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All Journal Jurnal Anestesiologi Indonesia Jurnal Anestesi Perioperatif Folia Medica Indonesiana Indonesian Journal of Tropical and Infectious Disease Majalah Kesehatan FKUB Health Notions Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya Nurse and Health: Jurnal Keperawatan Jurnal Neuroanestesi Indonesia Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Indonesian Journal of Anesthesiology and Reanimation (IJAR) Majalah Biomorfologi (Biomorphology Journal) Jurnal Layanan Masyarakat (Journal of Public Service) Jurnal Syntax Transformation Indian Journal of Forensic Medicine & Toxicology Jurnal Neuroanestesi Indonesia JKKI : Jurnal Kedokteran dan Kesehatan Indonesia Jurnal Inovasi Global

Semedi, Bambang Pujo

Departemen Anestesiologi Dan Reanimasi, Fakultas Kedokteran, Universitas Airlangga

Author-ID : 903166

Humanities Astronomy Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Dentistry Earth & Planetary Sciences Education Engineering Environmental Science Health Professions Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Library & Information Science Mathematics Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Other

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Efektivitas Body Surface Area dibanding Predicted Body Weight dalam Menentukan Volume Semenit untuk Mencapai Target PaCO2 pada Operasi Tumor Ota Nurofik, Nanang; Airlangga, Prananda Surya; Semedi, Bambang Pujo; Utariani, Arie; Hanindito, Elizeus; Hamzah, Hamzah
Jurnal Neuroanestesi Indonesia Vol 8, No 1 (2019)
Publisher : Departement of Anesthesiology and Intensive Care Dr. Hasan Sadikin Hospital Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v8i1.213

Latar Belakang dan Tujuan: Manajemen neuroanestesi pada operasi tumor otak bertujuan untuk mencegah terjadinya cedera otak sekunder dan memberikan lapangan operasi yang baik. Hal ini dapat dicapai melalui brain relaxation therapy. Penelitian ini bertujuan menganalisis efektifitas Body Surface Area (BSA) dan Predicted Body Weigh (PBW) untuk menentukan volume semenit dalam mencapai target PaCO2 pada pasien yange menjalani operasi tumor otak.Subjek dan Metode: Penelitian analitik observasional dengan desain cross-sectional melibatkan 31 pasien yang menjalani operasi tumor otak di RSUD Dr Soetomo Surabaya. Pasien yang memenuhi kriteria, dilakukan pengukuran tinggi badan dan berat badan, kemudian dibagi dalam 2 kelompok BSA dan PBW. Kelompok BSA mendapat volume semenit 4xBSA (laki-laki) dan 3.5xBSA (perempuan). Kelompok PBW mendapat volume semenit 100mL/kgBB. Tiga puluh menit setelah pengaturan ventilasi mekanik, dilakukan pemeriksaan analisa gas darah untuk menilai PaCO2.Hasil: Penentuan volume semenit menggunakan BSA menghasilkan volume yang lebih besar dibanding PBW pada pasien normal hingga obesitas.Penggunaan BSA dibanding PBW secara signifikan memiliki PaCO2 lebih rendah (33.55±3.43: 39.29±3.32 mmHg) dengan nilai p=0.0001. Simpulan: Penggunaan BSA dalam menentukan volume semenit efektif dalam mencapai target PaCO2 pada pasien yang menjalani operasi tumor otak. Effectiveness of Body Surface Area over Predicted Body Weightto determine Minute Volume to achieve PaCO2 Target in Brain Tumor SurgeryAbstractBackground and Objective: Neuroanesthesia management in brain tumor surgery aims to prevent secondary brain injury and provide a good operating field. This goal can be achieved by brain relaxation therapy .This study aims to analyze the effectiveness of Body Surface Area (BSA ) and Predicted Body Weigh (PBW) in determining minute volume to achieve PaCO2 target in brain tumor surgery patient.Subject and Methods: This was an observational analytic study with a cross-sectional approach. Thirty patient with brain tumor surgery were enrolled in this study. Patient who met the inclusions criteria was measured for height and weight then divided into two groups of BSA and PBW. The BSA group gets a minute volume 4xBSA for men and 3.5xBSA for women. The PBW group received minute volume 100mL / kg. Thirty minutes after adjusting mechanical ventilation, a blood gas analysis was examined to measure PaCO2 value.Results: Minute volume which is predicted by BSA had a greater volume than PBW in normal to obese patient. Body surface area is statistically significant compared to PBW in reducing PaCO2 average (33.55±3.43: 39.29±3.32 mmHg) with p value = 0.0001.Conclusion: Body surface areaas more effective to determine minute volume compare to PBW to achievePaCO2 target in brain tumor surgery patient.

