Danu Soesilowati
Bagian Anestesiologi dan Terapi Intensif RSUP Dr. Kariadi

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Journal : Jurnal Kedokteran Diponegoro

PERBANDINGAN PEMBERIAN HEPARIN SUBKUTAN DAN INTRAVENA TERHADAP KADAR FIBRINOGEN PADA PENCEGAHAN DEEP VEIN THROMBOSIS Rangga, Valentino; Soesilowati, Danu
MEDIA MEDIKA MUDA 2012:MMM VOLUME 1 NUMBER 1 YEAR 2012
Publisher : MEDIA MEDIKA MUDA

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Abstract

ABSTRACTBackground: Deep vein thrombosis (DVT) is a condition where thrombus is formed in a deep vein especially in the lower limbs and inguinal. Blood clots can obstruct blood flow from lower limbs to the heart. DVT is an often occured disease and can be fatal and deathly if it is not get diagnosed and treated effectively. Giving anticoagulants such as heparin either intravenously or subcunaneosly can prevent thrombus formation. Fibrinogen levels is directly proportional to the risk of a thrombus generation.Methods: An observational study with cross-sectional approach. Data were derived from secondary data with total sample of 20 which divided into two groups. Group 1 was an ICU patient who given intravenous heparin and Group 2 given subcutaneous heparin. Fibrinogen levels were recorded and compared before and after one day heparin administration.Results: There is no significant differences (p=0,226) between fibrinogen levels before and after intravenous heparin administration (388,56209,31 mg/dl vs 468,93178,38 mg/dl). In subcutaneous heparin group there is a significant (p=0,006) increase in levels of fibrinogen before and after heparin administration (265,2790,67 mg/dl vs 453,93112,49 mg/dl). After comparing pre-post fibrinogen levels in both groups (60,37228,85 mg/dl vs 188,66169,19 mg/dl), we obtained no significant difference between two groups (p=0,171).Conclusions: No significant differences between administering heparin intravenously and subcutaneously against fibrinogen levels as a prophylactic of deep vein thrombosis in ICU.Key words: Intravenous heparin, subcutaneous heparin, fibrinogen levels, deep vein thrombosis
PERBANDINGAN PEMBERIAN HEPARIN SUBKUTAN DAN INTRAVENA TERHADAP KADAR D-DIMER PADA PENCEGAHAN DEEP VEIN THROMBOSIS PRIAMBODO, BHIMO; Soesilowati, Danu
MEDIA MEDIKA MUDA 2012:MMM VOLUME 1 NUMBER 1 YEAR 2012
Publisher : MEDIA MEDIKA MUDA

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Abstract

Background: Deep vein thrombosis ( DVT ) is a condition in which thrombus formed in a deep vein especially in the lower limbs and inguinal. One way to find out thrombosis in the blood vessels circulation is by d-dimer levels examination. Giving anticoagulants such as heparin either intravenously or subcutaneously can prevent thrombus formation.Aim: This study aimed to compare subcutaneous and intravenous heparin against d-dimer levels in the prevention of deep vein thrombosis.Methods: An observational study with cross-sectional approach. Data were derived from secondary data with total sample of 20 patients which divided into two groups. Group 1 was an ICU patient who given intravenous heparin and Group 2 given subcutaneous heparin. D-dimer levels were recorded before and after getting treatment. Statistical test using paired t-test, Wilcoxon, and Mann Whitney (with degrees of significance <0,05).Results: In this study, a decrease in the d-dimer levels of intravenous group 207.60+748.544 μg/L (no significant difference, p=0,403) while in subcutaneous group amounted to 337.70+1445.950 μg/L (no significant difference, p=0,514). The comparative difference test result obtained both groups did not differ significantly (p=0,909).Conclusions: There is no significant difference between administering subcutaneous and intravenous heparin against d-dimer levels in the prevention of deep vein thrombosis.Key words: Intravenous heparin, subcutaneous heparin, deep vein thrombosis, d-dimer levels
PERBANDINGAN PEMBERIAN HEPARIN INTRAVENA DAN SUBKUTAN TERHADAP KADAR PPT DAN PTTK PADA PENCEGAHAN DEEP VEIN THROMBOSIS Rizki, Djanuar; Soesilowati, Danu
MEDIA MEDIKA MUDA 2012:MMM VOLUME 1 NUMBER 1 YEAR 2012
Publisher : MEDIA MEDIKA MUDA

