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Journal : Indonesian Journal of Anesthesiology and Reanimation (IJAR)

Validity of Urine Syndecan-1 as A Predictor of Acute Kidney Injury In Pediatric Sepsis Patients Bambang Pujo Semedi; Arie Utariani; Nugroho Setia Budi; Ninik Asmaningsih; Lucky Andriyanto
Indonesian Journal of Anesthesiology and Reanimation Vol. 3 No. 2 (2021): 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 (453.614 KB) | DOI: 10.20473/ijar.V3I22021.62-70

Abstract

Introduction: AKI (Acute Kidney Injury) complications in sepsis patients generally occur 24 hours after admission to ICU. Creatine Serum Concentration is a standard parameter to diagnose AKI. Unfortunately, the changes in creatine serum concentration will only be seen several days after the decrease of renal function to 50%.  The low detection ability has been linked with time loss before preventive therapy is commenced. Furthermore, this instigates the need for biomarkers to ensure early detection. Objective: This study aimed to identify cut-off points of urine syndecan-1 and to measure the prediction ability of urine syndecan-1 towards the AKI occurrence in pediatric sepsis patients. Materials and methods: This study was a prospective cohort study performed at a single center in Dr. Soetomo General Hospital, Surabaya. The inclusion criterion was all children admitted to the resuscitation room from October until December 2019. Furthermore, urine sampling is carried out at 0, 6, 12, and 24 hours for a syndecan-1 urine examination, and every procedure performed on the patient will be recorded. This action was continued up to the third day and aimed to evaluate some factors related to AKI at 48-72 hours of admission. Result and Discussion: Out of 41 pediatric sepsis patients, 30 patients fulfilled the inclusion criteria and 57% had AKI. The value of urine syndecan-1 at hour-0 and hour-6 was significantly featured a cut-off point. Conclusion: The value of urine syndecan-1 at hour-0 and hour-6 are valid parameters to predict the occurrence of AKI grades 1, 2, and 3 in pediatric septic patients at 48-72 hours after their hospital admission. The best cut-off value of urine syndecan-1 at the 0th hour was 0.67 ng/ml.
EuroSCORE II as Predictor of Mortality and Morbidity in Post-CABG Patient in Dr. Soetomo General Academic Hospital Rama Azalix Rianda; Bambang Pujo Semedi; Agus Subagjo; Yoppie Prim Avidar
Indonesian Journal of Anesthesiology and Reanimation Vol. 4 No. 1 (2022): 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 (364.453 KB) | DOI: 10.20473/ijar.V4I12022.14-21

Abstract

Introduction: European System for Cardiac Operative Risk Evaluation (EuroSCORE) is a scoring system to predict mortality risk after cardiac surgery. EuroSCORE II was introduced to replace and show superiority over EuroSCORE I which tends to overestimate the risk of heart surgery procedures and have a low discrimination ability. Meanwhile, this is the first study to analyze EuroSCORE II as a predictor of mortality and morbidity in Indonesians. Objective: This study aims to analyze EuroSCORE II as a predictor of mortality and morbidity in Indonesians. Materials and Methods: This is a retrospective study using medical records of CABG patients in Dr. Soetomo General Academic Hospital from January 2016 to December 2017. Results and Discussion: Out of 39 Patients who have performed CABG surgery, most were male (89.7%) with the highest age range of 46-65 years (59%). Deceased patients had an average EuroSCORE II of 22.36% and SD±26.97%7%, while 27 patients who survived had an average EuroSCORE II of 6.78% and SD±6.4%. Based on morbidity assessment, EuroSCORE II only accurately predicted the risk of kidney failure and did not properly assess the length of inotropic use, vasopressors, hospitalization time, the risk of arrhythmias, low cardiac output syndrome, Durante-operative bleeding, and the need for blood transfusion. These inaccuracies occurred because the samples that were included varied based on their standard deviation and pattern-less graph. Conclusion: EuroSCORE II is inadequate to predict morbidity and mortality in postoperative patients, therefore, it is considered less effective.
Effectiveness and Safety of Prolonged Needle Decompression Procedures in Tension Pneumothorax Patients with COVID-19 Mirza Koeshardiandi; Zulfikar Loka Wicaksana; Bambang Pujo Semedi; Yoppie Prim Avidar
Indonesian Journal of Anesthesiology and Reanimation Vol. 4 No. 1 (2022): 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 (305.887 KB) | DOI: 10.20473/ijar.V4I12022.47-54

