cover
Contact Name
Prihatma Kriswidyatomo
Contact Email
ijar@fk.unair.ac.id
Phone
+628123008875
Journal Mail Official
ijar@fk.unair.ac.id
Editorial Address
Departemen Anestesiologi dan Reanimasi Fakultas Kedokteran Universitas Airlangga-RSUD Dr Soetomo Surabaya Gedung Anestesi Baru-RSUD Dr Soetomo Surabaya Jl. Mayjen Prof. Dr. Moestopo No 6-8, Airlangga, Gubeng, Surabaya, 60286, Indonesia
Location
Kota surabaya,
Jawa timur
INDONESIA
Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Published by Universitas Airlangga
ISSN : 27224554     EISSN : 2686021X     DOI : 10.20473/ijar.V2I12020.1-7
Core Subject : Health,
IJAR is a scientific journal published by Department of Anesthesiology and Reanimation, Faculty of Medicine Universitas Airlangga. IJAR is an English language journal. IJAR FOCUSES original research, review article, case report, and correspondence, on anesthesiology; pain management; intensive care; emergency medicine; disaster management; pharmacology; physiology; clinical practice research; and palliative medicine. This journal is a peer-reviewed journal established to improve the understanding of factors involved in anesthesiology and emergency medicine.
Articles 39 Documents
Fluid Resuscitation in Trauma Kun Arifi Abbas
Indonesian Journal of Anesthesiology and Reanimation Vol. 1 No. 2 (2019): Indonesian Journal of Anesthesiology and Reanimation
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (984.385 KB) | DOI: 10.20473/ijar.V1I22019.52-57

Abstract

Introduction: Trauma is a problem faced everyday in the emergency room of the hospital where the researcher works. The degree of trauma from the mildest to life threatening can be found in sufferers. The cause of death in trauma sufferers is hypovolemic shock due to bleeding. The amount of blood loss volume from the patient can be estimated by looking at the clinical signs of the patient. Literature Review: In the condition of tissue hypoperfusion, it will cause a chain process which will eventually lead to cell death. Hypoperfusion causes anaerobic metabolism, lactic acidosis (coagulopathy, enzyme dysfunction), Na-K pump malfunction (cellular swelling and cell death), there is hypothermia (increase of oxygen demand, coagulopathy). Hypoperfusion will cause a vicious circle, in which processes that aggravate one another will occur. With the administration of fluids (crystalloid, colloid, transfusion) will improve the hypoperfusion that occurs in the body. Conclusion: The management of hypovolemic shock due to bleeding requires an understanding of the physiology and pathophysiology that occurs due to bleeding. To get maximum results and improve  outcome  from sufferers, it needs solid team work. Treatment can be different depending on the conditions, equipment and facilities of the hospital / emergency room as well as the policies of each place.
Electrolytes Profile of Critically Ill Patients Admitted To Pediatric Intensive Care Unit (PICU) Dr. Soetomo General Hospital Amalia Citra Octavia; Arina Setyaningtyas; Pesta Parulian Maurid Edwar
Indonesian Journal of Anesthesiology and Reanimation Vol. 2 No. 1 (2020): INDONESIAN JOURNAL OF ANESTHESIOLOGY AND REANIMATION
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (760.563 KB) | DOI: 10.20473/ijar.V2I12020.1-7

Abstract

Introduction: Fluid and electrolyte disorders can be affected by various conditions or diseases. Electrolyte disorders are often found in pediatric patients with critically ill conditions and are associated with increased morbidity also mortality that requires extra care in the Pediatric Intensive Care Unit (PICU). Objective: To describe the electrolyte profile of critically ill patients with electrolyte disorders admitted to the Pediatric Intensive Care Unit (PICU) Dr. Soetomo General Hospital. Materials and Methods: The study was conducted prospectively with a descriptive method in patients with electrolyte disorders aged 1 month – 18 years old admitted to PICU Dr. Soetomo General Hospital, Surabaya in a period from August to November 2018. Data on patient age, gender, electrolyte profile (sodium, potassium, calcium, chloride), and origin before PICU admission were recorded. Results and Discussion: From 37 patients with electrolyte disorders showed that patients were dominated by the male in 56.8% (n=21), in the age group of infants or 1-12 months old in 45.9% (n=17). Common main diagnosis in most patients were digestive system disorders in 27% (n=10), followed by central nervous system, respiratory system, kidney and cardiovascular disorders, and the origin before PICU admission were from Emergency Room (ER) in 62.2% (n=23). There were found 97 incidences of electrolyte disorders. Most frequent electrolyte disorders were hypocalcemia in 59.5% (n=22), hypokalemia in 54.1% (n=20), hyponatremia in 40.5% (n=15) and the least was hypochloremia in 35.1% (n=13). Mean serum sodium level was 138.18 ± 12.071, serum potassium level was 3.608 ± 1.2247, serum calcium level was 8.057 ± 1.9473 and serum chloride level was 101.45 ± 13.266. Conclusions:  Critically ill patients admitted in PICU tend to experience low electrolyte levels.
Screening Protocol of Propofol Infusion Syndrome Muzaiwirin Muzaiwirin; Arie Utariani
Indonesian Journal of Anesthesiology and Reanimation Vol. 2 No. 2 (2020): Indonesian Journal of Anesthesiology and Reanimation
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (477.477 KB) | DOI: 10.20473/ijar.V2I22020.67-76

