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ALBUMIN, LEUKOSIT, AND PROTROMBIN AS PREDICTORS OF SEPSIS MORTALITY AMONG ADULT PATIENTS IN SOETOMO GENERAL HOSPITAL, SURABAYA, INDONESIA Zharfan, Rahmat Sayyid; Hakim, Ahmad Lukman; Purba, Abdul Khairul Rizki; Sulistiawan, Soni Sunarso; Semedi, Bambang Pujo
Indonesian Journal of Anesthesiology and Reanimation Vol 1, No 1 (2019): INDONESIAN JOURNAL OF ANESTHESIOLOGY AND REANIMATION
Publisher : Departement Anesthesiology and Reanimation - Faculty of Medicine Universitas Airlangga

Introduction: Sepsis is presented as a complex 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 an analytic observational study with a case-control approach. The data were extracted from patients' 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.

THE EFFECT OF BASIC LIFE SUPPORT (BLS) TRAINING IN THE KNOWLEDGE AND SKILL LEVEL OF COMMUNITY IN SIDODADI VILLAGE, LAWANG, INDONESIA Stella, Maria Arni; Wulandari, Prima Hapsari; Subianto, Tantri Adhiatama Lukitaningrum; Jahari, Farah Adiba Binti Mohamad; Aisyah, Aida Nur; Mahmudah, Isna; Sandjaja, Steven; Prabowo, Septian Dwi; Nuswantoro, Djohar; Widodo, Heri S
Indonesian Journal of Anesthesiology and Reanimation Vol 2, No 1 (2020): INDONESIAN JOURNAL OF ANESTHESIOLOGY AND REANIMATION
Publisher : Departement Anesthesiology and Reanimation - Faculty of Medicine Universitas Airlangga

Introduction: About 300.000 ? 350.000 Indonesian people suffer from cardiac arrest each year. Basic Life Support (BLS) is the first immediate response needed by cardiac arrest people, especially the out of hospital cardiac arrest (OHCA) patient. BLS that given from public to OHCA could increase the survival rate up to 2 ? 3x higher. Unfortunately, the Indonesian still did not know what is cardiac arrest, how to recognize it, and how to do BLS. Objective: The objective of this study was to identify the effect of BLS training in the knowledge and skill level of community in Sidodadi Village, Lawang, Indonesia. Method and Material: This experiment used a quasi-experimental design with 102 of the random sampling of people age 20-40 in Sidodadi Village, Lawang, Indonesia. The sample was given pre-test and post-test knowledge questioner before and after joining BLS training. The sample?s skill was scored by an assistant doctor using a skill checklist. The data then analysed with a t-paired sample test, Wilcoxon sum rank test, and Pearson correlation. Result and Discussion: The score of women is higher than men both in pre-test and post-test, with the significance of p=0,039 for pre-test and p=0,001. 99% who joined BLS training have a significant increase in knowledge with p=0,001. Conclusion: The increase in knowledge and skill is correlated for an excellent and good level of the score, but not correlated in a bad level. About 99% of people who have joined BLS training have a significant increase in knowledge and skill. These trained people have the willingness to be a bystander for cardiac arrest people near them.

PAIN TREATMENT ON TRAUMA PATIENT IN DR.SOETOMO GENERAL HOSPITAL EMERGENCY ROOM Amaliin, Khoir; Nurrahmah, Atiya; Rehatta, Nancy Margarita; Effendi, Choesnan
Indonesian Journal of Anesthesiology and Reanimation Vol 1, No 1 (2019): INDONESIAN JOURNAL OF ANESTHESIOLOGY AND REANIMATION
Publisher : Departement Anesthesiology and Reanimation - Faculty of Medicine Universitas Airlangga

Introduction: Uncontrolled pain has many negative effects to the body. The Guideline of Pain Management has been specifically arranged, but assessment and pain treatment in the Emergency Room (ER) have not adequate yet. Integrated pain assessment before and after treatment is very important in monitoring pain management effectiveness. Objective: The aim of this study was to determine pain score of emergency patients before and after treatment. This study was also conducted to record the treatment timing that was given by the paramedics in the emergency room. Method and Material: This study was a description research with 40 trauma patients as samples in the ER at Dr. Soetomo Hospital. Patient?s pain level was measured twice, before the treatment and an hour after that. The pain level was measured using Visual Analog Scale (VAS). Patients were given ketorolac 30mg intravenous as the treatment. Result and Discussion: There were2.5% of the patients VAS 1 and the other 12.5% VAS 10. An hour after treatment 20% of the ER patients were free of pain and the rest 7.5% VAS 6. The average of VAS before the treatment were 6.38 ± 2.1and an hour after later they decreased to 2.23 ± 1.7. There were only 67.5% of the ER patients that were treated in the 1st hour, 17.5% of them were treated in the 2nd hour, the other 10% were treated in the 3rd hour, and the last 5% of them were treated in the 4th hour. Conclusion:The average value of pain was decreased when one hour after administration of pain therapy by paramedics, but therapy at different times showed no difference in the level of pain reduction that can be inferred.

