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Majalah Anestesia dan Critical Care
Published by Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif Indonesia
ISSN : -     EISSN : 25027999     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology
Majalah ANESTESIA & CRITICAL CARE (The Indonesian Journal of Anesthesiology and Critical Care) is to publish peer-reviewed original articles in clinical research relevant to anesthesia, critical care, and case report . This journal is published every 4 months (February, June, and October) by Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif Indonesia (PERDATIN).
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Articles 10 Documents
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Search results for , issue " Vol 33 No 2 (2015): Juni" : 10 Documents clear
Acid-Base Balance: Stewart’s Approach Pradian, Erwin; Maskoen, Tinni Trihartini; Destiara, Andy Pawana
Majalah Anestesia dan Critical Care Vol 33 No 2 (2015): Juni
Publisher : Perdatin Pusat

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Abstract

The Henderson-Hasselbalch approach to acid-base balance allows explanation and quantification of many disorders of acid-base phisiology and is still widely used in clinical practice. However, complex metabolic disorders, such as those present in critically ill patients, can be difficult to define and treat using this approach. Peter Stewart proposed a different approach to acid-base physiology based upon physicochemical principles, which are electrochemical neutrality, conservation of mass and law of mass action. According to Stewart, there are only three variables influence the dissociation of water. These independent variables are pCO2, total concentration of weak acid [ATot] and strong ion difference (SID). Another different is if in Henderson-Hasselbalch approach pointed on bicarbonat ion, Stewart use chloride ion as the important anion as the causatif factor so there are also known the terms hyperchloremia acidosis, dilutional acidosis and contraction alkalosis.
Clinical Manifestations of Iscehaemic and Reperfusion Injury Pradian, Erwin; , Rizki; Maskoen, Tinni Trihartini
Majalah Anestesia dan Critical Care Vol 33 No 2 (2015): Juni
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Abstract

Although restoration of blood low to an ischaemic organ is essential to prevent irreversible tissue injury, reperfusionper se may result in a local and systemic inlammatory response that may augment tissue injury in excess of thatproduced by ischaemia alone. Cellular damage after reperfusion of previously viable ischaemic tissues is deinedas ischaemia-reperfusion (I-R) injury. I-R injury is characterized by oxidant production, complement activation,leucocyte endothelial cell adhesion, platelet-leucocyte aggregation, increased microvascular permeability anddecreased endothelium-dependent relaxation. In its severest form, I-R injury can lead to multiorgan dysfunctionor death. Although our understanding of the pathophysiology of I-R injury has advanced signiicantly in the lastdecade, such experimentally derived concepts have yet to be fully integrated into clinical practice. Treatment ofI-R injury is also confounded by the fact that inhibition of I-R-associated inlammation might disrupt protectivephysiological responses or result in immunosuppression. Thus, while timely reperfusion of the ischaemic areaat risk remains the cornerstone of clinical practice, therapeutic strategies such as ischaemic preconditioning,controlled reperfusion, and anti-oxidant, complement or neutrophil therapy may signiicantly prevent or limit I-Rinducedinjury in humans.
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
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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.
The Effect of General Anesthesia compared to Spinal Anesthesia for Caesarean Section on Neonatal APGAR Score christiana, monica; Bisri, Tatang
Majalah Anestesia dan Critical Care Vol 33 No 2 (2015): Juni
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Abstract

For the last decades, Casearean delivery cases has increased significantly. The choice of anesthesia technique for surgical procedure consider its safety for both the mother and neonates. Neonatal APGAR scoring has been used as the parameter of neonate’s well being and success of obstetric anesthesia technique. Several previous studies have recommended the excellence of regional anesthesia compared to general one. This study was conducted to compare the effect of general anesthesia to spinal anesthesia on the APGAR score of the neonates. The objective of this study is to describe the general anesthesia and spinal anesthesia effect in Caesarean delivery on AGPAR score. Rertospective study of 64 parturient patients underwent elective Caesarean section from January to June 2015. Data were obtained from medical record of Melinda Mother and Child Hospital, Bandung. Subjects were distributed into 2 groups of 32 patients each. Group I underwent general anesthesia, while the other underwent spinal anesthesia. Parameter asessments were APGAR, blood pressure, pulse, and okxygen saturation. Data recoded were analized with t test and p<0.05 considered as significant. First minute APGAR scores were recorded unsignificantly higher (p=0.326) in Group I (8.87± 0.33) compared to Group II (8.78± 0.42). However, fifth minute APGAR scores were significantly (p=0.000) better in Group II (9.75±0.46) compared to Group I (9.25±0.44). Spinal anesthesia technique in caesarean section procedure had a significantly better effect on neonatal APGAR score compared to genaral anesthesia.
Post-operative Emergence Agitation in Children Undergoing Inhalation General Anesthesia in Cipto Mangunkusumo Hospital: Study on Incidence and Affecting Factors Wijaya, Andi Ade; Kapuangan, Christopher; Aktara, Betardi
Majalah Anestesia dan Critical Care Vol 33 No 2 (2015): Juni
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Abstract

