postoperative mortality and complication rates between both the groups except for significantly higher proportion of post-operative arrythmias after Custodiol cardioplegia (26% vs. 8%, P = 0.01). Custodiol was associated with significantly lower levels of blood troponin and higher levels of blood lactate for 6 h after CABG. Custodiol results in significantly shorter durations of mechanical ventilation (11.98 ± 4.03 vs. 18.28 ± 8.84 h, P < 0.001) and intensive care unit (ICU) stay (70.04 ± 14.80 vs. 80.20 ± 19.91 h, P = 0.01), with non-significantly shorter duration of post-operative hospital stay (7.98 ± 2.76 vs. 9.24 ± 3.41 days, P = 0.06). Conclusion: Custodiol as a single shot without interruption of the operative technique offers shorter durations of mechanical ventilation and ICU stay than blood cardioplegia, with more acceptable levels of post-operative troponin in high-risk patients who underwent early CABG for recent STEMI.
{"title":"Custodiol-HTK Solution Vs. Conventional Cardioplegia for Myocardial Protection During Coronary Artery Bypass Grafting Following Recent ST-Elevation Myocardial Infarction","authors":"Walaa Saber, M. El-Ghannam, Y. Mubarak, H. Mahdy, R. Khorshid","doi":"10.4103/bjoa.bjoa_20_22","DOIUrl":"https://doi.org/10.4103/bjoa.bjoa_20_22","url":null,"abstract":"Background: Histidine-tryptophan-ketoglutarate (HTK), Bretschneider’s, or Custodiol is an intracellular crystalloid cardioplegic solution which is claimed to offer single shot cardioplegia for myocardial protection during complex cardiac procedures for up to 3 h. We aimed to compare the clinical outcome of early coronary artery bypass grafting (CABG) using blood cardioplegia vs. Custodiol solution for myocardial protection in patients with recent ST-elevation myocardial infarction (STEMI). Materials and Methods: This prospective comparative study included 100 patients with recent STEMI who underwent early CABG at our institution between January 2019 and December 2020. The patients were divided into two groups: group A (n = 50) received blood cardioplegia and group B (n = 50) received Custodiol-HTK crystalloid cardioplegia. Results: There were non-significant differences in postoperative mortality and complication rates between both the groups except for significantly higher proportion of post-operative arrythmias after Custodiol cardioplegia (26% vs. 8%, P = 0.01). Custodiol was associated with significantly lower levels of blood troponin and higher levels of blood lactate for 6 h after CABG. Custodiol results in significantly shorter durations of mechanical ventilation (11.98 ± 4.03 vs. 18.28 ± 8.84 h, P < 0.001) and intensive care unit (ICU) stay (70.04 ± 14.80 vs. 80.20 ± 19.91 h, P = 0.01), with non-significantly shorter duration of post-operative hospital stay (7.98 ± 2.76 vs. 9.24 ± 3.41 days, P = 0.06). Conclusion: Custodiol as a single shot without interruption of the operative technique offers shorter durations of mechanical ventilation and ICU stay than blood cardioplegia, with more acceptable levels of post-operative troponin in high-risk patients who underwent early CABG for recent STEMI.","PeriodicalId":8691,"journal":{"name":"Bali Journal of Anesthesiology","volume":"6 1","pages":"97 - 102"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43996174","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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