TRIAGE KNOWLEDGE OF EMERGENCY ROOMS NURSES AT DR SOETOMO REGIONAL GENERAL HOSPITAL Widyani, Fariza Nur Aini; Basuki, April Poerwanto; Nuswantoro, Djohar
Indonesian Journal of Anesthesiology and Reanimation Vol 2, No 1 (2020): INDONESIAN JOURNAL OF ANESTHESIOLOGY AND REANIMATION
Publisher : Departement Anesthesiology and Reanimation - Faculty of Medicine Universitas Airlangga

Introduction: Triage is a system to sort patients based on their urgency for care during an emergency. In addition, to determine patient?s severity, triage reduces time wasted and overcrowding in the emergency room.1 Triage errors such as over-triage or under-triage must not exceed 35% and 5% of the total numbers of patients respectively. Dr. Soetomo General Hospital of Surabaya with its status as one of type ?A? hospital in Indonesia that has good amenities, facilities, and infrastructures which is also the main referral hospital from Primary or Secondary Health Care, is prone to patients overcrowding. The high number of patients and the demands for high-quality service as the main referral hospital require higher qualification from health care professionals in term of cognitive, skills, and attitude. Objective: This study conducted to evaluate the level of knowledge of the ER (Emergency Room) nurses at Dr. Soetomo General Hospital in 2019 towards triage. Methods and Materials: This study is a quantitative descriptive study using a validated questionnaire with 32 nurses as the samples. Results and Discussion: Demographic profile showed that majority of nurses are: female (52%), age 26 ? 35 years old (46 %), graduated from D3 (61%), have been working in this field for >15 years (46%), attended Basic Life Support Training (33%), and have moderate knowledge in triage (61%). Conclusion: Emergency room nurses of Dr Soetomo General Hospital had adequate knowledge in triage. The researcher considers there might be some factors influencing nurse?s knowledge in triage.

PAIN LEVEL OF POSTOPERATIVE ORTHOPEDIC PATIENTS AT DR. SOETOMO GENERAL HOSPITAL Wicaksono, David; Herawati, Lilik; Sulistyono, Herdy
Indonesian Journal of Anesthesiology and Reanimation Vol 1, No 1 (2019): INDONESIAN JOURNAL OF ANESTHESIOLOGY AND REANIMATION
Publisher : Departement Anesthesiology and Reanimation - Faculty of Medicine Universitas Airlangga

Introduction: Postoperative pain is the most undesirable consequence of the surgery. If it is not managed properly, it can lead to a long healing. However, assessment and treatment of postoperative pain in surgical wards still have not received attention. Differences in patient?s pain level after surgery and after being transferred to the surgical ward is very important in monitoring the effectiveness postoperative pain management. Objective: This study was conducted to determine the overview of pain level experienced by patients following orthopedic surgery and to know the individual factors that can affect the patient's pain level. Method and Material: This research was observational analytic with 43 orthopedic postoperative patients as a sample. The Patients? pain level were measured by the Numeric Rating Scale (NRS) at one hour after surgery and 24 hours after surgery. Result and Discussion: The Pain level one hour after surgery varied between pain level 0 as much as 53% to pain level 8 as much as 4.7%. The results of measurements of pain 24 hours after surgery only 23.3% of the patients who did not complain of pain, and there was a patient who experienced pain level 10. The results of the statistical calculation, the difference between the level of pain one hour and 24 hours post-surgery obtained value of p=0.037 (p<0.05). Conclusion: There was a significant difference between the pain level at one hour and 24 hours post-surgery. It might be due to the process of peripheral and central sensitization in patients with delayed pain management. It also may be influenced by individual factors as well as medical personnel.

