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INDONESIA
Jurnal Respirologi Indonesia
Published by Perhimpunan Dokter Paru Indonesia
ISSN : 08537704     EISSN : 26203162     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology
Jurnal Respirologi Indonesia (JRI) is an online and printed scientific publication of the Indonesian Society of Respirology (ISR). The journal is published thrice-monthly within a year (January, April, July and October). The journal is focused to present original article, article review, and case report in pulmonary and critical care medicine.
Arjuna Subject : -
Articles 241 Documents
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Simultaneous Bilateral Spontaneous Pneumothorax in an HIV Positive Tuberculosis Patient Arie Gradiyanto Nugroho; Edijono Edijono; Sri Sarwosih Indah Marthaty
Jurnal Respirologi Indonesia Vol 43, No 2 (2023)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v43i2.261

Abstract

Background: Even though tuberculosis has been linked to pneumothorax for a long time and has caused significant morbidity and mortality in some patients, it has been the topic of few publications and analyses, thus very little study has been done to evaluate and review on this matter.Case: In this article, we reported a 39-year-old male, presented to the ER with breathlessness for the last 3 days accompanied by increased sputum productivity. The patient had an active pulmonary tuberculosis taht was under treatment, as well as HIV. Physical examination showed low chest expansion, weakened breathing sounds on both lungs, and the use of accessory breathing muscles. The chest X-ray showed bilateral pneumothorax. The patient underwent emergency chest decompression with a 16-gauge needle on both sides, followed by the insertion of an IPC and chest tube. The patient's breathlessness got significantly better, and after 35 days, the IPC was removed.Discussion: Pneumothorax is a frequent complication in Tuberculosis with HIV, with a prevalence of 6.8% compared to 0.95-1.4% in Tuberculosis without HIV. The progression of breathlessness in bilateral pneumothorax on HIV positive Tuberculosis patient is slower, up to 3 days since onset, compared to pneumothorax occured in other etiologies. Secondary pneumothorax usually occurs after extensive destruction of the lungs, leaving a little functionality and lower cardiopulmonary reserve, thus requiring prompt evaluation and more aggresive lifesaving treatment.Conclusion: Based on this case, bilateral pneumothorax found in HIV-associated TB patients comes with an insidious onset but warrants immediate evaluation and aggressive treatment or surgery if necessary.
CORRELATIONS BETWEEN MEASUREMENT RV, RV/TLC, FRC/TLC WITH CLINICAL SYMPTOMS IN COPD PATIENTS IN PERSAHABATAN HOSPITALS JAKARTA Derallah Ansusa Lindra; Faisal Yunus; Triya Damayanti
Jurnal Respirologi Indonesia Vol 43, No 4 (2023)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v43i4.571

Abstract

Introduction: This is a preliminary study to measure lung volume in patients with stable COPD in RSUP Persahabatan Jakarta to determine the prevalence of the increasing value of the lung volume in patientswith stable COPD.Methods: This study used a cross-sectional study design of outpatiens with stable COPD who visited Asthma-COPD clinica RSUP Persahabatan Jakarta. The Lung volume test using a gas dilution MBNW taken consecutively from February to March 2016.Results: Test Spirometry and Lung volumes performed on 36 subjects. There were 3 subjects (8.3%) the COPD group A, 10 subjects (27.8%) COPD Group B, 9 subjects (25%) COPD Groups C and 14 subjects (8.9%) COPD Group D. At the age >60 years of 9 there were subjects (25%) and ≥60 years of 27 subjects (75%). Value RV / TLC has a significant relationship with the MmRC scale, a 6-minute walking test and exacerbation within one year, however of FRC / TLC significantly associated with MmRC scale.Conclusion: Value RV / TLC has a significant relationship with the MmRC scale, a 6-minute walking test and exacerbation within one year, however of FRC / TLC significantly associated with MmRC scale.
Is Vaccination Related to The Cure Rate of COVID-19 Patients with Comorbidities? Mia Herdiyani Achmad; Reviono Reviono; Yusup Subagio Sutanto; Jatu Aphridasari; Windu Prasetyo
Jurnal Respirologi Indonesia Vol 43, No 3 (2023)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v43i3.324

