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INDONESIA
The Indonesian Journal of Anesthesiology and Critical Care
ISSN : -     EISSN : -     DOI : -
Core Subject : Health,
Arjuna Subject : -
Articles 18 Documents
Chlonidine 15 mcg Intrathecal as Prevention in Incidence of Post Spinal Anesthesia Shivering on Caesarea Surgery Hayatunnisa, Nurul Ulfah
The Indonesian Journal of Anesthesiology and Critical Care Vol. 28 No. 3 September 2010
Publisher : The Indonesian Journal of Anesthesiology and Critical Care

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Abstract

Background: The aim of this study is to know whether klonidin 15 mcg intrathecal can prevent incidence of shivering in pregnant woman who undergoing caesarea surgery with spinal anesthesia. Methods: In this double blind study, 178 parturients women with physical status ASA I-II undergoingcaesarean section using spinal anesthesia in Emergency Operating Theatre and Central Surgery Installation of Cipto Mangunkusumo Hospital were included in this study. Subarachnoid anaesthesia was performed in all patients. Those parturitions women were randomly divided into two groups. One group received bupivacaine 0.5%H 10 mg with adjuvant morphin HCL 0,1mg and chlonidine 15 mcg intrathecal and the other received bupivacaine 0.5%H 10 mg with adjuvant morphin HCL 0,1mg and NaCl 0.9% 0.1cc intrathecal. We observed incidence and degree of shivering at 5 minutes interval until 90 minutes. Tympanic temperature, hemodynamic parameter and adverse reactioon were recorded at 15 minutes interval until 90 minutes during the perioperative period. Results: There was significant diff erence (p=0,000) incidence of shivering between two groups. In chlonidine groups 4 parturitions had shivering (4.49%), while in control groups 33parturitions (37,08%) had shivering. There was significant diff erence (p=0,000) between two groups in degree of shivering. In chlonidine groupsthe degree of shivering more lower than control groups. The decrease in core temperature in chlonidine groups more lower than control groups (p<0,005). There were no significant difference in nausea, vomitus and ephedrin used between two groups. Conclusions: Addition of 15 mcg chlonidine intrathecal signifi cantly reduce the incidence and degree of shivering in the parturitions women undergoing caesarean section using spinal anesthesia. Keywords: Spinal anesthesia, Shivering, chlonidine intrathecal
Comparison of Several Povidone Iodine 10%-Alcohol 70% Contact Time for Back Skin Antiseptic in Cipto Mangunkusumo Hospital Kusumadewi, Niluh
The Indonesian Journal of Anesthesiology and Critical Care Vol. 28 No. 3 September 2010
Publisher : The Indonesian Journal of Anesthesiology and Critical Care

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Abstract

Background: The aim of this study is to determine skin colonization after application of povidone iodine 10%-Alcohol 70% over a periode of cantact time for antisepsis procedure on the patient’s back. Methods: In this clinical trial study, blinding only applied on microbiology laboratory staff . The study compares bacteria’s colonization post antisepsis procedure on back skin using povidone iodine (PI) 10% followed by alcohol 70% in several diff erent periods of contact. Results: The mean log of colony after application of PI 10%-alcohol 70% showed significant reduction compared to baseline group for each contact time tested (p<0.01). The 100% negative colony growth was showed in 180 second group. The reduction factor of mean colony 60 and 120 second were not signifi cantly diff erent with reference group (p>0.05), which meant that PI contact time for 60 or 120 second was as eff ective as reference time. Conclusions: Contact time of PI 10%-alcohol 70% for 60 and 120 second were as eff ective as 180 second in reducing colony count for antisepsis procedure on back skin. Keywords: Antiseptics, eff ective, back skin, povidone iodine 10%, contact time.
Comparison of The Effectiveness of Methylprednisolone 2 mg/Kg, 10 mg/Kg, 30 mg/Kg to Prevent IL-6’s Increment in Patient with Congenital Heart Disease Undergoing Open Cardiac Surgery Taufik, Thariq Emyl
The Indonesian Journal of Anesthesiology and Critical Care Vol. 28 No. 3 September 2010
Publisher : The Indonesian Journal of Anesthesiology and Critical Care