EFFECTIVENESS OF KETOPROFEN SUPPOSITORIA AS PREEMPTIVE ANALGESIA FOR POSTOPERATIVE PAIN IN PATIENTS UNDERGOING ELECTIVE SURGERY WITH GENERAL ANESTHESIA Lestari, Lupi; Hanindito, Elizeus; Utariani, Arie
Indonesian Journal of Anesthesiology and Reanimation Vol 2, No 1 (2020): INDONESIAN JOURNAL OF ANESTHESIOLOGY AND REANIMATION
Publisher : Departement Anesthesiology and Reanimation - Faculty of Medicine Universitas Airlangga

Introduction: Effective postoperative pain management provides improved patient comfort and satisfaction, earlier mobilization, fewer pulmonary and cardiac complications, reduced risk deep vein thrombosis, fast recovery, and reduced cost of care. Preemptive analgesia, initiated before the surgical procedure to prevent pain in the early postoperative period, has the potential to be more effective than a similar analgesic treatment initiated after surgery. As a part of multimodal analgesia, the use of NSAIDs should always be considered for acute postoperative pain management. NSAIDs can be used preoperatively as a part of the preemptive regimen and for postoperative pain control to increase the efficacy of opioids and reduce its side effects. Material and Method: This research was experimental research with a case-control design of the study. The samples separated into two groups, the first group got ketoprofen suppository before the induction, and the second group didn?t get the ketoprofen suppository The intensity of pain measured with the Numeric Rating Scale (NRS) or Wong-Baker Faces Pain Scale was the variable studied at different postoperative times (30 min, 60 min, 120 min, 2-6 hours, 6-12 hours). The total amount of rescue analgesics (fentanyl) and side effects were other variables of this study. Result and Discussion: The result is ketoprofen suppository as preemptive analgesia administrations can reduce postoperative pain. Numeric Rating Scale was significantly lower in the ketoprofen group compared to the control group (p < 0,05) at 30 min, 60 min, 230 min, 2-6 hours, 6-12 hours. The number of postoperative analgesics needed in the recovery room was significant differences among both groups (p < 0,05). Conclusion: Preemptive analgesia in patients who underwent an operation with general anesthesia with ketoprofen suppository was effectively in blocking noxious stimuli and central sensitization, with subsequent prevention of acute postoperative pain.

DURATION OF VENTILATION SUPPORT USAGE AND DEVELOPMENT OF VENTILATOR-ASSOCIATED PNEUMONIA: WHEN IS THE MOST TIME AT RISK? Alfaray, Ricky Indra; Mahfud, Muhammad Iqbal; Faizun, Rafiqy Sa'adiy
Indonesian Journal of Anesthesiology and Reanimation Vol 1, No 1 (2019): INDONESIAN JOURNAL OF ANESTHESIOLOGY AND REANIMATION
Publisher : Departement Anesthesiology and Reanimation - Faculty of Medicine Universitas Airlangga

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%.

PROFILE HEMODYNAMICS (BLOOD PRESSURE AND HEART RATE) CHANGES IN THE USE OF ADRENALINE IN CESAREAN SECTION WITH SPINAL ANESTHESIA AT DR SOETOMO SURABAYA HOSPITAL Rahmah, Ainur; Utariani, Arie; Basori, Achmad
Indonesian Journal of Anesthesiology and Reanimation Vol 2, No 1 (2020): INDONESIAN JOURNAL OF ANESTHESIOLOGY AND REANIMATION
Publisher : Departement Anesthesiology and Reanimation - Faculty of Medicine Universitas Airlangga

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.

SOCIAL-FAIRNESS PERCEPTION IN NATURAL DISASTER, LEARN FROM LOMBOK: A PHENOMENOLOGICAL REPORT Yofrido, Filipus Michael; Harjana, Lila Tri
Indonesian Journal of Anesthesiology and Reanimation Vol 1, No 1 (2019): INDONESIAN JOURNAL OF ANESTHESIOLOGY AND REANIMATION
Publisher : Departement Anesthesiology and Reanimation - Faculty of Medicine Universitas Airlangga

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

ELECTROLYTES PROFILE OF CRITICALLY ILL PATIENTS ADMITTED TO PEDIATRIC INTENSIVE CARE UNIT (PICU) DR. SOETOMO GENERAL HOSPITAL Octavia, Amalia Citra; Setyaningtyas, Arina; Edwar, Pesta Parulian Maurid
Indonesian Journal of Anesthesiology and Reanimation Vol 2, No 1 (2020): INDONESIAN JOURNAL OF ANESTHESIOLOGY AND REANIMATION
Publisher : Departement Anesthesiology and Reanimation - Faculty of Medicine Universitas Airlangga

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.

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Contact Name
Arie Utariani

Contact Email
ijar@fk.unair.ac.id

Phone
+628123008875

Journal Mail Official
arieutariani@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

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name Arie Utariani

Contact Email ijar@fk.unair.ac.id

Phone +628123008875

Journal Mail Official arieutariani@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

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Contact Name
Arie Utariani

Contact Email
ijar@fk.unair.ac.id

Phone
+628123008875

Journal Mail Official
arieutariani@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