Abstract

Background: Prior vaccination can prevent a COVID-19 patient from falling into moderate, severe, and critical conditions. The effect of vaccination on COVID-19 patients’ recovery has been widely studied. However, its correlation in critically severe COVID-19 patients with comorbidity has not been fully understood yet. This study aims to determine the correlation of vaccination in critically severe COVID-19 patients with comorbidity of hypertension and/or Diabetes Mellitus (DM).Methods: A retrospective cohort study was conducted in critically severe COVID-19 patients with hypertension and/or DM treated in Dr. Moewardi Hospital, Surakarta, Indonesia from March 2021 to September 2021. The data were taken from patients’ medical records. We analyzed all data statistically with Chi-Square and fisher's exact test, and a p-value of < 0.05 was considered significant.Results: There were 489 patients included in our study, 247 patients with hypertension and DM, and 242 patients without comorbidities. Vaccination status was significantly associated with the cure rate of critically severe COVID- 19 patients with hypertension (p=0.018), but not with DM (p=0.606). There was no significant association between age to the cure rate of critically severe COVID-19 patients with hypertension and DM (p=0.953). Vaccination status was related among patients with comorbidities and without comorbidities (p<0.001).Conclusion: Vaccination was significantly correlated the cure rate of moderate to critically severe COVID-19 patients with hypertension and without comorbidities.
DIFFERENCES IN C-REACTIVE PROTEIN LEVEL BASED ON CLINICAL SEVERITY AND OUTCOME OF COVID-19 PATIENTS AT RSUP. DR. M. DJAMIL PADANG Isnaniyah Usman; Irvan Medison; Deddy Herman
Jurnal Respirologi Indonesia Vol 43, No 4 (2023)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v43i4.427

Abstract

Background: Inflammatory process in COVID-19 can increase inflammatory markers such as C-reactive protein , procalcitonin , and interleukin. The level of C-reactive protein describes the severity of the viral infection. Several studies have been conducted to investigate the link between C-reactive protein levels and the severity of COVID-19. The purpose of this study is to see if there are any differences in C-reactive protein levels based on clinical degrees and outcomes of COVID-19 patients treated at RSUP by Dr. M. Jamil Padang.Methods: This is a retrospective cohort study with  sample of all COVID-19 patients treated at RSUP by Dr. M. Djamil Padang who met the inclusion and exclusion criteria. The study lasted from December 1, 2021 to June 1, 2022. Data were analyzed using univariate,bivariate and confounding analysis. Results: The characteristics of the patients  were mostly women (51.0%) with range of age 50-59 years (28.0), the most comorbid was hypertension (46.0%). Less than half of the total subjects had secondary infection (49.0%). Most of the subjects had a critical clinical severity (75.0%) and had a length of stay ≤14 days (77.0%) and more than half of the subjects died (65.0%). C-reactive protein levels were higher in patients with critical clinical degrees (89.00 mg/L) compared to moderate (37.50 mg/L) and severe (23.00 mg/L), C-reactive protein levels in patients with long hospitalization ≤ 14 days (97.00 mg/L) was higher than >14 days (88.50 mg/L), and C-reactive protein levels were higher in patients who died (93.00 mg/L) than those who were alive (68.00 mg/L).Conclusion: C-reactive protein levels differed significantly based on clinical severity, length of stay and end of stay status of COVID-19 patients.
Magnesium and Phosphate Ion Levels in Mechanically Ventilated Patients Treated at Persahabatan Hospital’s Intensive Care Unit (ICU) and Respiratory Intensive Care Unit (RICU) in 2018 Filemon Suryawan Handjaja; Menaldi Rasmin; Prasenohadi Prasenohadi; Ernita Akmal
Jurnal Respirologi Indonesia Vol 43, No 3 (2023)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v43i3.456

Abstract

Background: History shows that respiratory system has a long and complicated arrangement so that many factors can affect a human’s ability to breathe. Some electrolytes often considered as most important are sodium (Na+), potassium (K+), calcium (Ca2+) and chloride (Cl-). Other than that, magnesium (Mg2+) and phosphate (PO43-) are also important in all processes, especially at the neuromuscular junction and in muscle cells as adenosine triphosphate (ATP). Some researchers have found that PO43- affected patients’ clinical condition and ventilator weaning success, although Mg2+ gave inconsistent results. Until now, there have not been any studies or data about the significance of Mg2+ and PO43- in ventilator weaning in Indonesia.Methods: This was a cross sectional study with total sampling. A vein blood sample was taken after ICU/RICU admission at Persahabatan Hospital. Blood sample was taken consecutively until it reached a minimum of 30 subjects (pilot study). All patients found with mechanical ventilation were included, except for patients with complicated procedure (e.g. avian influenza, multidrug-resistant tuberculosis). Blood sample was analyzed for Mg2+, inorganic phosphate (Pi) and other additional tests. Failure in weaning was defined as reintubation within 48 hours after extubation or failure in the spontaneous breathing trial (SBT).Results: Of the 31 subjects evaluated, there were 3 patients with weaning failure. The median Mg2+ value was 0.5 (0.5-2.6) in successfully weaned patients and 0.6 (0.6-2.7) in patients with weaning failure, lower than its normal value. The mean Pi value was 4.21±1.17 (normal value) in successfully weaned patients and 5.43±0.47 (high value) in patients with weaning failure. Further analysis found that no significant relation was found between weaning and patient’s characteristics other than heart rate and Ca2+, although it was not clear if there were some biases which could affect these results. Low Mg2+ value was observed in 23 subjects, no low Pi value was seen in all subjects, high Mg2+ value was found in 1 subject, high Pi value was observed in 11 subjects, and the rest was in the normal range.Conclusion: The median Mg2+ value in both weaning groups (successful and failed) were below the normal limit at 0.5 (0.5-2.6) and 0.6 (0.6-2.7). Mean Pi value in the successful weaning group was 4.21±1.17 (within normal range), and the value in failed weaning group was 5.43±0.47 (above normal range).
THE CORRELATIONS BETWEEN CLINICAL CHARACTERISTICS AND INFLAMMATION MARKERS WITH CHEST X-RAYS IN COVID-19 PATIENTS AT ULIN GENERAL HOSPITAL BANJARMASIN Muhammad Nor; Ira Nurrasyidah; Mashuri Mashuri
Jurnal Respirologi Indonesia Vol 43, No 4 (2023)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v43i4.407

