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All Journal Medical Journal of Indonesia Majalah Anestesia dan Critical Care
Amir S Madjid
Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, University of Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Health Professions Medicine & Pharmacology

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Thoracic epidural anesthesia attenuates hemorrhagic-induced splanchnic hypo-perfusion in post-resuscitation experimental hemorrhagic shock Madjid, Amir S
Medical Journal of Indonesia Vol 17, No 2 (2008): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (462.129 KB) | DOI: 10.13181/mji.v17i2.304

Abstract

The purpose of present study was to assess the effects of thoracic epidural anesthesia on splanchnic perfusion, bacterial translocation and histopathologic changes in experimental hemorrhagic shock in short-tailed macaques (Macaca nemestrina). Sixteen Macaca nemestrinas were randomly assigned to one of two groups i.e. the lidocaine group (n = 8), receiving general anesthesia plus lidocaine thoracic epidural anesthesia; and the saline group (n = 8), receiving general anesthesia alone as control. Hemorrhagic shock was induced by withdrawing blood gradually to a mean arterial pressure (MAP) of 40 mm Hg, and maintained for 60 minutes. Animals were then resuscitated with their own blood and ringer lactate solution (RL). After resuscitation, epidural lidocaine 2% was given in the lidocaine group and saline in the control group. Resuscitation that was performed after one hour hemorrhagic shock, with hemodynamic variables and urine output returned to normal, revealed there was no improvement of splanchnic perfusion. PgCO2, P(g-a)CO2, and pHi remained in critical value and tended to deteriorate in the saline group. Contrast to saline group, splanchnic perfusion in lidocaine group tended to improve. This condition was supported by the finding of less bacterial translocation and better histopathologic changes in lidocaine thoracic epidural anesthesia group than in saline group. This study concludes that lidocaine thoracic epidural anesthesia attenuates splachnic hypoperfusion in post-resuscitation hemorrhagic shock in Macaca nemestrina. (Med J Indones 2008; 17: 73-81)Keywords: thoracic epidural anesthesia, lidocaine, hemorrhagic shock, splanchnic hypoperfusion, bacterial translocation
Correlation between Modified Clinical Pulmonary Infection Score with Duration of Mechanical Ventilation of Pneumonia Patient in ICU Cipto Mangunkusumo Hospital Madjid, Amir S; Sugiarto, Adhrie; Putri, Regina Prima; Alatas, Anas
Majalah Anestesia dan Critical Care Vol 33 No 2 (2015): Juni
Publisher : Perdatin Pusat

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Abstract

Current extubation parameters are not entirely accurate. Therefore, weaning from mechanical ventilation is difficult, especially in pneumonia patient. One of scoring system for evaluation of pneumonia patient is modified clinical pulmonary infection score (MCPIS). This score evaluates temperature, leucocyte count and differential count, volume and consistency tracheal secretion, oxygenation and chest x-ray. This study aimed to estimate the correlation between MCPIS score with duration of mechanical ventilation of pneumonia patient in ICU Cipto Mangunkusumo Hospital. This was a prospective cohort study among pneumonia patients with mechanical ventilation at ICU Cipto Mangunkusumo Hospital from October 2014 to February 2015. MCPIS were measured at the point of admission and 72 hours after admission. Date of extubation was recorded to determine the duration of mechanical ventilation. There were 48 subjects included in this study. Early MCPIS score (median 6) was higher than MCPIS score after 72 hours (median 5) with mechanical ventilation duration 3-19 days (median 7). There was no significant correlation between early MCPIS score with mechanical ventilation duration (p=0,180; r=0,197). There was significant moderate correlation between MCPIS score after 72 hours with mechanical ventilation duration (p=0,000; r=0,539). This study concluded there was significant correlation between MCPIS after 72 hours with mechanical ventilation duration in pneumonia patients in ICU.
Co-Authors Alatas, Anas Putri, Regina Prima Sugiarto, Adhrie