I Gusti Agung Gede Utara Hartawan, I Gusti Agung Gede
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PREVALENSI KEMATIAN PASIEN DI RUANG TERAPI INTENSIF RUMAH SAKIT UMUM PUSAT SANGLAH DENPASAR PERIODE JANUARI – DESEMBER 2015 Sasmari Brahmani, Ida Ayu Mas; Utara Hartawan, I Gusti Agung Gede
E-Jurnal Medika Udayana Vol 8 No 12 (2019): Vol 8 No 12 (2019): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (373.548 KB)

Abstract

Ruang terapi intensif (RTI) merupakan salah satu unit pelayanan sentral yang berada di rumah sakit. Pasien yang dirawat di RTI adalah pasien-pasien yang dalam kondisi kritis dan mengancam nyawa. Kematian di RTI dapat dikatakan tinggi. Oleh karena itu, penting dilakukan penelitian terhadap prevalensi kematian pasien di RTI RSUP Sanglah Denpasar, karena rumah sakit tersebut merupakan rumah sakit rujukan utama di Bali.Rancangan penelitian yang digunakan adalah deskriptif retrospektif. Pengambilan sampel menggunakan teknik total sampling. Penelitian dilakukan di RTI RSUP Sanglah Denpasar. Data pasien diperoleh dari register pasien RTI RSUP Sanglah Denpasar periode Januari - Desember 2015. Pada 1531 sampel yang memenuhi kriteria inklusi dan eksklusi didapatkan sebanyak 24,8% (n=379) pasien meninggal dan 75,2% (n=1152) keluar dalam kondisi hidup. Prevalensi kematian pada pasien bedah dan bukan bedah adalah 58,3% (n=221) dan 41,7% (n=158). Prevalensi kematian pasien bedah dengan dan tanpa ventilator mekanik adalah 71,5% (n=158) dan 28,5% (n=63), sedangkan prevalensi kematian pasien bukan bedah dengan dan tanpa ventilator mekanik adalah 47,5% (n=75) dan 53,5% (n=83). Kelompok penyakit bedah terbanyak adalah pasca-kraniotomi (43,9%), sedangkan pada kelompok penyakit bukan bedah adalah gangguan pernafasan (22,2%). Kata kunci: prevalensi kematian pasien, bedah, bukan bedah, ventilator mekanik, RTI
Effectiveness of Infusion Warmer Use to Prevent the Occurrence of Hypothermia and Shivering After General Anesthesia Action in General Hospital Center Sanglah Denpasar Wiryana, Made; Sinardja, I Ketut; Budiarta, I Gede; Agung Senapathi, Tjokorda Gde; Widnyana, Made; Aryabiantara, I Wayan; Utara Hartawan, I Gusti Agung Gede; Parami, Pontisomaya; Kusuma Wijaya, Andi; Putra Pradhana, Adinda
Bali Journal of Anesthesiology Vol 1, No 1 (2017)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/bjoa.v1i1.3

Abstract

Introduction: Shivering and hypothermia after general anesthesia is a common complication in the recovery room. Heating methods and drugs  widely used, but not yet effective. The purpose of this study was to evaluate the effectiveness of using the infusion warmer in maintaining normal core temperature and prevent shivering. Materials and Methods: The study was a non blindnes randomized control trial study. This study aimed to compare the effectiveness of the use of infusion warmer in preventing the incidence of hypothermia and shivering after general anesthesia. Research conducted at the Sanglah Hospital in October 2016, with sample calculations 58 people who meet the inclusion and exclusion criteria. Both were divided into 2 groups, 29 groups of infusion warmer and 29 people without the infusion warmer Recording the results of assessing multiple parameters vital signs, hemodynamic, aldrette score, body temperature, and shivering from the beginning, after induction, and minutes to 5, 15, 30 , 60 in the recovery room. The data obtained were analyzed with SPSS software with a significance level of p <0.005 expressed significantly, with a relative risk <1 as a preventive. Results: From a comparative picture of events shivering and hypothermia in minutes to 5, 15, 30, 60 in the recovery room seen that the treatment group based on the group lower warmer than in the non warmer. This shows that the use of warmer can prevent the incidence of shivering and hypothermia in patients after general anesthesia. In test statistically significant with p <0.05. Conclusions: The use of infusion warmer can help reduce the incidence of hypothermia and shivering after general anesthesia action.
Non-Convulsive Status Epilepticus (NCSE) in ICU Wiryana, Made; Sinardja, I Ketut; Aryabiantara, I Wayan; GdeAgung Senapathi, Tjokorda; Gede Widnyana, I Made; Utara Hartawan, I Gusti Agung Gede; Parami, Pontisomaya; Ryalino, Christopher; Putra Pradhana, Adinda
Bali Journal of Anesthesiology Vol 1, No 1 (2017)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/bjoa.v1i1.5

