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Zulkifli

Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Universitas Sriwijaya, Palembang, Indonesia

Author-ID : 3483031

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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Positive Cumulative Fluids Balance Related to Mortality Events in Sepsis Patients Treated at Intensive Care Unit, Dr. Mohammad Hoesin General Hospital Palembang Zulkifli; Fredi Heru Irwanto; Legiran; Nadia Maharni
Journal of Anesthesiology and Clinical Research Vol. 2 No. 2 (2021): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Introduction. Sepsis is a syndrome that describes physiological dysfunction, pathological, and biochemistry caused by infection. Fluid balance is an indicator that can monitor input and output. This study was aimed to evaluate the relationship between positive cumulative fluid balance and the mortality rate of sepsis patients treated in the intensive care unit. Method: This study design is a retrospective study. The inclusion criteria consist of patients diagnosed with sepsis written in the medical record, 18-65 years old, and patients admitted in intensive care unit dr Moh. Hoesin General Hospital. Data were analyzed using SPSS 22.0 with the normality of data distribution, independent sample t-test, Mann-Whitney analysis, chi-square, Fisher’s Exact to measure the relationship, and using Medcalc version 14 application to measure cut-off value, ROC curve AUC, cross-sectional point, sensitivity, and specificity. Result. The result showed that characteristic between age (p=0,491), gender (p=0,703) did not differ significantly between survived and non-survived patient. Length of stay (p=0,002), balance (p=0,000), and ward unit (p=0,014) has a significant different between survived and non survived patient. In chi square analysis, p value=0,000with odds ratio 7,083. Cut-off value of ROC curve is -97 mL with AUC 0,844, sensitivity 76,1% and specificity 79,3%. Conclusion. Cumulative positive balance patient in the sepsis patient correlates with increased mortality in a sepsis patient in Dr. Mohammad Hoesin General Hospital Palembang.

The Comparison of Duration Endotracheal Tube Insertion Using Aerosol Box And without Aerosol Box in Elective Surgery Patients in the Covid-19 Pandemic Zulkifli; Agustina Br Haloho; Legiran; Muhammad Ikhsan Kartawinata
Journal of Anesthesiology and Clinical Research Vol. 2 No. 2 (2021): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Introduction. The aerosol box can reduce the risk of droplet and aerosol transmission from the patient to the operator when performing intubation, but in practice, an aerosol box makes the glottis visualization less evident, and the operator moves less space with less space the aerosol box. This study aimed to compare ETT duration using an aerosol box and without an aerosol box using a video laryngoscope. Methods: This study was a clinical trial with a post-test-only control design. The study was carried out from February 2021 to May 2021 at the Central Operating Theater of dr. Mohammad Hoesin General Hospital Palembang. The sample in this study was all patients who underwent elective surgery under general anesthesia using intubation at the Central Surgical Installation of dr. Mohammad Hoesin Palembang. After the data is collected, it is analyzed using the SPSS 22.0 program with the appropriate test. Results. There were no differences in subject characteristics (age, sex, BMI, Mallampati score, TMD, Cormack Lehane, limited mouth opening, short neck, limited mouth movement) between the group using the aerosol box and the group without the aerosol box. The duration of intubation without an aerosol box is 30.67 + 2.63 seconds, and using an aerosol box is 44.53 + 2.89 seconds. There was a significant difference between the two groups in the duration of patient intubation (p < 0.001). However, there was no significant difference in complications in the two groups (p >0.05). Conclusion. The duration of the endotracheal tube insertion using an aerosol box is more extended than without an aerosol box in elective surgery patients.