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Abstract

Background: Thrombosis in the United States is the leading cause of death. About 2 million people die every year either because of an artery or vein thrombosis. In Indonesia, the incidence of diseases caused by thrombosis, such as stroke and heart attack, have the highest mortality rate. Morbidity of this disease is also quite high, one of them is Deep Vein Thrombosis (DVT) which can be a complicated to pulmonary embolism. Prophylaxis for DVT is relatively easy, by using the anticoagulant heparin. However, control of the dose of heparin must also be considered because it can cause bleeding if the dose is too high. One way to monitor the heparin was to assess the Plasma Prothrombin Time (PPT) and Partial Thromboplastin Time with Kaolin (PTTK).Objectives: To determine the effect of intravenous and subcutaneous heparin distribution on the value of PPT and PTTK towards DVT prevention.Methods: This design was observational - analytic with a cross sectional design by collecting data from the medical records in dr. Kariadi central hospital Semarang. 20 patients who has fulfill the inclusion and exclusion criteria, which the data taken was PPT and PTTK levels among ICU / HCU patients who has given the anticoagulant heparin in intravenously or subcutaneously. Data described in the table and performed by chi-square, Wilcoxon and Mann-whitney tests with SPSS for Windows 17.0.Results: There is no significant difference (p = 0.386) between the value of the PPT before and after distribution of intravenous heparin (15.580 + 4.405seconds vs 14,210 + 3,627 seconds). While, the distribution of subcutaneous heparin found no significant difference (p = 0.553) in the PPT between before and after distribution of heparin (14.680 + 2.907 seconds vs. 13.690 + 2.978 seconds). And there were no significant differences (p = 0.646) between the PTTK before and after intravenous heparin (43.490 + 40.803 seconds vs. 41.480 + 30.030 seconds). While the value of PTTK to the subcutaneous heparin given between before and after administration of heparin (31.110 + 11.157 seconds vs. 43.040 +20.008 seconds) found no significant difference (p = 0.203) After the difference in PPT values between intravenous and subcutaneous administration of heparin, found no significant difference (p = 0.832). And the difference on the PTTK between intravenous and subcutaneous administration of heparin found no significant difference (p = 0.597)Conclusion: There was no significant difference in the value of PPT and PTTK between the distribution of intravenous and subcutaneous heparin in the prevention of deep vein thrombosis.Key words: DVT, PPT, PTTK, anticoagulant heparin.
PENGARUH PEMBERIAN RINGER ASETAT MALAT DAN RINGER LAKTAT TERHADAP KADAR BASE EXCESS PASIEN OPERASI BEDAH SESAR DENGAN ANESTESI SPINAL Priyono, Agung Kurniawan; Soesilowati, Danu; Hendrianingtyas, Meita
MEDIA MEDIKA MUDA Vol 3, No 1 (2014): MEDIA MEDIKA MUDA
Publisher : Jurusan Kedokteran Umum, Fakultas Kedokteran, Universitas Diponegoro

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Abstract

Latar Belakang : Pemberian cairan ringer laktat sering dikaitkan dengan kejadian asidosis. Keadaan asidosis dapat menyebabkan vasodilatasi pembuluh darah yang akan memperburuk keadaan hipotensi. Kejadian asidosis dapat dicegahmelalui pemberian cairan yang sesuai dengan konsentrasi plasma tubuh. Ringer asetat malat memiliki kandungan asetat dan malat untuk mencegah asidosis. Keadaan asam basa dapat dilihat melalui pemeriksaan sederhana BGA yang dapat dilihat dari kadar base excess.Tujuan : Meneliti perbedaan perubahan kadar base excess antara preload 20cc/kgBB ringer laktat dengan preload 20cc/kgBB ringer asetat malat.Metode : Penelitian ini menggunakan rancangan deskriptif analitik dengan metode belah lintang. Sampel diambil secara purposive sampling dan didapatkan data catatan medis 15 orang dengan ringer laktat sebagai cairan preload dan data catatan medis 15 orang dengan ringer asetat malat sebagai cairan preload dan menjalani operasi bedah sesar dengan anestesi spinal pada bulan September – Oktober 2013. Digunakan uji T - tidak berpasangan untuk analisis statistik.Hasil : Perbedaan perubahan kadar base excess sebelum dan sesudah pemberian preload kelompok yang menggunakan ringer laktat 1,50 +1,577. Perbedaan perubahan kadar base excess sebelum dan sesudah pemberian preload kelompok yang menggunakan ringer asetat malat 1,28+ 1,688 dengan nilai kemaknaan (p>0,05).Kesimpulan : Perbedaan perubahan kadar base excess pada pemberian ringer laktat dan ringer asetat malat sebagai cairan preload tidak memiliki kemaknaan yang bermakna secara statistik.