Laporan Kasus : PERAWATAN GAGAL NAPAS AKUT AKIBAT PNEUMONITIS LUPUS DI UNIT PERAWATAN INTENSIF DENGAN FASILITAS TERBATAS Hanif, Hanif; Semedi, Bambang Pujo; Utariani, Arie
Majalah Kesehatan FKUB Vol 7, No 1 (2020): Majalah Kesehatan
Publisher : Faculty of Medicine Universitas Brawijaya

Pneumonitis lupus, salah satu manifestasi klinis SLE, dapat mengalami perburukan hingga menjadi gagal napas. Penanganan yang tepat diperlukan, meskipun dengan fasilitas terbatas. Mendiskusikan pengalaman klinis dalam menangani pasien dengan gagal napas akut di unit perawatan intensif (ICU) dengan keterbatasan fasilitas. Wanita 23 tahun dirawat di ICU dengan gagal napas akut yang dicurigai akibat pneumonitis lupus. Pemeriksaan laboratorium untuk mengkonfirmasi diagnosis tidak tersedia. Keputusan untuk mempertahankan pasien dengan bantuan ventilator atau ekstubasi dibuat berdasarkan parameter klinis saja. Pada awalnya, kemajuan terapi cukup menjanjikan. Pasien dapat bernapas spontan untuk beberapa hari, sebelum kemudian perlu di intubasi ulang akibat flare lupus kedua. Kondisi klinis pasien memburuk dengan cepat dan akhirnya pasien meninggal.Â Meskiput banyak keterbatasan di ICU, penilaian klinis dan evaluasi ketat sangat diperlukan sebagai dasar pengambilan keputusan penting seperti kapan harus memulai dan menghentikan bantuan ventilator.

Soluble Cluster of Differentiation 25 (sCD25) as a Predictor of Mortality of COVID-19 Patients in Surabaya, Indonesia Harida Zahraini; Betty Agustina Tambunan; Bambang Pujo Semedi
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17553

The purpose of this study was to analyze and determine the cut-off level of sCD25 as a predictor ofmortality in COVID-19 patients. In an observational analytic study with a prospective cohort design, thestudy population was COVID-19 patients who were hospitalized at RIK RSUD Dr. Soetomo Surabayafor the period July 2020-December 2020. Sampling was taken by consecutive sampling, divided intotwo groups, mild-moderate and severe-critical groups. The examination of sCD25 levels in both groupswas carried out on day-0 and day-6 of hospitalization using the sandwich ELISA method. The pairedgroup statistical analysis used the Wilcoxon range test, the unpaired group used the Mann WithneyU test. ROC curve analysis to determine the cut off level of sCD25 as a predictor of mortality. Therewere a total of 83 study patients consisting of 36 patients in the mild-moderate group, 47 patients inthe severe-critical group. There was a difference in sCD25 levels between mild-moderate COVID-19patients who were treated on day-6 compared to day-0, whereas in the severe-critical group there wasno difference in sCD25 levels. There was a difference in sCD25 levels in COVID-19 patients betweenthe mild-moderate group by severe-critical. The level of sCD25 with a cut off of 3.14 ng/mL (AUC0.719, p = 0.001) can be used as a predictor of mortality in COVID-19 patients with a sensitivity of96.2%, a specificity of 47.4%. Levels of sCD25 >3.14 ng/mL can be used as a predictor of mortality inCOVID-19 patients