Abstract

Introduction: Propofol is often used as sedation for a long time in the ICU. The use is at risk of Propofol Infusion Syndrome (PRIS) which is characterized by arrhythmias or decreased heart function, metabolic acidosis, rhabdomyolysis, and acute renal failure. Literature Review: The pathophysiology of PRIS is due to a disturbance in cell metabolism which inhibits the transport of Free Fatty Acid (FFA) into cells and inhibits the mitochondrial respiration chain. The management of PRIS is supportive of every symptom that arises so that screening is needed as a treatment to reduce high mortality rates. Screening using creatine phosphokinase (CPK) and lactate is supporting data as an initial introduction for symptoms of PRIS. Conclusion: PRIS can occur if continuous administration of propofol > 4 mg / kg / hour. CPK levels> 5000 IU / L become a benchmark to stop propofol before the onset symptoms of PRIS. Implementation of screening protocol is very helpful for clinicians to reduce mortality in ICU due to the use of propofol.
Opioid-Sparring and Multimodal Analgesia as Parts of Enhanced Recovery After Surgery (ERAS) Applied In The Ksatria Airlangga Floating Hospital Pratama Ananda; Bambang Pujo Semedi; Christrijogo Sumartono Waloejo; Arie Utariani
Indonesian Journal of Anesthesiology and Reanimation Vol. 3 No. 1 (2021): Indonesian Journal of Anesthesiology and Reanimation
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (136.648 KB) | DOI: 10.20473/ijar.V3I12021.17-21

Abstract

Introduction: Enhanced Recovery After Surgery (ERAS) protocol is a perioperative multimodal service program designed to achieve a faster surgical recovery period and a better outcome, the key in reducing morbidity in surgery is by reducing the “surgical injury” and reducing the body’s stress response caused by the surgery. The success of the ERAS protocol depends on the interpretation and collaboration of the multidisciplinary team, therefore though the protocol is carried out in a hospital that has sufficient facilities and resources, the obstacle in the implementation of ERAS can still happen. The implementation of ERAS protocol in the non-permanent hospital service facility becomes a challenge in itself. Case Reports: From the two case reports of the implementation of ERAS protocol in the Ksatria Airlangga Floating Hospital (RST-KA) it is obtained that the key success of the anesthesia in ERAS protocol above lies on the administration of opioid-sparring therapy where it will reduce the use of opioid. Although there are many obstacles obtained in the RST-KA, the use of ERAS protocol can be conducted by making effective use of opioid-sparring combined with the administration of multimodal analgesia. Conclusion: Therefore, it can be concluded that the ERAS protocol can be applied in the social service concept in the non-permanent health facility.
Social-Fairness Perception in Natural Disaster, Learn from Lombok: A Phenomenological Report Filipus Michael Yofrido; Lila Tri Harjana
Indonesian Journal of Anesthesiology and Reanimation Vol. 1 No. 1 (2019): INDONESIAN JOURNAL OF ANESTHESIOLOGY AND REANIMATION
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (296.301 KB) | DOI: 10.20473/ijar.V1I12019.1-7