Abstract

Introduction: Coronavirus disease-19 (COVID-19) has become a pandemic that is still ongoing today. This is a new challenge for health workers in handling emergency cases. Several COVID-19 patients arrived at the hospital with severe respiratory problems. Meanwhile, other pathological conditions causing respiratory failure must also be considered, such as pneumothorax. Objective: This study aimed to examine the effective emergency procedures to treat COVID-19 cases with tension pneumothorax. Case report: A 45-year-old male patient arrived with a referral letter from a pulmonologist with a diagnosis of simple pneumothorax and pneumonia. The patient also presented a positive SARS COV-2 PCR test result. The patient complained about a worsening of shortness of breath. A symptom of dry cough for 14 days was also reported. Chest radiograph examination subsequently indicated right tension pneumothorax. In the emergency ward, needle decompression procedure connected to the vial containing sterile intravenous fluids was performed. Re-examination of the chest x-ray demonstrated right pulmonary re-expansion. The patient was monitored and after four days, needle decompression was removed and no chest tube was inserted because complete resolution of the lungs had occurred. Discussion: This case illustrates that tension pneumothorax causes worsening of the patient's condition with COVID-19 diagnosis. In another case of tension pneumothorax in a COVID-19 patient, needle decompression of the 2nd intercostal space and the mid-clavicular line was performed as initial treatment followed by chest tube insertion as definitive treatment. However, in this case, chest tube approach was not carried out because the patient had demonstrated clinical and radiological improvement and a worsening condition had not occurred. Conclusion: Prolonged needle decompression connected to a vial containing sterile intravenous fluids as deep as 2 cm from the water surface is an effective procedure in the management of tension pneumothorax even without the installation of a chest tube.
Albumin, Leukosit, And Protrombin As Predictors Of Sepsis Mortality Among Adult Patients In Soetomo General Hospital, Surabaya, Indonesia Rahmat Sayyid Zharfan; Ahmad Lukman Hakim; Abdul Khairul Rizki Purba; Soni Sunarso Sulistiawan; Bambang Pujo Semedi
Indonesian Journal of Anesthesiology and Reanimation Vol. 1 No. 1 (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 (195.271 KB) | DOI: 10.20473/ijar.V1I12019.8-12

Abstract

Introduction: Sepsis is presented as acomplex and multifactorial syndrome where the morbidity and mortality rates still high around the world. Strong evidencewith regard to early predictive factors for mortality and morbidity is rare to be provided. Objective: The aim of this study was to analyse the prominent predictors from the values of laboratory findings among patients with sepsis. Method and Material: The study was aan analytic observational study with a case-control approach. The data were extracted from patients’s medical records between 2014 and 2015. This study involved 50 septic patients admitted to Dr. Soetomo General Hospital, Surabaya, Indonesia. Blood urea nitrogen (BUN), creatinine serum, albumin, leukocytes count, haemoglobin, hematocrite, platelets, sodium, potassium, chloride, prothrombin time (PT), and activated partial thromboplastin time (APTT) were collected from blood samples. Logistic regression was used to estimate sepsis related mortalities frequencies and the relationship between laboratory findings and under 28-days mortality. Result and Discussion: From 50 patients, 22 patients were died (44%). The regression model was intially conducted using all three biomarkers as covariates, then using backward elimination, the covariate with the highest p-value was eliminated. The process was repeated until covariates with statistically significant remained. Multivariate analysis showed that albumin, leukocytes count, and prothrombin time (PT) were the findings associated with high mortality. The independent predictors of mortality identified by further multivariate regression analysis were taken into account as a lower than 3.5 g/dL of albumin, above12.000/µL of leukocytes count, and prolonged more than 14 seconds of prothrombin time; with p value <0,05 respectively (0.029; 0.049; 0.027). Conclusion: Notably, low albumin level, elevated levels of leukocytes, and prolonged prothrombin time were clinically considered as independent predictors of mortality among adult patients with sepsis.
Knowledge of General Practitioner Doctors and Midwives Who Has and Has Not Attended Neonatal Resuscitation Course Has No Significant Difference Vincent Geraldus Enoch Lusida; Bambang Pujo Semedi; Bambang Herwanto
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 (405.07 KB) | DOI: 10.20473/ijar.V1I22019.38-42