Abstract

Background: Chest x-ray is one of the parameters to estimate the severity and prognosis of COVID-19. Arterial oxygen saturation (SaO2), partial pressure of arterial oxygen (PaO2), and respiratory index (PaO2/FiO2) can also predict the disease severity. Other parameters like inflammation markers also have been used as predictors for prognosis. Based on those considerations, this study will examine their connection and find their correlation. Methods: This is an analytic observational retrospective study design. The samples were moderate-critical COVID-19 patients in Ulin General Hospital Banjarmasin from July - December 2021 who met the inclusion and exclusion criteria. Statistical tests were used to see the relationship between clinical characteristics and inflammation markers with chest X-ray, using various scoring systems (Brixia, sRALE, and modified Soetomo score). Results: Total subjects were 67 patients. The data analysis found that the severity of the disease had a significant relationship with the severity of the chest X-ray (sig. < 0.001). The PF ratio also had a significant negative correlation (sig. < 0.001) with the severity of the chest x-ray. For inflammation markers, NLR, CRP, and LDH significantly correlated with a chest x-ray. The patient's outcome is also associated with a chest X-ray (sig. < 0.015). Conclusion: There were significant correlations between clinical characteristics and inflammation markers on the chest X-ray severity, and sRALE was a better scoring system to assess chest x-ray severity than other scoring systems. Keywords: COVID-19, disease severity, inflammation markers, PF ratio, chest X-ray
Effectiveness of COVID-19 Antivirus Therapy and Its Relationship with Vaccination: A Retrospective Analysis Andi Utari Prasetya Ningrum; Retnosari Andrajati; Nadia Farhanah Syafhan; Aditya Wirawan
Jurnal Respirologi Indonesia Vol 43, No 3 (2023)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v43i3.434

Abstract

Background: COVID-19 is known to have infected more than a million people. COVID-19 can be treated with antivirals. Besides antiviral drugs, vaccination becomes one of the strategies to suppress the spread of COVID-19. This study aimed to analyze the effectiveness of antivirus and the relationship between vaccination and the effectiveness of the two antiviral therapies in COVID-19 patients based on improvements in the patient's clinical condition, length of stay, and mortality.Methods: This study used a retrospective cohort design conducted at the Universitas Indonesia Hospital, Depok, Indonesia. Data were taken from medical records and hospital databases from January 2021 to August 2022. The antivirals in this study were remdesivir and favipiravir. The samples were divided into two groups, namely the vaccinated and unvaccinated groups.Results: The factor affecting the effectiveness of remdesivir and favipiravir therapy was the severity of COVID-19. It was shown that vaccination had a significant effect on improving clinical conditions, reducing length of stay, and reducing mortality in patients treated with remdesivir who had been vaccinated compared to those who had not been vaccinated. In patients who received favipiravir therapy and were vaccinated, it also showed an effect on improving clinical conditions, length of stay, and mortality compared to patients who were not vaccinated, although the results were not statistically significant.Conclusion: Vaccination had a positive effect on the effectiveness of remdesivir and favipiravir in COVID-19 patients, which could improve the patient's clinical condition in a better direction, as well as reduce length of hospitalization and mortality.
Clinical Performance of the Aspergillus Western Blot IgG Kit for Serodiagnosis of Chronic Pulmonary Aspergillosis in Post-Tuberculosis Patients Anna Rozaliyani; Sresta Azahra; Findra Setianingrum; Heri Wibowo
Jurnal Respirologi Indonesia Vol 43, No 4 (2023)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v43i4.562