The Comparison of Plasma Cortisol Levels between 0.125% Bupivacaine and 5 mg Continuous Oxycodone in Lower Extremity Orthopedic Surgery Zulkifli; Agustina Br Haloho; Legiran; Pirma I.R.M
Journal of Anesthesiology and Clinical Research Vol. 2 No. 2 (2021): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Introduction: Pain is a problem often encountered in postoperative patients. Study has shown after a procedure, 80% patients experience acute pain. This postoperative pain will affect patient’s quality of life therefore necessitating quick and proper treatment. Tissue trauma during surgery will have influence on body system, including endocrine. One of endocrine system response is cortisol secretion. Cortisol levels may be attenuated by bupivacaine and oxycodone. The aim of this study was to determine the efficacy of bupivacaine0,125% and oxycodone 5 mg on pain perception measured by cortisol in patients undergoing orthopedic surgery of the lower limb. Methods: A randomized clinical trial, double-blind study was performed at Mohammad Hoesin General Hospital in Palembang, South Sumatra, from November to May 2021. There were forty samples and divided into two groups (bupivacaine 0,125% and oxycodone 5 mg). Groups were divided by block randomization by computerized random number generator. Blinding were done by making analgesic has the same packages to prevent knowledge of which intervention is being done. Data were analyzed using independent t-test, ANOVA, Mann-Whitney and Chi Square with SPSS version 22.0. Results: There were no statistically significant differences between the two groups on age, gender, body mass index and duration of surgery. In bupivacaine group, cortisol level decreased from 12.94±6.99 µg/dl to 11.32±5.42 µg/dl meanwhile oxycodone group cortisol levels increased from 11.81±8.47 µg/dl to 11.82±7.56 µg/dl. There were no significant difference between two groups relating to cortisol levels. Conclusions: No significant difference was found on administration of bupivacaine 0,125% and oxycodone 5 mg as epidural analgesia on cortisol level in postoperative orthopedic surgery of the lower limb patient.

Correlation of SOFA Score and Hormone Value for Predicting 28-days Mortality for Septic Patients Zulkifli; Agustina Br Haloho; Ziske Maritska; Dipta Anggara
Journal of Anesthesiology and Clinical Research Vol. 2 No. 2 (2021): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Introduction. Sepsis is a group of symptoms of organ dysfunction that can be life-threatening because of dysregulation of body response toward ongoing infection. Organ dysfunction in sepsis can be measured by Sequential Organ Failure Assessment (SOFA) and T3 hormone. The study was aimed to identify the correlation of T3 in predicting mortality of 28 days patients in Intensive Care Unit RSMH Palembang. Method. This study design is cohort prospective. The inclusion criteria consist of a patient diagnosed with sepsis and septic shock in the Intensive Care Unit, 18-64 years old. Patients with a history of thyroid disease, pregnant or post-pregnancy, the patient admitted in referral from other hospitals, and patients with a history of psychiatry medication and thyroid medication were excluded. Data collected is the patient whose stay in Intensive Care Unit RSMH followed in 28 days from January 2021 until the sample was fulfilled (39 samples). Analyzing data was SPSS version 23 with chi-square analysis and Fisher's Exact to identify the relationship. Pearson correlation to identify correlation coefficient, and Medical application to measure AUC, cutoff value, sensitivity, and specificity. Result. The result showed that age (p=0,445). gender (p=1,00), need of ICU (p=0,228), isolation-nonisolation ward (p=0,437) didn't have any significant relationship toward mortality. SOFA score correlate statistically with positive correlation and medium strength (0,633) toward mortality of sepsis patient (p=0,000). T3 hormon correlate positively with medium strength (0,514) toward mortality of sepsis patient (p=0,001). T3 hormone toward SOFA correlate negatively (-0,365) with significant correlation (p=0,22). T3 hormone has AUC 0,291 with sensitivity 3,3% and specificity 67,7%. Conclusion. T3 hormone has a significant negative correlation to mortality in sepsis patients but cannot be used to predict mortality with a low AUC value (0,291).

Co-Authors Dipta Anggara Fredi Heru Irwanto Legiran Muhammad Ikhsan Kartawinata Nadia Maharni Pirma I.R.M Ziske Maritska

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