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All Journal Jurnal Anestesiologi Indonesia Jurnal Berita Ilmu Keperawatan Indonesian Journal of Anesthesiology and Reanimation (IJAR) Solo Journal of Anesthesi, Pain and Critical Care Journal of Anesthesiology and Clinical Research
Yunita Widyastuti
Department Of Anesthesiology And Intensive Care, Faculty Of Medicine, Public Health, And Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Proporsi Kejadian Awareness selama Anestesi Umum pada Pasien Pediatrik dengan Monitored Anesthesia Care (MAC) Yunita Widyastuti; Fadhilah Zulfa; Djayanti Sari
JAI (Jurnal Anestesiologi Indonesia) Vol 13, No 1 (2021): Jurnal Anestesiologi Indonesia
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v13i1.25264

Abstract

Latar Belakang: Selama anestesi berlangsung, awareness intraoperatif dapat terjadi. Kejadian awareness intraoperatif pada pasien dewasa dengan anestesi umum dilaporkan sebesar 0,1%, sedangkan pada pasien pediatrik sebesar 2,7% dan 5%. Penelitian mengenai awareness intraoperatif pada pasien pediatrik dengan monitored anesthesia care (MAC) belum pernah dilakukan di RSUP Dr. Sardjito Yogyakarta.Tujuan: Mengetahui angka kejadian awareness selama anestesi umum pada pasien pediatrik dengan MACMetode: Studi observasional dilakukan pada 30 pasien pediatrik (usia 1-18 tahun) yang direncanakan akan dilakukan MAC. Kedalaman anestesi dimonitor dengan menggunakan index of consciousness (IoC) dan skor pressure, heart rate, sweating, tears (PRST)/Skor Evan. Proporsi awareness dianalisis dan dikelompokkan dalam kriteria-kriteria seperti usia, jenis kelamin, status fisik, indikasi tindakan yang dilakukan, serta medikasi yang digunakan untuk anestesi.Hasil: Pasien dengan nilai IoC positif awareness sebesar 63,3%, sedangkan pasien dengan skor PRST positif awareness sebanyak 3,33%. Penjelasan mengapa hasil dari IoC lebih besar adalah karena nilai pada IoC dapat dipengaruhi oleh nistagmus yang terjadi pada pasien-pasien yang menggunakan ketamin (15/30 (50%)).Kesimpulan: Kejadian awareness intraoperatif pada pasien pediatrik dengan prosedur MAC di RSUP Dr. Sardjito sebanyak 3,33%. Pencegahan awareness diperlukan agar awareness tidak terjadi lagi di kemudian hari.
The Voice of the Qur'an's Potential in Pain Management : Review Study Iwan Purnawan; Yunita Widyastuti; Sri Setiyarini; Probosuseno Probosuseno
Jurnal Berita Ilmu Keperawatan Vol 15, No 2 (2022): July 2022
Publisher : Universitas Muhammadiyah Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23917/bik.v15i2.16990

Abstract

Pain is multidimensional. Pharmacological therapy is still not optimal and has unwanted side effects. Therefore, a safe, effective, and comprehensive non-pharmacological therapy is needed to compensate for the lack of pharmacological therapy. Listening to the recitation of the Quran in several studies has been shown to have a relaxing effect in various situations. The study aims to see whether listening to the Quran as a type of non-pharmacological therapy will help people overcome pain. Method used is comprehensive search on multiple databases (Clinical Key, Cochrane Lab, Medline, Host EBSCO, ProQuest, Science Direct, and Springer Link) using the term "Quran, Holy Quran, Koran, Quran, Pain, Pain Management, and endorphins.". There were 209 articles found, and after several screening stages, 9 articles met the inclusion and exclusion criteria. The level of evidence and the Cochrane Collaboration's tool for assessing the risk of bias was used to assess the article's quality.  The result is listening to The Qur'an has been shown to reduce pain in post-surgery, blood sampling, wound care, dysmenorrhea, and childbirth. Some studies are still lacking evidence and are biased. Listening to the Quran is highly recommended for use as a health service.
Outcome Comparison Between Insulin-Dependent and Non Insulin-Dependent Patients after Open Adult Cardiac Surgery Juni Kurniawaty; Budi Yuli Setianto; Supomo Supomo; Yunita Widyastuti; Cornelia Ancilla; Cindy Elfira Boom
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 3, No 1 (2023): April 2023
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v3i1.66306