Abstract

Introduction: Disasters occur in all areas of the world and cause harm to populations, property, infrastructure, economies, and the environment.1Harm to populations includes death, injury, disease, malnutrition, and psychological stress.1Social-friction often isn’t recognized during disaster response and recovery. Objective: This report explored the existence of social-friction in disaster situation which able to make recovery more complex. Method: This was qualitative study with phenomenology report approach. The data collection was done by indepth interviewing five inhabitants when doing emergency disaster response two weeks after massive earthquake in North Lombok. Result and discussion: Two out of five inhabitants were Lombok native-people, the rest were immigrant. An inhabitant reported their feeling treated unfair by aid agencies because they received less aid than others. In another chance, when distributing clean-water, we were intercepted, they argue that they got more lack of water than another group who live far distally. Both claimed treated unfair making a dispute friction.Ethnic or social origin, language, religion, gender, age, physical or mental disability, and sexual orientation are just some of the deep-rooted causes of social-friction that can have such a devastating impact on their lives.Social-friction in everyday life rarely endangers lives, but in an emergency situation, it can be life-threatening. It affects not only people’s ability to survive the crisis, also their capacity to recover and regain their livelihoods. Conclusion: Risk reduction and preparedness are just as important a part of the process as any aspect of a disaster.Dialogue is fundamental in good programme design, monitoring and evaluation, and systematic efforts to listen to all groups affected by disaster can help pre-empt and remedy unfair-perception.Perhaps,most importantly, understanding and respecting the complex cultural context in which aid agencies are working and using the strategies and mechanismsto detectand minimize social-friction, will result great improvement in the effectiveness and equity of perceived support in humanitarian assistance.2
Profile Hemodynamics (Blood Pressure And Heart Rate) Changes in The Use of Adrenaline in Cesarean Section With Spinal Anesthesia at Dr Soetomo Surabaya Hospital Ainur Rahmah; Arie Utariani; Achmad Basori
Indonesian Journal of Anesthesiology and Reanimation Vol. 2 No. 1 (2020): INDONESIAN JOURNAL OF ANESTHESIOLOGY AND REANIMATION
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (239.896 KB) | DOI: 10.20473/ijar.V2I12020.27-32

Abstract

Introduction: spinal anesthesia block is one of anesthesia technique that  aims to block motor nerves resulting in paresis or anesthesia and paralysis or loss of muscle function in myotomes that are the same level as blocked dermatomes. Caesarean section is one of the surgical actions that are often performed mainly in birth cases. Besides that, the mechanism of the effects of giving birth to the operation of type B autonomic caesarean section autonomic nerve pronglion nerve which results in a decrease in the resistance of peripheral veins and peripheral vasodilatation which results in an imbalance in hemodynamics especially in blood pressure and heart rate and cause of hypotension. Vasopressor, fluid therapy, vasoconstrictor are given to reduce the toxicity of local anesthesia and to overcome hypotension. Objective: To determine hemodynamic changes (blood pressure and pulse) in spinal anesthesia block surgery patients with caesarean section at Dr Soetomo Hospital. Material and Method: This research is descriptive with a retrospective from January - March 2018, the sample taken with total sampling from secondary data from the central medical record at RSUD Dr. Soetomo. Results and Discussion: 68 samples were obtained from inclusion and exclusion criteria there was a change in blood pressure and pulse in patients with caesarean section with spinal anesthesia block with the addition of vasoconstrictors. There was a decrease in average systolic pressure 13.25, diastole 18.25 and pulse 4.5 and in no increase. There was a decrease in average systolic pressure 11.9286, diastole 13.8929 and pulse 5.6429 and no addition of p> 0.05 the two are not significantly different. Conclusion: addition of adrenaline to spinal anesthesia in caesarean section patients was not cause significant hemodynamic (blood pressure and heart rate) changes.
Effectivity Comparison of Ketamine and Morphine as Post-Operative Analgesic in Spinal Surgery Nenden Suliadiana Fajarini; Nancy Margarita Rehatta; Arie Utariani
Indonesian Journal of Anesthesiology and Reanimation Vol. 1 No. 2 (2019): Indonesian Journal of Anesthesiology and Reanimation
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (325.95 KB) | DOI: 10.20473/ijar.V1I22019.43-51

Abstract

Introduction: Patients who undergo spinal procedure, experience the post-operative pain as the major problem. From the Visual Analog Scale (VAS), patients scale their pain around 8. An inadequate pain management could fasten the healing process and reduce patient life quality. Opioid group as the gold standard still inflicts several problems, such as respiratory depression. Moreover, the combination NSAID and opioid which used to suppress the side effect, still burden the healthcare cost. In a research of analgesic, through the discovery of N-Methyl D Aspartate receptor, researchers found an explanation of the ketamine effect in relieve chronic and intense pain which safer and cheaper. Method and Material: This research using single blind randomized control trial. Comparing 0.25mg/kg ketamine IV followed by ketamine 0,1mg/kg/h for the intervention group and 0.02mg/kg/h of morphine for the control group to manage the first 24 hours pain sensation. If patient VAS was more than 4, patient would get additional 0.5mg/kg ketamine (intervention group) and 25μg fentanyl (control group). Result and Discussion: From 17 patients each groups, the VAS values were better in control group rather than on intervention group. Low dose ketamine can’t be compared with morphine to manage post spinal procedure pain. There were no hemodynamic changes, respiratory rate depression, loss of consciousness and hallucination, nystagmus, vomiting and hyper salivation. Even though 11.8% of the subject were nausea. The morphine group tends to experience hemodynamic changes and loss of consciousness in the first 12 hours but still within normal range. In the control group, 47.1 % patients were having nausea in the first hour, but only 17.6% of them who actually vomited. Conclusion: The analgesic effect of morphine is higher than ketamine, but the amount effect of ketamine is lower than morphine so that ketamine is more effective and safer given in the room.
Duration Of Ventilation Support Usage And Development Of Ventilator-Associated Pneumonia: When Is The Most Time At Risk? Ricky Indra Alfaray; Muhammad Iqbal Mahfud; Rafiqy Sa'adiy Faizun
Indonesian Journal of Anesthesiology and Reanimation Vol. 1 No. 1 (2019): INDONESIAN JOURNAL OF ANESTHESIOLOGY AND REANIMATION
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (264.31 KB) | DOI: 10.20473/ijar.V1I12019.26-31