Penggunaan Ventilatory Ratio dan Dead Space Fraction Sebagai Prediktor Mortalitas Pada Pasien COVID-19 dengan Acute Respiratory Distress Syndrome Muh Kemal Putra; Arie Utariani; Bambang Pujo Semedi; Christrijogo Soemartono Waloejo; Hardiono Hardiono
Jurnal Anestesi Perioperatif Vol 9, No 1 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v9n1.2274

Pada pasien COVID-19 dengan ARDS terjadi gangguan oksigenasi dan ventilasi. Menurut kriteria Berlin ARDS, oksigenasi diukur dengan PaO2/FiO2, namun tidak mengukur ventilasi alveolar yang diukur dengan dead space yang dapat terjadi akibat kondisi, seperti kerusakan endotel, mikrotrombus, dan penggunaan ventilator yang berlebih. Tujuan penelitian ini menganalisis penggunaan ventilatory ratio (VR) dan dead space fraction (Vd/Vt) sebagai prediktor mortalitas pasien COVID-19 ARDS. Penelitian ini adalah analitik kohort retrospektif. Data dikumpulkan dari rekam medik pasien COVID-19 yang dirawat di RIK RSUD Dr. Soetomo periode Juni–September 2020 dengan teknik total sampling terhadap subjek yang memenuhi kriteria inklusi dan tidak termasuk eksklusi. Data yang dikumpulkan adalah nilai VR dan Vd/Vt (diambil dari data laboratorium), kondisi klinis pasien dan pengaturan ventilator 24 jam pertama setelah terintubasi. Penelitian ini didapatkan 77 dari 80 subjek yang memenuhi kriteria. Nilai VR berhubungan dengan mortalitas secara signifikan dengan nilai p 0,001; cut off 1,84; sensitivitas 84,2%; spesifisitas 85%; RR 30,22; CI 95%: 7,31–124,89. Vd/Vt dan mortalitas menunjukkan hubungan yang signifikan terhadap mortalitas dengan nilai p 0.001. Uji analisis Spearman VR dengan Vd/Vt didapatkan hasil korelasi yang kuat dengan koefisien korelasi 0,704 dan p 0,001. Simpulan, nilai VR dan Vd/Vt dapat digunakan sebagai prediktor mortalitas pasien COVID-19 dengan ARDS dan keduanya mempunyai korelasi yang kuat. VR dapat menggantikan Vd/Vt.Use of Ventilatory Ratio and Alveolar Dead Space Fraction as Predictorz of Mortality in Covid-19 Patients with Acute Respiratory Distress SyndromeCOVID-19 with ARDS experience impaired oxygenation and ventilation. In Berlin ARDS criteria, oxygenation is measured by PaO2 /FiO2, but does not measure alveolar ventilation, which is measured through the dead space produced in this conditions, such as endothelial damage, microthrombus, and excessive use of entilator. The purpose of this study was to analyze the use of ventilatory ratio (VR) and dead space fraction (Vd/Vt) as predictors of mortality in patients with COVID-19 ARDS. This study was a retrospective cohort analytic study one medical records of COVID-19 patients treated in an inpatient unit of a referral hospital in Indonesia. The ethical clearance was obtained from the Health Research Ethics Committee of Dr. Soetomo Hospital, Indonesia. Data were collected through total sampling of medical records that met the inclusion and exclusion criteria. The VR and Vd/Vt scores were collected from the laboratory data, patient clinical condition, and ventilator setting 24 hours after intubation. Of all medical records screened, 77 out of 80 samples met the criteria. VR was significantly associated with mortality with a p value of 0.001 (cut-off point:1.84, sensitivity: 84.2%, specificity: 85%, RR: 30.22, and 95%, CI: 7.31–124.89). Similarly, Vd/Vt and mortality showed a significant relationship with mortality with a p value of 0.001 (cut-off: 0.25, sensitivity: 85%, specificity: 86%, RR: 34.71, 95% CI: 8.24–146.05). The Spearman analysis test between VR and Vd/Vt showed a strong correlation with a correlation coefficient of 0,704 and p 0,001. Thus, VR and Vd/Vt can be used as predictors of mortality in COVID-19 patients with ARDS and because both have a strong correlation. VR can also substitute Vd/Vt.