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Abstract

Background: Although there were so many open cardiac surgery on patient with congenital heart disease in RSCM, there were still a few of studies about using methylprednisolone in this case. This study based on the count of IL-6 and not other cytokine because of difficultness in counting and measuring other cytokine such as TNF-α, IL-1, and also IL-8 that depended on temperature. Methods: This double blinded randomized clinical trial compares effectiveness of several dosage of methylprednisolone for preventing the increasing of IL-6 post open cardiac surgery in congenital heart disease. Results: Post operative IL-6 increases significantly. Group with the dosage 30 mg/kg showed the smallest increment of IL-6 compared with group with the dosage 2 mg/kg and 10 mg/kg. Several dosages of methylprednisolone not significantly related with inpatient period in ICU (p>0,05). Conclusions: Methylprednisolone is not able to prevent the increment of IL-6. Dosage is not related with the inpatient period in ICU. Keywords: Methylprednisolone, IL-6, congenital heart disease, cardiac surgery.
Acid-Base Disorder due to Hypernatremia in Head Injury T, Yulius
The Indonesian Journal of Anesthesiology and Critical Care Vol. 28 No. 3 September 2010
Publisher : The Indonesian Journal of Anesthesiology and Critical Care

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Abstract

Head injury potentially endanger the patient. Incident in male is greater than in female. Brain damage that is caused by this incidence include primary and secondary brain damage. Management of head injury in ICU should include prevent another complication such as hypernatremia caused by osmotic over treatment. Hypernatremia could induce metabolic alkalosis and compensatory hypoventilation. Keywords: Head injury, hypernatremia, metabolic alkalosis, compensatory hyperventilation.
Uroseptic with Septic Shock Manibuy, Fransiscus Jefri
The Indonesian Journal of Anesthesiology and Critical Care Vol. 28 No. 3 September 2010
Publisher : The Indonesian Journal of Anesthesiology and Critical Care

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Abstract

Recently, severe sepsis is still being a main cause of death in ICU. Almost 15% of patients that were cared in ICU were the patients with severe sepsis and two third of those severe sepsis were septic shock. Eventhough urosepsis is the most infection type that cause severe sepsis and septic shock, there were still low a ention for this case.
Acute Kidney Injury on Sepsis Surachtono, Surachtono
The Indonesian Journal of Anesthesiology and Critical Care Vol. 28 No. 3 September 2010
Publisher : The Indonesian Journal of Anesthesiology and Critical Care

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Acute renal failure among sepsis patients who are being hospitalized in intensive care unit, may suffer more critical condition. The death rate is higher, lengthened care period, and higher cost, particularly also followed by multiple organ failure. Several acute and chronic conditions may increase death rate. A woman, 68 years old, admitted in intensive care unit with hypotension and low level of consciousness. Diagnosis is supported with bronchopneumonia and sepsis shock symptoms. The patient encountered acute renal failure during the treatment in intensive care, and needed a dialysis therapy as a renal substitution therapy. Keywords: Acute renal failure, Bronchopneumonia, Sepsis, Multiple organ failure, Renal substitution therapy.
Sepsis Napitupulu, Herald
The Indonesian Journal of Anesthesiology and Critical Care Vol. 28 No. 3 September 2010
Publisher : The Indonesian Journal of Anesthesiology and Critical Care