Abstract

Introduction: Ventilator-Associated pneumonia (VAP) is pneumonia that occurs in patients who have been mechanically ventilated for a duration of more than 48 hours. The duration of ventilator use was identified as a risk factor which is a trigger of VAP. Objective: This study aimed to determine the association between the duration of ventilator use and the incidence of VAP in patients in the Intensive Care Unit of Dr. Mohammad Hoesin General Hospital, Palembang. Method and Material: This study was an observational analytic study using a cross-sectional design. The samples were all patients who use a ventilator for more than 48 hours at the ICU room period of July 1, 2014, to June 30, 2015. Data were obtained from the patient’s medical records of a total of 146 patients, but the number of patients who comply with the criteria was 106 patients. Result and Discussion: Out of the 106 samples, 41 patients (38.7%) developed VAP and 65 patients (61.3%) did not develop VAP. The analysis using Chi-Square test showed that patients who used ventilator for >5 days had an OR = 3.273 compared to patients using ventilator 2-5 days (p-value = 0.016; 95% CI = 1.223 to 8.754). Conclusion: There is a significant association between the duration of ventilator use and the incidence of VAP in patients at the ICU of Dr. Mohammad Hoesin General Hospital, Palembang. Patients using ventilators for more than 5 days 3,386 times more at risk of developing VAP compared to patients using ventilators 2-5 days. The riskiest time for the patient using ventilator was more than 5 days of usage. And, the mortality rate of VAP patients was 63.4% from 41 patients while the mortality rate of whole ICU patients was 50.9%.
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
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.
Laparotomy Exploration In Pediatric With Severe Thrombocytopenia: A Report Rudy Vitraludyono; Arie Utariani
Indonesian Journal of Anesthesiology and Reanimation Vol. 3 No. 1 (2021): Indonesian Journal of Anesthesiology and Reanimation
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (281.309 KB) | DOI: 10.20473/ijar.V3I12021.10-16

Abstract

Introduction: Perioperative bleeding in patients was a serious problem in the exploration of laparotomy, especially in severe thrombocytopenia patients. In addition, spontaneous bleeding often occurs in patients who have a platelet count of less than 10 to 20.109 cells. L-1 blood. When surgery must be performed on a patient with platelet counts < 50.109 cells L-1, platelet concentrate was urgently needed to be transfused during induction of anesthesia. Benefits and risks of transfusion before surgery had to be done on a per-patient basis. The available data was very limited in informing perioperative management of patients with thrombocytopenia. However, there have been previous reports of surgery cases in 66-year-old patients with a history of immune thrombocytopenia (ITP) and diagnosed with acute appendicitis related to disseminated intravascular coagulation (DIC), showing excellent postoperative hemostasis. Another one, a seven-year-old boy who has a severe refractory case of ITP with very low platelet counts was referred to urgent splenectomy performed without increase platelet counts before, and then the patient underwent plasma exchange (PE) after surgery. Those reports aimed to present 2 cases of laparotomy exploration in pediatric patients with severe thrombocytopenia. Case Report: The first laparotomy exploration was conducted on an 11-year-old boy who suffered acute perforated appendicitis. The patient obtained general anesthesia with intubation. The second laparotomy exploration was conducted on a 1-month-old baby boy with a weight of 3400 grams who suffered bowel low-level obstruction suspect Hirschsprung disease. The patient also obtained general anesthesia with intubation. Discussion The general anesthesia with oral intubation was successfully afforded to both patients for the laparotomy exploration with the preoperative condition under severe thrombocytopenia with receiving platelet transfusion therapy before surgery. Complications of spontaneous bleeding at the time of intubation were not found, no bleeding-difficult-intubation during surgery, and no symptoms of spontaneous bleeding were found. Postoperatively, platelet levels gradually improved. Conclusion: Exploration of laparotomy in patients with severe thrombocytopenia can be carried out with the support of platelet transfusion and providing general anesthesia with oral intubation to patients.

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