Abstract

Introduction: Infant death is most prominent in the neonatal period. The success of neonatal resuscitation practice has many contributing factors. One of which is the health workers’ knowledge of the Neonatal Resuscitation Program (NRP) algorithm. Therefore, it is necessary to conduct studies to evaluate the health workers’ knowledge of the Neonatal Resuscitation Program who are educated in neonatal resuscitation course and has taken part in Neonatal Life Support practice in primary health care (PHC)  Objective: This study aims to analyze the knowledge of general practitioners and midwives who has or has not attended in neonatal resuscitation course in Surabaya PHC Methods and Materials: this research is descriptive, cross-sectional research. All Basic Emergency Obstetric and Newborn Care (BEmONC) PHC in Surabaya which are Jagir PHC, Banyu Urip PHC, Medokan Ayu PHC, Tanah kali Kedinding PHC, Tanjungsari PHC, Balongsari PHC, Sememi PHC, Simomulyo PHC is included in this research from 2018 to 2019. A nine-item questionnaire referenced from The Textbook of Neonatal Resuscitation 7th Edition is given to ten respondents in each BEmONC PHC. Results and Discussion: from the total sample of 78 respondents, 32 (41,0%) receive a high score, 20 (25,7%) receive a middle score, and 26 (33,3%) receive a low score. The data shows that there is no significant score difference between respondents who has or has not participate in the NRP course (p=0,419). Conclusion:  There is no correlation between difference knowledge midwives and general practitioners who had and had not attended neonatal resuscitation training at basic emergency obstetric and newborn care in public health center Surabaya.
Intracranial Hemorrhage in Patients With Hemophilia A Nugroho Setia Budi; Prananda Surya Airlangga; Bambang Pujo Semedi
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 (767.662 KB) | DOI: 10.20473/ijar.V2I22020.59-66

Abstract

Introduction: Intracranial hemorrhage in inherited bleeding disorders is a medical emergency. The location of bleeding in most children is subdural and the most common cause is hemophilia. Although intracranial bleeding that occurs in people with hemophilia ranges from less than 5% of events, it is a life-threatening medical emergency so appropriate treatment is needed. Case Report: A boy patient 11 years old, 20kg weights have a seizure at home and followed by a decrease in consciousness. It was founded abnormalities in the form of anemia, prolonged FH (PPT 4x and APTT 4x), and hypocalcemia. The patient then was given main therapy; FVIII 100 IU/dL according to the FVIII target level calculated. The therapy continued with 500IU/12 hours according to the daily target of FVIII 50IU/dL. Discussion: The patient’s condition was getting better day by day. The patient’s consciousness started to improve after 14 days of postoperative. One month after that, the patient received koate treatment as the episodic handler. Diagnosing the exact cause in patients who have intracranial hemorrhage provides appropriate management so that the patients could be helped. Conclusion: Good collaboration between anesthesiologists, neurosurgeons, and pediatrics will increase the probability of successful management of critical bleeding without major sequelae.
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