Studi Komparatif Ukuran Pipa Nafas Tanpa Cuff Pada Pasien Pediatri Berdasar Diameter Subglotis Dengan Metode Konvensional Khildan Miftahul Firdaus; Elizeus Hanindito; Bambang Pujo Semedi
Jurnal Anestesi Perioperatif Vol 8, No 3 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v8n3.2126

tersendiri. Pipa endotrakeal (ETT) yang terlalu kecil/besar meningkatkan risiko komplikasi. Prediksi ukuran ETT berdasar atas usia merupakan metode yang paling sering digunakan namun ternyata tidak selalu tepat pada aplikasinya. Parameter lain seperti diameter subglotis atau diameter kelingking tangan dapat menjadi alternatif untuk memprediksi ukuran ETT pediatri. Tujuan penelitian ini menganalisis dan membandingkan akurasi prediksi ukuran ETT tanpa cuff berdasar berbagai variabel pada pasien pediatri di RSUD Dr Soetomo Surabaya mulai Februari hingga April 2020. Subjek penelitian ini pasien usia 2–9 tahun, PS ASA 1–2 yang akan dilakukan operasi elektif. Saat preoperatif, usia, berat, dan panjang badan dicatat. Saat intraoperatif, diameter kelingking tangan dan diameter subglotis menggunakan USG diukur dan dicatat. ETT yang digunakan adalah ETT tanpa cuff berdasar atas diameter subglotis. ETT dianggap tepat apabila memberikan audible air leak pada tekanan 10–25 cmH2O. Bila ETT terlalu kecil/besar maka dilakukan reintubasi. Tiap-tiap parameter dilakukan uji korelasi, agreement test, serta predictive performance menggunakan MAPE, dan RMSE. Dari 48 pasien, didapatkan hasil bahwa prediksi ukuran ETT tanpa cuff berdasar atas diameter subglotis memiliki akurasi yang paling baik hingga 91,67% (r=0,973, koefisien kappa 0,892; p<0,001, MAPE 0,803%, dan RMSE 0,144). Simpulan, prediksi berdasar atas diameter subglotis merupakan metode yang akurat untuk memprediksi ukuran ETT tanpa cuff pediatri. Subglottic Diameter Ultrasonographic Assessment for Estimating Pediatric Uncuffed Endotracheal Tubes Compared to Conventional MethodsAnatomical differences in pediatric airways could be quite a challenge. Choosing endotracheal tube (ETT) optimum size is essential as a larger or smaller tube may cause undesirable complications. ETT size prediction based on age formula is most commonly used, but is not always successful. The little finger diameter and subglottic diameter are alternative parameters to predict pediatric uncuffed ETT optimum size. This study analyzed and compared the multiple variable-based formulas’ accuracy to predict the pediatric uncuffed ETT optimum size. The ETT prediction used subglottic diameter-based formulas. Clinically fit ETT has an audible air leak within the pressure of 10–25 cmH2O. If the ETT predicted was relatively too small/big than clinically fit ETT, it was changed to one size smaller/ bigger. Each variable was then analyzed by correlation test, regressed against clinically fit ETT to test the agreement rates, and predictive performance was assessed using mean absolute percentage error (MAPE), and root mean square error (RMSE). From 48 patients it found that subglottic diameter formulas offered the best result in predicting optimum size uncuffed ETT in pediatrics with an agreement rate up to 44 of 48 patients got the right clinically fit uncuffed ETT (91.67%, r=0.973, kappa 0.892, p-value<0.001, MAPE 0.803%, and RMSE 0.144). In conclusion, the prediction based on subglottic diameter using USG is the best method to predict the optimum size of uncuffed ETT in pediatrics.