Abstract

Background: Chronic pulmonary aspergillosis (CPA) due to Aspergillus spp., causing slowly progressive destruction to lung parenchyma, is a major complication of pulmonary tuberculosis (TB). Detecting Aspergillus-specific IgG is critical for diagnosing CPA.Methods: We evaluated the performance of Aspergillus Western Blot (Asp-WB) IgG kit (LDBio Diagnostics, Lyon, France), a commercialized immunoblot assay for the diagnosis of CPA in 63 post-tuberculosis patients.Results: The sensitivity and specificity of Asp-WB were 50% and 93%. There was significant difference of Asp-WB positive results in probable CPA (n = 13) and non-CPA (n = 3) group (50% vs. 8%, p < 0.001). False negative results of Asp-WB were detected from non-fumigatus CPA that grew Aspergillus niger. CPA patients with mild symptoms (less than 3 months) indicated early progression of CPA might showed positive Asp-WB test resultd in low sensitivity of Asp-WB test.Conclusion: This study concluded that Asp-WB has potential to use as confirmatory test to assist diagnosis of CPA in post-TB patients. 
Primary Spontaneous Pneumothorax In Healthy Tall and Thin Male Secondary to Smoking: A Case Report and Literature Review Budi Yanti; Rina Marlena
Jurnal Respirologi Indonesia Vol 43, No 3 (2023)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v43i3.554

Abstract

Background: Primary Spontaneous Pneumothorax (PSP) refers to the collapse of a lung without any underlying disease and is commonly observed in tall, thin young men, with smoking as an under-recognized risk factor. The management of PSP can vary significantly across different health centers. This case report highlights a young man with a pneumothorax without an underlying illness but has a smoking habit who initially gets treatment with an insertion of a chest tube.Case: This study focused on a 19-year-old man complaining of sudden right chest pain. The patient was a smoker for the past four years, and the examination showed hypersonic and vesicular loss on the right side. The laboratory tests revealed normal limits, and the sputum indicated the absence of tuberculosis. Chest X-ray showed an avascular radiolucent area in the right lung, and a Chest CT scan confirmed the presence of a hypodense area of air density in the right hemithorax. Right PSP was diagnosed and managed using a chest tube drainage on admission. After four days of treatment, he exhibited improvement and was discharged. A recurrence of pneumothorax was not discovered in the subsequent six-month follow-up period.Conclusion: Despite being a rare disorder, PSP should be considered during the physical examination of patients. It is also important to reassess the risk factors that can contribute to the onset of pneumothorax. The clinicians should be able to identify PSP and emphasize tall, thin, and young men at greater risk of pneumothorax in a pulmonary emergency.
The Effect of Dexamethasone on IL-6 Levels in Confirmed COVID-19 Patients Treated at RSUP Dr. M. Djamil Padang Bobby Hasibuan; Irvan Medison; Fenty Anggrainy
Jurnal Respirologi Indonesia Vol 43, No 3 (2023)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v43i3.426

Abstract

Background: Elevated IL-6 levels have been found in COVID-19 patients and are associated with a poor prognosis. According to COVID-19 management guidelines, several types of corticosteroids can be used as therapy modalities for COVID-19 patients, including dexamethasone, methylprednisolone, and hydrocortisone. The purpose of this study was to examine how dexamethasone administration affected changes in IL-6 levels in confirmed COVID-19 patients at RSUP Dr. M. Djamil Padang.Methods: This was a retrospective cohort study with a sample of all COVID-19 patients who met the inclusion and exclusion criteria and were treated in the COVID-19 isolation ward at RSUP Dr. M. Djamil Padang. The study began in June 2021 and concluded in July 2022. The data was analyzed both descriptively and analytically. The distribution of frequencies and proportions of each variable was included in the univariate analysis. Bivariate analysis employs data-scale-appropriate statistical tests such as the T-test to determine the relationship between independent and dependent variables.Results: The characteristic of the patients were mostly 18-49 years old (37.22%), female (55.67%), of severe clinical degree (49.44%), had no comorbidities (52.78%) and the majority (77.78%) received dexamethasone in the recommended dose (1 x 6 mg). The study's findings revealed that there was no difference in IL-6 values before and after dexamethasone administration in patients with moderate clinical degrees,  but there were differences in IL-6 values before and after dexamethasone administration in patients with severe and critical clinical degrees.Conclusion: The IL-6 level has significantly decreased following dexamethasone administration. Dexamethasone administration causes significant changes in IL-6 values in severe and critical degrees but not in moderate clinical degree.

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