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All Journal Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Philia Setiawan
Department of Anesthesiology and Reanimation, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
Medicine & Pharmacology

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Profile of Airway Patency, Respiratory Rate, PaCO2, and PaO2 in Severe Traumatic Brain Injury Patients (GCS Maria Marind Desrianti Hutauruk; Ira Dharmawati; Philia Setiawan
Indonesian Journal of Anesthesiology and Reanimation Vol. 1 No. 2 (2019): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (172.032 KB) | DOI: 10.20473/ijar.V1I22019.32-37

Abstract

Introduction: Traumatic Brain Injury (TBI) is the most common neurotrauma with high morbidity and mortality. Many guidelines recommend the use of mechanical ventilation for severe TBI patients, but there are limited resources of procuring ventilator machine in hospitals especially in developing countries. Yet it is not comparable with the number of TBI patients. Objective: This study is purposed to provide the profile of ventilation and oxygenation (airway patency, RR, PaCO2, and PaO2) in severe TBI patients (GCS<9) admitted in the Emergency Room (ER) of Dr. Soetomo General Academic Hospital Surabaya. Method and Material: This is a retrospective study using medical records of patients with TBI who were admitted in the ER of Dr. Soetomo General Academic Hospital from January to December 2017. The patient's general characteristics, blood gas analysis (PaCO2, PaO2), airway patency were recorded and analyzed. Results and Discussion: Thirty-seven severe TBI patients were included in the analysis. 30 men (81.1%) and 7 women (18.9%) with an average of 37±16 years old (range: 5-65) were studied. Most of the patients (94.6%) had MAP between 60 and 160 mmHg, PaCO2<35 mmHg (72.9%), PaO2>60 mmHg (100%), RR>20 breaths per minute (70.2%), and patent airways (64.9%) with simple support of oxygen. 8.1% of all of those patients had PaCO2>45 mmHg. Conclusion: Most of the severe TBI admitted in the ER of Dr. Soetomo General Academic Hospital had hypocapnia or respiratory rate higher than the normal range. Though one-third of the patient has partial obstruction of the airway, no significant hypoxemia is found.
Comparing Alteration of MMSE (Mini-Mental State Examination) Scores as Cognitive Function Test in Geriatrics After General and Regional Anesthesia Ferrie Budianto; Philia Setiawan; Hamzah Hamzah; Erikavitri Yulianti
Indonesian Journal of Anesthesiology and Reanimation Vol. 2 No. 2 (2020): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (526.621 KB) | DOI: 10.20473/ijar.V2I22020.47-52

Abstract

Introduction: An alteration of cognitive function in geriatrics often occurred after a surgery procedure. To do a surgery, patients would go through the process with anesthesia, whether it is  general or regional anesthesia. We aimed to identify the effect of general and regional anesthesia in increasing the risk of alteration in cognitive function from geriatrics who underwent elective surgery followed by other risks. Material and Method: This observational analytic study has a total sample of 60 patients who aged 60 years or more, and half of the total sample underwent an elective surgery with general anesthesia, whereas the other half with regional anesthesia at Gedung Bedah Pusat Terpadu Dr. Soetomo General Hospital in a range of October – November 2016. The cognitive function of patients was assessed with MMSE which is done in approximately 10 – 15 minutes. Result and Discussion: There was a statistically significant correlation between age and both preoperative MMSE score also the alteration of MMSE score after 3 days in patients with regional anesthesia (P-value = 0.032; 0.044). Also, the correlation between educational status and preoperative MMSE score (P-value = 0.001). There was also a statistically significant difference in alteration of the MMSE score after 3 days between patients with general and regional anesthesia which went through the hypotension phase (P-value = 0.022; 0.003). We identified that both general and regional anesthesia could lead to alteration of MMSE score (P-value = 0.001; 0.02) and there was a statistically significant difference between both of them (P-value = 0.001). Conclusion: Both general and regional anesthesia could lower the cognitive function of geriatrics, especially general anesthesia which happened to have a higher risk to occur. Other factors such as age, educational status, and hemodynamic condition during surgery, had their impacts toward lowering cognitive function in geriatrics.
Co-Authors Erikavitri Yulianti Ferrie Budianto Hamzah Hamzah Ira Dharmawati Maria Marind Desrianti Hutauruk