Zainal, Rizal
Perdatin Pusat

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Hubungan antara Klorheksidin 0,2% dan Povidone Iodine 1% dengan Ventilator-Associated Pneumonia (VAP): Studi Kohort Lestari, Mayang Indah; Puspita, Yusni; Zainal, Rizal; Theodorus, Theodorus
Majalah Anestesia dan Critical Care Vol 34 No 1 (2017): Februari
Publisher : Perdatin Pusat

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Abstract

Ventilator-associated pneumonia (VAP) adalah infeksi nosokomial tersering di ruang Intensive Care Unit (ICU) RSUP Dr. Moh. Hoesin (RSMH) Palembang, angka kejadiannya pada bulan Juli 2011–Juni 2012 cukup tinggi (31,69%) dengan angka mortalitas 54,7%. Mekanisme utama dalam patogenesis VAP ialah aspirasi bakteri gram positif dan negatif patogenik yang berkoloni di daerah orofaring. Tindakan modulasi kolonisasi tersebut sangat bermakna dalam mencegah VAP. Pemberian povidon iodin 1% dan klorheksidin 0,2% sudah sering dilakukan namun belum ada penelitian mengenai hubungannya terhadap kejadian VAP. Penelitian ini bertujuan untuk mengetahui hubungan antara klorheksidin 0,2% dan povidoneiodine 1% terhadap kejadian VAP. Studi kohort telah dilakukan di ICU RSMH pada bulan Februari – Juli 2014. Terdapat 32 subjek penelitian yang memenuhi kriteria inklusi dan dibagi menjadi dua kelompok, yaitu yang mendapatkan klorheksidin 0,2% dan povidoneiodine 1%. Dilakukan uji χ2 menggunakan statistical program and service solution (SPSS) versi 21.0. Karakteristik umum subjek penelitian yang meliputi usia, jenis kelamin, skor APACHE II, diagnosis, dan lama intubasi antara dua kelompok tidak menunjukkan perbedaan bermakna (p>0,05). Terdapat hubungan antara povidoneiodin 1% dan klorheksidin 0,2% terhadap kejadian VAP (RR 1,286) namun hubungan tersebut tidak bermakna (p=0,48). Kata kunci: Klorheksidin 0,2%, kolonisasi, orofaring, povidoneiodin 1%, ventilator associated pneumonia Relationship between Chlorhexidine 0.2% And Povidone Iodine 1% with Ventilator-Associated Pneumonia: Cohort Study Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in intensive care unit (ICU) in RSUP Dr. Moh. Hoesin (RSMH) Palembang, its incidence from July 2011 to June 2012 is quite high (31.69%) with mortality rate as high as 54.7%. Major mechanism in VAP pathogenesis is oropharygeal positive and negative pathogenic colonization aspiration. Colonization modulating intervention is signifantly important in VAP prevention. Povidoneiodine 1% and chlorhexidine 0.2% has been frequently used but there is no study yet about their correlation with VAP. This study was determined the correlation is between chlorhexidine 0.2% and povidone iodine 1% to VAP. Cohort study was conducted in ICU RSMH since February to July 2014. There was 32 subjects included and divided into two groups, chlorhexidine 0,2% and povidon iodine 1%. Analysis has been done with χ2 test by using SPSS® version 21.0. General characteristics among subjects in both groups including age, sex, APACHE II score on admission, diagnosis, and duration of intubation were not significantly different (p>0.05). There was a correlation between Povidoneiodine 1% and chlorhexidine 0.2% with VAP incidence (RR 1.286) but was not statistically significant (p=0.48).  Key words: Chlorhexidine 0.2%, colonization, oropharyngeal, povidon iodine 1%, ventilator-associated pneumonia
Co-administration of dexmedetomidine and levobupivacaine results in better onset and duration of epidural anesthesia in lower extremity orthopedic surgery Zulkifli, H.; Affandi, Ihsan; Zainal, Rizal; ., Theodorus
Bali Journal of Anesthesiology Vol 3, No 1 (2019)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (533.523 KB) | DOI: 10.15562/bjoa.v3i1.61

Abstract

ABSTRACTBackground: The goal of this study is to know the efficacy of the addition of 0.5 mcg/kg dexmedetomidine to 15 mL isobaric 0.5% levobupivacaine on the onset and duration of sensory and motor blockade of epidural anesthesia in lower extremity orthopedic surgery.Methods: Randomized clinical double-blind trials were conducted in Dr. Mohammad Hoesin Hospital Palembang. A total of 34 patients underwent lower extremity surgery met the inclusion and exclusion criteria. Data were analyzed by independent t-test and Mann-Whitney test using SPSS 22.0 software.Result: The onset of sensory block in group D was 5.41±1.84 minutes compared to 17.59± 2.65 in Group C (p <0.001), as seen in Table 2. The sensory block duration was 362.41±25.66 minutes in Group D compared to 215.82±15.69 in Group C (p <0.001). The onset of the motoric block in group D was 16.53±1.81 minutes compared to 26.12±2.78 in Group C (p <0.001), while the motoric block duration was 301.29±20.55 minutes in Group D compared to 167.35±17.24 in Group C (p <0.001).Conclusion: The addition of 0.5mcg/kg dexmedetomidine to 15 ml isobaric 0.5% levobupivacaine in epidural anesthesia provide faster onset and prolonged duration in both motoric and sensory block in patients undergoing lower extremity surgery