Analisis Faktor Risiko Oxygenation Index, Oxygen Saturation Index, dan Rasio Pao2/Fio2 sebagai Prediktor Mortalitas Pasien Pneumonia COVID-19 dengan ARDS di Ruang Perawatan Intensif Isolasi Khusus RSUD Dr Soetomo Samuel Hananiel Rory; Arie Utariani; Bambang Pujo Semedi
Jurnal Anestesi Perioperatif Vol 9, No 1 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v9n1.2275

Pada kasus berat, pneumonia COVID-19 terjadi perburukan secara cepat dan progresif yang menyebabkan ARDS. Pengukuran parameter oksigenasi seperti oxygenation index (OI) dan oxygen saturation index (OSI) pada beberapa penelitian menunjukkan superioritas dibanding dengan rasio PaO2/FiO2 dalam menilai status oksigenasi dan derajat keparahan ARDS. Penelitian ini bertujuan melakukan analisis faktor risiko OI, OSI, dan Rasio PaO2/FiO2 terhadap mortalitas pasien pneumonia COVID-19 dengan ARDS. Penelitian ini adalah penelitian analitik observaional dengan desain cohort-prospective terhadap pasien dewasa pneumonia COVID-19 dengan ARDS berdasar atas kriteria Berlin. Data perhitungan OI, OSI, dan rasio PaO2/FiO2 diambil pada 30 menit pertama pascapemasangan ventilator mekanik. Analisis regresi logistik digunakan untuk menganalisis faktor risiko OI, OSI, dan rasio PaO2/FiO2 terhadap mortalitas 28 hari pasien pneumonia COVID-19 dengan ARDS. Hasil penelitian didapatkan pada 77 pasien yang memenuhi kriteria inklusi dan tidak termasuk eksklusi, hanya variabel OI yang terbukti signifikan sebagai prediktor independen mortalitas dengan nilai p 0,043, sementara OSI dan rasio PaO2/FiO2 tidak signifikan. Dari ketiga variabel, OI mempunyai AUC tertinggi, yakni 0,935 dibanding dengan variabel OSI dan rasio PaO2/FiO2. Simpulan, OI terbukti sebagai prediktor independen mortalitas pada pasien pneumonia COVID-19 dengan ARDS.Oxygen Index, Oxygenation Saturation Index, and Pao2/Fio2 Ratio as Predictors of Mortality in Pneumonia Covid-19 with ARDS Patients Treated in Intensive Isolated Care Unit In severe COVID-19 cases, worsening of pneumonia occurs rapidly and leads to ARDS. Oxygenation parameters such as oxygenation index (OI) and oxygen saturation index (OSI) has been shown to be superior when compared to the PaO2/FiO2 ratio in assessing the oxygenation status and ARDS severity in some studies. Currently, there are limited studies that explore the prognostic values of these parameters in pneumonia COVID-19 with ARDS. This study aimed to analyze the OI, OSI, and PaO2/FiO2 Ratio as predictors of mortality in pneumonia COVID-19 with ARDS in patients treated in the intensive isolated care room. This was an observational analytic study conducted at dr. Soetomo Hospital, Indonesia, on adult patients who met the criteria for pneumonia COVID-19 with ARDS based on Berlin criteria. Data on OI, OSI, and PaO2/FiO2 were collected based on the results of measurements 30 minutes post-intubation and mechanical ventilation in these patients. Logistic regression analysis was used to analyze the OI, OSI, and PaO2/FiO2 as risk factors for 28 days mortality of pneumonia COVID-19 patients with ARDS. In a total of 77 patients eligible for the analyses, it was observed that OI was independently associated with hospital mortality (p 0.043) while OSI and PaO2/FiO2 ratio were not statistically significant. From these three variables, the AUC for mortality prediction was the greatest for OI (AUC 0.935, p<0.05). In conclusion, OI is the only one that is proven to be the independent predictor mortality with the highest sensitivity and specificity compared to the OSI and PaO2/FiO2 ratio for patients with pneumonia covid-19 with ARDS.