Abstract

Background: Insulin-dependent diabetic patients usually have poor glycemic control and higher risk of complications than non-insulin-dependent diabetic patients. However, the difference in clinical outcomes between these two groups of patients who underwent open cardiac surgery was not established. Therefore, this study compares the short-term outcome of insulin vs non-insulin-dependent diabetic patients after open cardiac surgery in a large-scale study.Methods: The study design was a retrospective cohort. All adults who underwent open cardiac surgery between January 1st 2016-December 31st 2020 in 4 tertiary hospitals in Indonesia were included in the study. From a total of 4.931 samples included in the study, 3.753 patients were non-diabetic (Group I) and 1.178 were diabetic (Group II). Group II was divided into subgroup IIA (930 non-insulin-dependent) and subgroup IIB (248 insulin-dependent). The main outcome was in-hospital mortality of open cardiac surgery patients.Result: In-hospital mortality between group I and II had no significant difference (6.8% vs 5.7%; p = 0.188), as well as IIA and IIB (5.6% vs 6%; p = 0.782). Multivariate analysis demonstrated that diabetes did not increase mortality of open cardiac surgery (OR 0.665; p = 0.021). In-hospital mortality of subgroup IIB was higher than subgroup IIA, but insulin therapy did not increase the risk of in-hospital mortality (OR 1.259; p = 0.464).Conclusion: Both insulin-dependent and non-insulin-dependent diabetes mellitus were not the predictors of poor short-term outcomes for open adult cardiac surgery patients.
Validity of Acute Physiology and Chronic Health Evaluation (APACHE) IV for the Prediction of Prolonged Intensive Care Unit (ICU) Length of Stay in Dr. Sardjito General Hospital in the COVID Era Muhammad Mufti Sofyanoor; Yunita Widyastuti; Juni Kurniawaty; Djayanti Sari
Journal of Anesthesiology and Clinical Research Vol. 4 No. 2 (2023): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jacr.v4i2.302

Abstract

Introduction: APACHE IV was a good predictor of ICU length of stay in the USA and some countries outside the USA but poor in others. It is important to develop a scoring system for the Indonesian population, especially in this scope, Dr. Sardjito General Hospital. To develop such a scoring system, it is reasonable to study the validity of APACHE IV in ICU Dr. Sardjito General Hospital for predicting prolonged length of stay. Methods: A retrospective cohort observational study using data from January 1st, 2020, to December 31st, 2020, taken from the ICU of Dr. Sardjito General Hospital. The data are the patient's observed ICU LOS and data required in calculating APACHE IV score and ICU LOS prediction. Discrimination is calculated using the area under (AUC) the receiver operating characteristic curve (ROC) and calibration by the Hosmer-Lemeshow test. Results: Samples were 329 patients. APACHE IV ICU length of stay prediction showed moderate discriminatory ability (AUC-ROC: 0.74) and poor calibration (p <0.001) to predict prolonged ICU stay. The APACHE IV score has a strong discriminatory ability (AUC-ROC: 0.83). Using the DeLong method, the AUC from ROC APACHE IV score was greater than the AUC from ROC predicted length of stay in APACHE IV ICU (p <0.001). APACHE IV predicted ICU length of stay overestimated observed ICU length of stay. Conclusion: APACHE IV ICU length of stay prediction has moderate discrimination and poor calibration to predict prolonged ICU stay. The APACHE IV score has better discrimination than the APACHE IV ICU length of stay prediction in predicting prolonged ICU stay.
Validation of the APACHE IV Score for ICU Mortality Prediction in Dr. Sardjito Hospital During the Pandemic Era Rayhandika; Akhmad Yun Jufan; Yunita Widyastuti; Juni Kurniawaty
Indonesian Journal of Anesthesiology and Reanimation Vol. 5 No. 2 (2023): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V5I22023.72-80

Abstract

Introduction: ICU service quality must continuously improve to provide better patient service. One of these improvement efforts is the use of a risk prediction system to predict mortality rates in the ICU by utilizing risk factors. This system helps healthcare services perform evaluations and comparative audits of intensive services, which can also aid with more targeted planning. APACHE IV is considered to have good validity. However, its predictive capabilities may change over time due to various factors, such as the pandemic, where changes in the case mix may affect its predictive abilities. Therefore, this research tests the validity of APACHE IV on the Indonesian population through Dr. Sardjito Hospital patients. The findings can be utilized for future use and risk stratification, and ICU quality benchmarking. Objectives: This study aims to assess the validity of the APACHE IV score in ICU Mortality prediction in Dr. Sardjito Hospital for medical patients, surgical patients, and patients with both cases during the pandemic. Materials and Method: This study used retrospective data from 336 patients at Dr. Sardjito Hospital Yogyakarta from the 1st of January 2020 to the 31st of December 2021. All data required for calculating the APACHE IV score was collected, and the patient’s observed ICU Mortality was used. The model’s predictive validity is measured by finding the discrimination and calibration of the APACHE IV score and comparing it to the observed ICU mortality. Validation was also conducted separately for medical and surgical cases. Results: APACHE IV shows good discrimination ability in all cases (AUC-ROC 95% CI: 0.819 [0.772-0.866]) but poor calibration (p = 0.023) for mortality prediction in the ICU. For medical cases, the discrimination ability is poor but still acceptable (AUC-ROC 95% CI: 0.698 [0.614-0.782]), and in surgical cases, the discrimination ability is good (AUC-ROC 95% CI: 0.848 [0.776-0.921]). Both cases showed good calibration (p: medical = 0.569, surgical = 0.579) in predicting mortality during the pandemic. Conclusion: APACHE IV showed good discrimination but poor calibration ability for predicting mortality for all ICU patients during the pandemic era. Mortality prediction for surgical cases showed good discrimination and calibration. However, medical cases showed poor discrimination but good calibration.
Co-Authors Akhmad Yun Jufan Budi Yuli Setianto Cindy Elfira Boom Cornelia Ancilla Djayanti Sari Fadhilah Zulfa Iwan Purnawan Juni Kurniawaty Juni Kurniawaty Juni Kurniawaty Muhammad Mufti Sofyanoor Probosuseno Probosuseno Rayhandika Sri Setiyarini Supomo Supomo