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All Journal Jurnal Anestesiologi Indonesia Jurnal Anestesi Perioperatif Journal of Anesthesiology and Clinical Research

Fredi Heru Irwanto

Department Of Anesthesiology And Intensive Therapy, Faculty Of Medicine, Universitas Sriwijaya, Palembang, Indonesia

Author-ID : 3483032

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

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Correlation of Platelet-Lymphocyte Ratio (PLR) as 28-Days Sepsis Mortality Predictor in Intensive Care Unit of RSMH Palembang Tiara Santi Rizal; Fredi Heru Irwanto; Rizal Zainal; Mgs Irsan Saleh
Journal of Anesthesiology and Clinical Research Vol. 1 No. 2 (2020): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Introduction. Inflammatory and anti-inflammatory response are important in pathophysiology and mortality of sepsis. Platelet as first line inflammatory marker was found increasing during early phase of infection. Decrease in lymphocyte was caused by disrupted balance between inflammatory and anti-inflammatory response. Platelet-to- lymphocyte ratio (PLR) is a cheap and accessible biomarker of sepsis mortality. This study aims to find the sensitivity and specificity of PLR as mortality predictor of sepsis in 28 days. Methods. This observational analytic study with retrospective cohort design was conducted to 91 sepsis patients in intensive care unit of Dr. Mohammad Hoesin Palembang Central Hospital between January and December 2019. Samples were secondarily collected from medical record during June-July 2020. Data was analyzed using chi-square test, cog regression test, and ROC curve analysis. Results. The result found 50 patients (54,9%) died in 28 days. Morbidity score (Charlson) was the only statistically significant mortality parameter (p=0,009). The study reported PLR cut-off point of >272,22. The sensitivity and specificity of PLR as 28-days sepsis mortality predictor are 84% and 80,49% respectively. Conclusion. PLR is alternatively reliable mortality predictor in sepsis patient, accounted to its relatively high sensitivity and specificity.

The Effects of Ketamin-Midazolam and Ketamin-Propofol on Bispectral Index Score as Sedatives During Bone Marrow Puncture Procedure Among Pediatrics Aldiar; Fredi Heru Irwanto; Andi Miarta; Irfannuddin
Journal of Anesthesiology and Clinical Research Vol. 2 No. 1 (2021): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Background: Bone Marrow Puncture (BMP) is an invasive procedure associated with pain and anxiety. The ketamine-midazolam and the ketamine-propofol is an effectivecombination with minimal side effects. This study of the study aims to compare the effect of the combination of ketamine-midazolam and ketamine- propofol on sedation depth based on BIS in pediatric leukemia patients undergoing BMP. Methods: This study was a randomized controlled trial that was done single-blinded. The population was all pediatric patients diagnosed with leukemia who underwent BMP at RSMH and performed sedation. The research sample is the population that fulfill the inclusion and exclusion criteria. The sample size for each group was 25, with 50 Subjects in total. Sampling was done by block randomization. Results: This study found no differences in sex, age, and body weight between the two groups ([p=1.000], [p=0.845], and [p=0.147], respectively). In this study, there was no difference in mean MAP (p=0.592), oxygen saturation (p=0.164), heart rate (p=0.098), and respiratory rate (p=0.252) before intervention between the two groups. BIS value of the two groups had significant difference before and after the intervention where the two groups could reduce BIS to reach the optimal value of sedation <60 (p <0.05) There was no difference in BIS before intervention in the two groups (p=0.385). In this study, it was found that hypersalivation occurred more frequently in the ketamine-midazolam combination group. Conclusion: The combination of ketamine-midazolam and ketamine-propofol was equally good for sedation as indicated by a decrease in the mean BIS in patients undergoing BMP.

The Effectiveness of Mometasone Spray and Triamcinolone Acetonide Gel in Preventing Sore Throat, Cough, and Hoarse after Intubation Zentika. I. Fajri; Fredi Heru Irwanto; A Miarta; Theodorus
Journal of Anesthesiology and Clinical Research Vol. 2 No. 1 (2021): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Background: Endotracheal intubation is a procedure performed by inserting an endotracheal tube into the airway. With endotracheal intubation, there can be several complications ranging from mild to severe. Sore throat, coughing, and hoarseness were several endotracheal intbation complications. From several studies, it was found that the incidence of POST was 21-65%. This study aimed to determine the efficacy between 0.1% triamcinolone acetonide gel and 100 mcg mometasone spray in reducing sore throat, cough, and hoarseness due to endotracheal intubation. Method: A Randomized Controlled Trial, Open-Label was carried out on patients undergoing endotracheal intubation with general anesthesia in RSMH operating room from September 2020 - November 2020. Seventy-two study subjects met the inclusion criteria and were divided into two groups, namely the triamcinolone acetonide gel group, and the mometasone spray group. Analyzing data was SPSS version 23. Result: There were no difference between age, sex, ASA PS classification, and length of operation between the two groups (p> 0.05). Mometasone spray 100 mcg and triamcinolone acetonide gel 0.1% had the same effectiveness to reduce endotracheal intubation such as sore throat, cough, and hoarseness within 24 hours of endotracheal intubation (p> 0.05). There was a significant difference in the incidence of sore throat between two groups in the first hour (p = 0.039). Conclusion: There was no statistically significant difference between the efficiency of mometasone spray 100 mcg and triamcinolone acetonide gel 0.1% on a sore throat, cough, and hoarseness within 24 hours of endotracheal intubation (p > 0.05).

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.

Co-Authors A Miarta Aldiar Andi Miarta Chairil Gani Koto Irfannuddin Irfannuddin Legiran Mgs Irsan Saleh Nadia Maharni Puspita, Yusni Rizal Zainal Rudy Yuliansyah Rudy Yuliansyah Theodorus Tiara Santi Rizal Yuliansyah, Rudy Yusni Puspita Zentika. I. Fajri Zulkifli

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