Alatas, Anas
DiscoverSys Inc.

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INCIDENCE AND RISK FACTOR OF ACUTE KIDNEY INJURY POST OPEN HEART SURGERY IN PAEDIATRIC PATIENTS Heriwardito, Aldy; Alatas, Anas; Perdana, Aries; Sutedja, Anasthasia Devina
Bali Journal of Anesthesiology Vol 2, No 2 (2018)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/bjoa.v2i2.65

Abstract

Introduction: Acute Kidney Injury (AKI) was a frequently complication after open heart surgery, especially in paediatric patients < 2 years old and had been related with increased mortality and adverse renal outcomes. This study aimed to know the incidence of AKI post open heart surgery in paediatric patients and its relation with duration of cardiopulmonary bypass (CPB) and patient’s age in Indonesia tertiary national hospital.Methods: This was a cohort retrospective study, using medical record and Cardiac ICU chart data, of 195 paediatric patients who underwent open heart surgery from June 2014 - June 2015 in Integrated Cardiovascular Center Cipto Mangunkusumo hospital. After ethical approval from Research Ethic Committee, data were collected and sorted by inclusion and exclusion criteria. AKI was diagnosed based on RIFLE criteria. Data were analyzed by chi-square and multivariate analysis (SPSS software 22.0 version).Results: Incidence of AKI post open heart surgery in paediatric patients was 36.4%. Duration of CPB > 60 min had a significant correlation with increased incidence of AKI (p 0.043; RR 1.248). Patient’s age ≤ 2 years old also had a significant correlation with increased incidence of AKI (p<0.001; RR 2.431). Multivariate analysis results showed that both duration of CPB > 60 min and patient’s age ≤ 2 years old were significant risk factors of AKI (OR 2.951, OR 5.371).Conclusion: Incidence of AKI post open heart surgery in paediatric patients was 36.4%. Duration of CPB duration > 60 min and patient’s age < 2 years old were significant risk factors of AKI.
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.
Perbandingan Trapezius Squeezing Test dan Jaw Thrust Sebagai Indikator Kedalaman Anestesia pada Pemasangan Sungkup Laring Hidayat, Jefferson; Sugiarto, Adhrie; Alatas, Anas
Majalah Anestesia dan Critical Care Vol 34 No 1 (2016): Februari
Publisher : Perdatin Pusat

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Abstract

Manajemen jalan napas merupakan salah satu aspek penting dalam anestesiologi. Salah satu jenis alat bantu jalannafas yang sering digunakan adalah Laringeal Mask Airway (LMA/sungkup laring). Pemasangan sungkup laringtanpa pelumpuh otot membutuhkan kedalaman anestesi yang cukup. Trapezius squeezing test dan jaw thrustadalah dua uji klinis sederhana yang digunakan untuk menguji kedalaman anestesia. Penelitian ini bertujuan untukmembandingkan trapezius squeezing test dan jaw thrust sebagai indikator klinis menilai kedalaman anestesi padapemasangan sungkup laring dengan induksi anestesia menggunakan propofol. Sebanyak 128 pasien dirandomisasimenjadi dua kelompok yaitu kelompok 1 (kelompok jaw thrust) dan kelompok 2 (kelompok trapezius squeezingtest). Setelah premedikasi dengan midazolam 0,05 mg/kgBB dan fentanil 1 μg/kgBB, untuk induksi anestesiadiberikan propofol dosis titrasi. Manuver jaw thrust dan trapezius squeezing test dilakukan setiap 15 detik. Saatrespon motorik dari manuver hilang dilakukan pemasangan sungkup laring. Keberhasilan pemasangan padakelompok 1 dan 2 adalah 93,8% vs. 90,6% (p >0,05). Rata-rata penggunaan propofol pada kelompok 1 sebesar120,34 mg dan kelompok 2 sebesar 111,86 mg (p > 0.05). Pada kelompok 1 apnea dijumpai pada 10 pasien(15.6%) sedangkan pada kelompok 2 sebanyak 11 pasien (17.2%). Trapezius squeezing test sama baiknya denganjaw thrust sebagai indikator klinis dalam menilai kedalaman anestesia pada insersi sungkup laring. Kata Kunci: Jaw thrust, kedalaman anestesia, propofol, sungkup laring, trapezius squeezing test Airway management remains as one of the most important aspect in anesthesiology. Laryngeal Mask Airway(LMA) has been widely used as an airway device. Laryngeal mask insertion without muscle relaxant facilitationrequires an adequate anesthesia level. The purpose of this study was to compare trapezius squeezing test andjaw thrust maneuver as an indicator of anesthesia depth for laryngeal mask insertion, with propofol as inductionagent. There were 128 subjects who had been randomized into two groups: Group 1 (jaw thrust group) andGroup 2 (trapezius squeezing test group). All subjects received midazolam 0.05 mg/kg and fentanyl 1 μg/kg aspremedication. Propofol with titrated dose were used for anesthesia induction. Jaw thrust or trapezius squeezingtest maneuver were performed every 15 seconds in each group. When motoric responses were lost after maneuver,LMA was inserted. Succesfull LMA insertion were found in 93,8% patients (Group1) and 90,6% (Group 2) withp >0,05. Mean propofol consumptions were 120.34 mg in Group 1 and 111,86 mg in Group 2. Apnea was found in10 patients (15,6%) in Group 1 and 11 patients (17.2%) in Group 2. 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