Analisis Syndecan-1 Laktat dan Profil Lipid Sebagai Faktor Risiko Keparahan dan Mortalitas Sepsis Yopie Wiguna; Philia Setiawan; Bambang Pujo Semedi; Bambang Purwanto
Jurnal Anestesi Perioperatif Vol 9, No 1 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v9n1.2251

Pada sepsis, endothelial glycocalyx (EG), dapat rusak dan luruh melepaskan syndecan-1 ke dalam plasma. Kerusakan EG akan mengganggu mikrosirkulasi, menimbulkan hipoperfusi jaringan, dan meningkatkan kadar laktat. Gangguan profil lipid pada sepsis terjadi karena gangguan metabolisme dan kerusakan langsung hepatosit akibat meluruhnya EG. Penelitian ini bermaksud menganalisis syndecan-1, laktat, dan profil lipid sebagai faktor risiko keparahan dan mortalitas pada pasien sepsis. Penelitian ini adalah penelitian analitik observasional pada 39 pasien dewasa yang memenuhi kritera sepsis-3. Keparahan sepsis diklasifikasikan menjadi sepsis dan syok septik dan ditentukan dalam 6 jam setelah time zero berdasarkan penggunaan vasopresor, kecukupan resusitasi cairan, dan nilai laktat ulangan. Kematian 7 hari dihitung sejak time zero sepsis. Syndecan-1, laktat, dan profil lipid diambil dalam jam pertama setelah time zero dianalisis sebagai faktor risiko keparahan dan mortalitas 7 hari. Analisis data dilakukan dengan uji logistik regresi bivariat dan multivariat. Pada penelitian ini didapatkan 20 pasien dengan sepsis, 19 pasien dengan syok septik. Berdasar atas mortalitas 7 hari, 10 pasien meninggal dan 29 pasien bertahan hidup. Laktat dan syndecan-1 merupakan prediktor keparahan pada sepsis. Laktat merupakan variabel yang lebih superior dibanding dengan syndecan-1 sebagai prediktor keparahan sepsis. Laktat merupakan prediktor untuk mortalitas 7 hari pada pasien sepsis. Simpulan penelitian ini adalah laktat dan syndecan-1 merupakan prediktor keparahan pada sepsis. Laktat merupakan prediktor kematian 7 hari pada sepsis. Syndecan-1 Lactate and Lipid Profiles as Risk Factors for Severity and Mortality in SepsisIn sepsis, endothelial glycocalyx (EG) may experience damages and decay, releasing syndecan-1 into plasma. EG damages will disrupt microcirculation, causing tissue hypoperfusion and increasing lactate levels. Disorders of the lipid profile in sepsis occur due to metabolic disorders and direct hepatocyte damages due to EG shedding. This study intended to analyze the Syndecan-1, lactate, and lipid profiles as risk factors for severity and mortality in septic patients. This was an observational analytic study on 39 adult patients who met the criteria for sepsis-3. Sepsis severity was classified into sepsis and septic shock and was determined within 6 hours after time zero based on the vasopressor use, adequacy of fluid resuscitation, and repeat lactate values. The 7-day mortality was counted from time zero sepsis. Syndecan-1, Lactate, and Lipid Profiles were assessed within the first hour after time zero and analyzed as risk factors for severity and 7-day mortality. Data analysis was performed using bivariate and multivariate logistic regression tests. In this study, there were 20 patients with sepsis, 19 patients with septic shock. Based on the 7-day mortality, 10 patients died and 29 patients survived. Lactate and Syndecan-1 are predictors of severity in sepsis. Lactate is superior than Syndecan-1 as a predictor of sepsis severity and is a predictor of 7-day mortality in septic patients. Nonetheless, both lactate and Syndecan-1 are predictors of severity in sepsis.