Abstract

Epilepsy is a neurological disorder characterized by recurrent epileptic seizures. Non-convulsive status epilepticus (NCSE) is defined as a persistent change in mental status as opposed to the previous conditions, lasted at least 30 minutes long,  associated with continuous spike wave epileptiform EEG changes. Clinical manifestation of NCSE can present as confusion, personality changes, psychosis, and coma. Indeed NCSE prognosis is dependent on the underlying etiology of persistent EEG changes of. Preferred medication is focus on improving its fundamental pathological changes, such as metabolic disorders, infection, drugs toxicity, and immediate pharmacological treatment. Intravenous benzodiazepine is recommended asthe first drug of choice for NCSE and early recognition of treatment response can help to establish the diagnosis.  This patient has a good outcome which was influenced with short ictal period from the first episode upon arrival on reffered hospital, good initial response and management on emergency department, a conduct and thorough ICU monitoring, as well as the effective treatment response.
Low Dose Ketamin Wiryana, Made; Sinardja, I Ketut; Budiarta, I Gede; Agung Senapathi, Tjokorda Gde; Widnyana, Made; Aryabiantara, I Wayan; Utara Hartawan, I Gusti Agung Gede; Parami, Pontisomaya; Novita Pradnyani, Ni Putu; Putra Pradhana, Adinda
Bali Journal of Anesthesiology Vol 1, No 1 (2017)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/bjoa.v1i1.4

Abstract

Ketamine binds non-competitive against a phencyclidine receptors bound N-methyl-D-aspartate (NMDA), a receptor that is involved in the pathophysiology of acute pain. Ketamine has been used as an intravenous anesthesia, analgesia for acute and chronic pain at a dose of subanaesthetic. Ketamine is a dissociative anesthetic produces a state with a characteristic strong analgesia, amnesia, and catalepsy. Dissociative components resulting from the effect on the limbic system and talamoneokortikal. Low-dose ketamine as known as analgesia dose ketamine or subanestesia dose is 0.2 to 0.75 mg / kg IV. At low doses, ketamine does not increase the effect psikomimetik like dissociation or deep sedation. The combination with midazolam provides satisfactory sedation, amnesia and analgesia without significant cardiovascular depression.
Anesthesia on Pediatric Laproscopy Wiryana, Made; Sinardja, I Ketut; Kurniyanta, Putu; GdeAgung Senapathi, Tjokorda; Gede Widnyana, I Made; Utara Hartawan, I Gusti Agung Gede; Parami, Pontisomaya; Darma Junaedi, I Made; Putra Pradhana, Adinda
Bali Journal of Anesthesiology Vol 1, No 1 (2017)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/bjoa.v1i1.1

Abstract

Laparoscopic surgery has several advantages compared to a regular surgical procedures. This technique can reduce the stress of surgery, reduce the need for postoperative analgesia, decreased respiratory and wound complications, lowering long hospitalization, including in the intensive therapy, and the patient can go back to eat quickly. The magnitude of changes in vital signs that occur will be influenced by the patients age, cardiovascular function, and anesthetic agents are used. Physiological changes in pediatric laparoscopic surgery were similar to adults. Children have a higher vagal tone and sometimes a stimulus to the peritoneum by insufflation gas or penetration laparoscopic and trocar can lead to bradycardia and asystole. Intra-abdominal pressure is an important determinant for maintaining cardiovascular stability during laparoscopy. Adequate relaxation needed during the duration of the surgery.
Minimally invasive pain management in chronic musculoskeletal pain: A Community service at Blahkiuh I Health Center Parami, Pontisomaya; Suranadi, I Wayan; Utara Hartawan, I Gusti Agung Gede; Mahaalit, I Gusti Ngurah; Ryalino, Christopher; Pradhana, Adinda Putra
Bali Journal of Anesthesiology Vol 3, No 1 (2019)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (175.516 KB) | DOI: 10.15562/bjoa.v3i1.116

Abstract

ABSTRACTPain is a common complaint found in the population. Inadequate knowledge about pain management is the most common reason that triggers the inadequate management of pain. Pharmacological pain management is also not without risk. Various risks from the use of pharmacological agents related to side effects that can arise may also cause new problems. Several medical intervention techniques with invasive procedures for pain have also been carried out, although they are still less popular, due to a lack of public knowledge of this technique. We conducted a cost-free, minimally invasive pain procedure in people with chronic musculoskeletal pain in a public health center in a rural area in Bali Island to alleviate their pain-associated symptoms and to introduce this minimally invasive pain management technique.