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Sepsis is a clinical syndrome that caused by inflammation reaction initiated by infection. Sepsis is one of the biggest cause of death in USA that requires proper treatment according to the guideline of the (Surviving Sepsis Campaign) SSC to decrease morbidity and mortality. In this case, patient was admitted with fever, dyspnea, and bloating. First diagnosis of the patient was a fever observation, and then patient was admitted to ward for about a week before patient was admitted to ICU with sepsis and respiratory distress. Patient was intubated and supported by ventilator. Laboratory findings: Hb 11,7;Ht 35; Leu 29.000; Thromb 194.000; Ur 29; Cr 1,3; PCT 61,5 dan lactate 4,1. Treatment of this patient was being adapted with the guideline of SSC, even though the surgery indicated for  finding and controlling the infection’s etiology was started in more than 24 hours after the first management. After the surgery, patient was getting better, and patient was extubated on the fifth day, and admitted to IMC on seventh day. Keywords: sepsis, severe, surviving sepsis campaign
Management of Atrial Fibrillation After Cardiac Surgery Permana, I Made Adi; Poernomo, Herdono
The Indonesian Journal of Anesthesiology and Critical Care Vol. 28 No. 3 September 2010
Publisher : The Indonesian Journal of Anesthesiology and Critical Care

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Post-operative atrial fibrillation (POAF) is the most common complication encountered after cardiac surgery. The incidence of POAF reported in previous studies varies between 20% and 50%, depends on definitions and methods of detection. The peak incidence of POAF is between postoperative days 2 and 4 and it is seldom seen after the first week of surgery. Although generally well tolerated and seen as a temporary problem related to surgery, POAF can be life threatening, particularly in elderly patients and those with left ventricular dysfunction. POAF associated with increased post-operative thromboembolic risk and stroke, hemodynamic compromise, ventricular dysrhythmias, and iatrogenic complications associated with therapeutic interventions. The pathophysiology of POAF after heart surgery is not precisely known, but the mechanisms are thought to be multifactorial. Different risk factors have been reported, and many studies have evaluated the prophylactic effect of different pharmacologic or physical interventions. Thus, optimal preventive and treatment strategies are importance to reduce the impact of POAF. Keywords: atrial fibrillation, cardiac surgery, postoperative management
Intra Aortic Balloon Pump Permana, I Made Adi
The Indonesian Journal of Anesthesiology and Critical Care Vol. 28 No. 3 September 2010
Publisher : The Indonesian Journal of Anesthesiology and Critical Care

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Intra Aortic Balloon Pump (IABP) is a mechanical cardiac-assist device that benefits patients with actual or potential life-threatening circulatory problem. Intra Aortic Balloon Pump (IABP) reduces the resistance to left ventricular ejection and increases coronary and systemic blood flow. The technique for IABP therapy involves insertion of an 8 or 9.5 Fr helium-filled balloon via the femoral artery into the descending aorta. The device is preferably inserted through an existing vascular access site in an attempt to reduce the rate of vascular and hemorrhagic complications. The balloon is synchronized to deflate during early systole, thus decreasing le$ ventricular (LV) after load. In turn, LV ejection fraction (EF) and stroke volume (SV) are enhanced, leading to reduced myocardial oxygen consumption. The balloon inflates during early diastole, thus increasing coronary blood flow and peripheral perfusion. The IABP is usually commenced at a rate of 1 : 1. Once the benefit of IABP therapy is thought to be concluded, patients are usually gradually weaned from the pump at rates of 1 : 2 to 1 : 3 over 6-12 h. Key words : intra aortic balloon pump, coronary blood flow
Anesthesia Management in Pediatric Heart Catheterization Tanjung, Qadri Fauzi
The Indonesian Journal of Anesthesiology and Critical Care Vol. 28 No. 3 September 2010
Publisher : The Indonesian Journal of Anesthesiology and Critical Care

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The development of cardiac catheterization technique was originally started with a diagnostic and then followed by a therapy in which catheterization intervention has become a routine action in laboratory space catheterization. The continued development of catheterization resulted in the need for higher safety measures so that initially only need sedation in anesthesia to the more complex action even general anesthesia. Anesthetic techniques also evolved from initially only mild sedation that does not require the anesthesiologist to perform sedation with anesthesiologist should be accompanied and even to general anesthesia that require monitoring, such as surgery and post procedure management. Cardiac catheterization also can cause complications that make an anesthesiologist should be ready to perform emergency management cooperate with the Cardiologist and radiologist. Key words: cardiac catheterization, the child, treatment of anesthesia

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