Characteristics of Acute Kidney Injury in the Intensive Care Unit of Dr. Soetomo General Hospital, Surabaya Putu Laksmi Febriyani; Bambang Pujo Semedi; Widodo Widodo
Health Notions Vol 5, No 3 (2021): March
Publisher : Humanistic Network for Science and Technology (HNST)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33846/hn50305

Acute Kidney Injury (AKI) is one of the causes of morbidity and mortality among people in both developing and developed countries in the intensive care unit (ICU). In Indonesia, the incidence rate is 0.2% while for the Surabaya, AKI research has not been widely carried out and published. This study aims to determine the characteristics of AKI patients in ICU of Dr. Soetomo hospital covers the data distribution of sociodemographic, risk factors, and mortality. This descriptive study involving 23 inpatients at the ICU with AKI as the sample. Samples were selected using total sampling method. Data were collected from medical records with data collection sheets. The results were then analyzed descriptively and tested bivariate using logistic regression. The results showed that 82.6% of the patients were male with the highest age range of 50-56 years old (30.43%). AKI mortality rate in the intensive care unit was 30.43%. The primary diagnosis was diabetes mellitus (34.78%) and the highest exposure factor was a septic shock (38.70%). Factors associated with AKI mortality were diabetes mellitus (p = 0.000) and exposure to septic shock (p = 0.005). Keywords: acute kidney injury; intensive care unit

Comparison of central vein pressure between distal, medial, and proximal lumens with water manometer method Cornellius Hendra Purnama Aria Sumantrie; Bambang Pujo Semedi; Bambang Purwanto
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 5, No 2 (2021)
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30651/jqm.v5i2.5356

ABSTRACT Catheter Vein Pressure in ward-cared patients is rarely measured and considered invalid. The two catheter vein pressure postulates contradict, making confusion among health workers. Dr Russo said the distal-medial-proximal Catheter Vein Pressure has no difference but were denied by Susan S. Scott. Proof of postulate is needed as a solution to inward care. Therefore, this study aimed to compare the central vein pressure between distal, medial, and proximal lumens with the water manometer method. Forty-nine samples retrospective study were taken from the distal - medial - proximal Catheter Vein Pressure of the "zero" until fifth days. The differences are analyzed with Statistical Paired t Test with p-Value < 0.05 from SPSS ver. 26 to prove the right postulate. 49 samples were concluded to represent of population. Catheter Vein Pressure from day "zero" becomes zero difference, the fifth day 91.8% are no difference while the rest have difference of 0.2 - 1.0 cm H2O and the conclusion are no significant difference with 95% CI. The correlation scale of 0.998 and 0.999 proves that the three lumens tend to produce no differences. In conclusion, the distal - medial - proximal Catheter Vein Pressure values in this study have no significant differences and consistent from "zero" until fifth days. This is formulated as P distal = P medial = P proximal (cm H2O).Keywords : Central Vein Pressure, Pressure, distal - medial - proximal, no differences, ward patient.Correspondence : sumantrie_medicalgp@yahoo.com