Emergence agitation (EA) during recovery from general anesthesia is often found among pediatric population. The etiology of EA in children is not fully understood. Possible risk factors include pre-school age, recent inhalation anesthetics, poor adaptability, and parental presence during recovery. The aim of the present study was to assess the incidence of EA and the affecting factors in children undergoing inhalation anesthesia in Cipto Mangunkusumo Hospital. There were 78 samples, aged 2–12 years undergoing inhalation anesthesia. Behavior during induction of anesthesia was assessed with Pediatric Anesthesia Behavior (PAB) score. In post anesthesia care unit (PACU) the incidence of EA was assessed with Aono’s four-point scale upon admission (T0), after 5 min (T5), 15 min (T15) and 30 min (T30). The incidence of EA in children undergoing inhalation anesthesia in this study was 39,7%. The incidence was higher in 2–5 years old children with PAB score 2 or 3. Midazolam, type of inhalation anesthetic agents and parental presence during recovery do not appear to have any bearing on the incidence of EA. Age of the children and the behavior during induction of anesthesia have a strong correlation with the incidence of EA.
Effectivity of Fentanyl 1 μg/kg.weight to Prevent Emergence Agitation After General Anesthesia with Sevoflurane in Pediatric Patients Bernouli, Renny; Puspita, Yusni; Maas, Endang Melati; , Theodorus
Majalah Anestesia dan Critical Care Vol 33 No 2 (2015): Juni
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Abstract

Emergence agitation (EA) is a postanesthetic problem that interferes a child’s recovery and presents a challenge in terms of assessment and management. Fentanyl, a potent opioid, are hypotetised can prevent emergence agitation after general anesthesia with sevoflurane in pediatric patients. In this experimental clinical trial double-blind study, 34 children (age 2–7 years old) underwent elective minor surgery under general anesthesia with sevoflurane were selected to have an intravenous fentanyl 1μg/kgweight versus placebo before the end of the surgery. On thirty minutes after anesthesia, we evaluated agitation incidence (based on WATCHA score ≥3) and side effects of fentanyl. Recovery characteristics, including awakening time, duration of agitation, pain scale using FLACC scale, and discharge time were also recorded. All datas were analised using SPSS 21 and significantly different if p<0,10. The incidence of agitation on fentanyl group are lower in fentanyl group than placebo (17,6% versus 52,9%) and statistically different (p=0,071The incidence of vomiting are similar (5,9%) and there are no significant difference in awakening time. Fentanyl 1 μg/kgweight intravenous are proven effective to prevent emergence agitation after awakening from general anesthesia with sevoflurane in pediatric patients
Anaesthetic Management for a Patient with Uterine Perforation Due to Gestational Trophoblastic Disease with Hyperthyroidism wullur, caroline; Rismawan, Budiana
Majalah Anestesia dan Critical Care Vol 33 No 2 (2015): Juni
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Abstract

Gestational trophoblastic disease originates from abnormal proliferation of molar tissue and most of them are not complicated. However, life threatening condition such as hyperthyroidism may occur. Often, the diagnosis of hyperthyroid state is a retrospective one, as it can be missed in the emergency scenario of patient requiring molar evacuation. Trophoblastic hyperthyroidism poses a multiple of challenges to the anaesthesiologist. High output cardiac failure secondary to thyrotoxicosis, thyroid storm, hypertension and disseminated intravascular coagulation may occur in the perioperative period. We report a successful anaesthetic management of a patient with gestational trophoblastic disease with manifestations of hyperthyroidism whom underwent a trans-abdominal hysterectomy.
Airway Management in Patient Trauma Maxillofacialwith Mild Head Injury, Open Fracture Depressed, and Skull Base Fracture Sudjud, Reza Widianto; , suwarman; Patrianingrum, Meilani
Majalah Anestesia dan Critical Care Vol 33 No 2 (2015): Juni
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Abstract