Kesulitan “Weaning” pada Kasus Flail Chest Akibat Fraktur Sternum yang Tidak Teridentifikasi Pesta Parulian Maurid Edwar; Prananda Surya Airlangga; Agustina Salinding; Bambang Pujo Semedi; Teguh Sylvaranto; Eddy Rahardjo
JAI (Jurnal Anestesiologi Indonesia) Vol 10, No 1 (2018): Jurnal Anestesiologi Indonesia
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Latar Belakang:Trauma toraks menyebabkan 20% dari semua kematian akibat trauma. Salah satu yang memiliki morbiditas dan mortalitas tinggi adalah flail chestdan fraktur sternum merupakan sebagian kecil dari penyebab flail chest. Mengingat kejadiannya yang sangat jarang maka fraktur sternum sering menjadi jebakan diagnostik yang terlupakan pada flail chest.Laporan Kasus:Terdapat 2 kasus yang dilaporkan dengan trauma toraks. Kasus pertama adalah multitrauma dengan Injury Severity Score(ISS) 50, trauma kepala, trauma abdomen dan trauma ekstremitas. Setelah dilakukan stabilisasi hemodinamik selama 3 hari, pasien sulit disapih dari ventilasi mekanik. Setelah tidak ditemukan lagi sumber perdarahan dan hemodinamik stabil pasien segera disiapkan operasi daruratdan ditemukan penyebabnya adalah fraktur sternum yang tidak teridentifikasi sebelumnya. Kasus kedua adalah trauma toraks dengan ISS 17, secara klinis tampak flail chestdan foto toraks antero-posterior yang normal. Setelah dilanjutkan CT scantoraks ditemukan fraktur sternum yang menyebabkan pernafasan tidak adekuat. Segera dilakukan fiksasi eksternal dan hasilnya memuaskan.Diskusi: Fraktur sternum seringkali disebabkan oleh mekanisme trauma toraks anterior yang berat dan dapat menimbulkan manifestasi flail chestsehingga dapat meningkatkan morbiditas dan mortalitas terlebih lagi bila disertai adanya trauma pada sistem organ lain serta penggunaan ventilator mekanik jangka panjang dan sepsis. Kejadian fraktur sternum sangat jarang dan foto toraks lateral pada kasus trauma juga jarang dilakukan sehingga seringkali fraktur sternum tidak teridentifikasi. Dengan mengetahui mekanisme trauma, gejala klinis yang tidak sesuai dengan gambaran foto toraks antero-posterior dan sulitnya penyapihan dari ventilasi mekanik maka penggunaan ultrasonografi untuk skrining diharapkan dapat membantu menghindari jebakan terlambatnya identifikasi fraktur sternum.Kesimpulan:Pada trauma toraks dengan adanya fail chest, diagnostik dini diikuti fiksasi eksternal akan mengurangi morbiditas dan mortalitas pada pasien fraktur sternum.

Co-Authors Abdul Khairul Rizki Purba Agus Subagjo Agustina Salinding Ahmad Lukman Hakim Airi Mutiar Alivery Raihanada Armando Andre Ferdinand Karema Ardiansyah Arie Utariani Arie Utariani Arifoel Hajat Aryati Aryati Avidar, Yoppie Prim Bambang Herwanto Bambang Purwanto Bambang Purwanto betty Agustina Tambunan, betty Agustina Budiono Budiono Christrijogo Soemartono Waloejo Cornellius Hendra Purnama Aria Sumantrie Eddy Rahardjo Eddy Rahardjo Edwar, Pesta Parulian Maurid Elizeus Hanindito Faizatuz Azzahrah Syamsudi Fajar Perdhana Fajra Arif Hatman Habibah Teniya Ariq Fauziyah Hamzah Hamzah Hanif Hanif Hardiono Hardiono Harida Zahraini Herdiani Sulistyo Putri IG Eka Sugiartha IGAA Putri Sri Rejeki Imam Susilo Inna Maya Sufiyah Khildan Miftahul Firdaus Kuntaman Kuntaman Lila Tri Harjana Lucky Andriyanto Marsha Zahrani Marsheila Harvy Mustikaningtyas Maulydia, Maulydia Mirza Koeshardiandi Muh Kemal Putra Nanang Nurofik Ninik Asmaningsih Soemyarso Nugroho Setia Budi Nurofik, Nanang Philia Setiawan Prananda Surya Airlangga Prihatma Kriswidyatomo Pudji Lestari Purwo Sri Rejeki Puspa Wardhani Puspa Wardhani Puspitasari, Yessy Putu Laksmi Febriyani Rahmat Sayyid Zharfan Rama Azalix Rianda Rehatta, Nancy Margarita Rezki Muhammad Hidayatullah Robby Dwestu Nugroho Samuel Hananiel Rory Sandi Ardiya Rasitullah SATRIYAS ILYAS Soni Sunarso Sulistiawan Sulistiawan, Soni Sunarso Sundari Indah Wiyasihati Teguh Sylvaranto Tri Wahyu Martanto Utariani, Arie Verio Damar Erlantara Putra Vincent Geraldus Enoch Lusida Wahyu Krishna Adjie Arsana Wahyu Mananda Widodo Widodo Yopie Wiguna Zulfikar Loka Wicaksana

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