Establishing a secure airway in a trauma patient is essentials. Any law in airway management may lead to gravemorbidity and mortality. Maxillofacial trauma presents a complex problem with regard to the patient’s airway.Moreover, this patient sometimes accompanied with head injury and fracture cervical.In this case report, wereported male, 41 years old, came to the hospital Hasan Sadikin General Hospital with complaints wounds in thehead and face as a result of trafic accidents. This patient suffered trauma maksilofasialis with addition of minorhead injuries, open fractures depressed more than one tabula, incomplete cervical injury and skull base fractures.Management airway in this patient is spontaneous breathing that is achieved by administering propofol and gasgradually Sevolurane inhalation. Meanwhile, to prevent hemodynamic disturbances during laryngoscopy Fentanylwas given. The manual in-line stabilization was performed to prevent neck lexion when laryngoscopy intubation.In cases where airway is dificult to manage, intubation technique chosen is the one that anesthesiologist most feltcomfortable. Both of these factors are more relevant than the choice of technology.
Correction Hypocalemic Patients with Potassium Chloride in ICU of Dr. Hasan Sadikin Hospital Bandung in Januari–Februari 2014 Hidayat, Dede A; Fuadi, Iwan; Sitanggang, Ruli H.
Majalah Anestesia dan Critical Care Vol 33 No 2 (2015): Juni
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Abstract

Hypokalemia (Potassium plasma level <3.5 mEq/L) is the most common electrolyte imbalance found in the intensive care unit (ICU). Major etiologies of hypokalemia in ICU setting were related to low intake, gastro intestinal tract (GIT) disturbance, renal impairment, diuretic administration, insulin therapy and severe infection, which ranging from asymptomatic to the most severe symptom and causing death.This prospective observational study was conducted in the ICU of Dr. Hasan Sadikin Hospital Bandung from January to February 2014 with result 33 out of 105 admitted patients (31.4%) suffered from hypokalemia.From our observation, there was 17 patients (51.5%) with mild hypokalemia, 13 patients (39.4%) with moderate hypokalemia and 3 patients (9.1%) with severe hypokalemia. Correction with intravenous potassium chloride was given with improvement in 9 patients (53%) in mild hypokalemia group, 3 patients (23.1%) in moderate hypokalemia group but unfortunately no significant change was found in severe hypokalemia group after the correction. Complications were found mostly in geriatric patients with severe hypokalemia.The conclusion of this study is that from all patients admitted to the ICU of Dr. Hasan Sadikin Hospital Bandung from January ̶ February 2014, the incidence of hypokalemia was 31.3% (33 patients) with improvement occurred in 12 patients (36.4%) but 21 patients (63%) revealed no improvement after potassium chloride correction with worsening condition.
Incidence of Post Dural Puncture Headache (PDPH) after Spinal Anesthesia at Dr. Hasan Sadikin General Hospital Bandung in February–April 2015 Period , Suwarman; Sitanggang, Rully H.; Mayasari, Ferra; Yuwono, Hendro Sudjono
Majalah Anestesia dan Critical Care Vol 33 No 2 (2015): Juni
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Abstract

Post dural puncture headache (PDPH) occurs because of the cerebrospinal fluid leakage caused by dural puncture. Post dural puncture headache is a common complication after spinal anesthesia which incapacitating the patients. The purpose of our study is to describe the incidence of PDPH in patient undergone surgery with spinal anesthesia at Dr Hasan Sadikin General Hospital Bandung and obtaining the risk factor characteristics which associated with PDPH. This cross sectional observational study carried out 156 postoperative subjects with spinal anesthesia patients over February until April 2015. There were 10 subjects (6,41%) developed PDPH. The characteristics which assosciated with PDPH dan statistically significant (p value<0,05) are median and paramedian punctures technique (PR=19,722; CI 95% 6,377; 60,996), history of PDPH (PR=17,222; CI 95% 9,235; 32,469), and multiple punctures (PR=6,400; CI 95% 1,406; 29,132). Whereas, characteristic which associated independently with PDPH is the median and paramedian punctures technique (POR=29,121 CI 95% 33,842;220,745). Anesthesiologist have an important role to prevent PDPH with selection of spinal needle, selection of mastered technique, and improving anesthesiologist’s skill.

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