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All Journal Jurnal Anestesiologi Indonesia Majalah Kedokteran Bandung Jurnal Anestesi Obstetri Indonesia JOURNAL LA MEDIHEALTICO Jurnal Neuroanestesi Indonesia Biomedika
Hidayat, Nopian
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Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Veterinary

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Prevalensi dan Pola Sensitivitas Antimikroba Multidrug Resistant Pseudomonas aeruginosa di RSUD Arifin Achmad Anggraini, Dewi; Gusti Yulindra, Utari; Savira, Maya; Djojosugito, Fauzia Andrini; Hidayat, Nopian
Majalah Kedokteran Bandung Vol 50, No 1 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (427.057 KB) | DOI: 10.15395/mkb.v50n1.1150

Abstract

Resistensi antimikrob merupakan salah satu masalah kesehatan masyarakat yang besar yang dihadapi manusia sejak era ditemukan antimikrob. Angka multidrug resistant P. aeruginosa salah satunya semakin meningkat di berbagai belahan dunia yang berdampak pada kesulitan penanganan infeksi oleh bakteri ini. Penelitian deskriptif retrospektif ini bertujuan mengetahui prevalensi MDR P.aeruginosa dan pola sensitivitasnya. Data diambil dari hasil kultur bakteri dan uji resistensi antibiotik dari berbagai spesimen klinis pasien di RSUD Arifin Achmad sepanjang tahun 2015. Uji resistensi dilakukan dengan menggunakan alat Vitek 2 compact. MDR P. aeruginosa didefinisikan sebagai P. aeruginosa yang tidak sensitif terhadap tiga atau lebih golongan antibiotik berikut: meropenem atau imipenem, siprofloksasin, gentamisin atau amikasin, seftazidim atau sefepim, dan piperasilin/tazobaktam. Prevalensi MDR P. aeruginosa adalah 45,5%. Isolat MDR P. aeruginosa serta paling banyak berasal dari instalasi perawatan surgikal dan instalasi perawatan intensif, dan paling banyak berasal dari spesimen pus dan sputum. Sensitivitas P. aeruginosa paling baik dengan amikasin (76,9%), piperasilin/tazobaktam (57,2%), meropenem (57,0%), gentamisin (54,5%), sefepim (53,7%), seftazidim (49,6%), ciprofloksasin (48,8%) dan aztreonam (35,5%). Sensitivitas MDR P.aeruginosa terhadap antibiotik jauh lebih rendah dibanding dengan P. aeruginosa. Penelitian ini menunjukkan angka MDR P. aeruginosa tinggi khususnya di Pekanbaru. Pola sensitifas P. aeruginosa dapat menjadi pedoman dalam memilih antibiotik yang sesuai untuk infeksi karena P. aeruginosa.Kata kunci: Multidrug resistant, Pekanbaru, pseudomonas aeruginosa, sensitivitas antibiotik Prevalence and Antimicrobial Susceptibility Profile of Multidrug Resistant Pseudomonas aeruginosa in Arifin Achmad General HospitalAntimicrobial resistance is one of major public health problems since the era of antimicrobial discovery, inclusing multidrug resistant (MDR) P. aeruginosa. The prevalence of this resistance  is increasing in different parts of the world, leading to the difficulties in dealing with this bacteria. The aim of this descriptive retrospective study was to determine the prevalence of MDR P. aeruginosa and its susceptibility profile. Data were collected from the bacteria cultures and antibiotic susceptibility test results from various clinical specimens in Arifin Achmad General Hospital throughout 2015. The test was performed in VITEK 2 Compact. MDR P. aeruginosa is defined as P. aeruginosa which is not sensitive to three or more following antibiotics: meropenem or imipenem, ciprofloxacin, gentamicin or amikacin, ceftazidime or cefepime, and piperacilin/tazobactam. The prevalence of MDR P. aeruginosa was 45.5%. The isolates of MDR P. aeruginosa was mostly derived from pus and sputum specimens from the surgical ward and intensive care unit. .  The most sensitive antibiotics was amikacin (76.9%) followed by piperacilin/tazobactam (57.2%), meropenem (57.0%), gentamicin (54.5%), cefepime (53.7%), ceftazidime (49.6%), ciprofloxacin (48.8%), and aztreonam (35.5%). Antibiotic sensitivity in MDR P. aeruginosa was much lower than in P. aeruginosa. This study shows a high prevalence of MDR P. aeruginosa, especially in Pekanbaru. This susceptibility profile can serve as a guideline for the selection of appropriate antibiotics for infections caused by P. aeruginosa.Key words: Antibiotic susceptibility, multidrug resistant, Pekanbaru, pseudomonas aeruginosa
Manajemen Anestesi Seksio Sesarea dengan Miastenia Gravis Hidayat, Nopian; Uyun, Yusmein; Suryono, Bambang
Jurnal Anestesi Obstetri Indonesia Vol 5 No 1 (2022): Maret
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v5i1.82

Abstract

Miastenia Gravis (MG) merupakan penyakit autoimun yang jarang ditemukan. Kasus lebih banyak ditemukan pada wanita daripada laki-laki (rasio 3:2) dengan puncak onset pada usia dekade kedua dan ketiga (pada wanita) dan dekade kelima dan keenam (pria). Pada kasus ini, wanita 28 tahun gravida 38-39 minggu dengan MG dan fetal distress direncanakan untuk dilakukan seksio sesarea cito. Teknik anestesi yang dipilih yaitu spinal anestesi dengan Bupivakain 0.5% Heavy 10 mg+fentanyl 25 mcg di ruang intervertebrae L4-5.
Manajemen Anestesi pada Pasien Laparotomi Kista Ovarium Permagna dengan Teknik Rapid Sequence Induction Pardede, Annisaa Shafira; Hidayat, Nopian; Irawan, Dino
Jurnal Anestesi Obstetri Indonesia Vol 7 No 1 (2024): Maret
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v7i1.181

Abstract

Kasus kista ovarium permagna merupakan kasus yang jarang. Laporan kasus ini melaporkan manajemen anestesi pada pasien dengan kista ovarium permagna yang dilakukan tindakan laparotomi kistektomi dengan teknik anestesi umum. Pasien perempuan 51 tahun dikonsulkan dengan perut tampak membesar sejak lima belas tahun sebelum masuk rumah sakit. Saat ini pasien terasa sulit berjalan dan berbaring akibat masa yang sangat besar pada abdomen. Pasien direncanakan untuk menjalani laparotomi kistektomi dengan teknik anestesi umum. Tanda-tanda vital dan hasil pemeriksaan durante dan pasca laparotomi kistektomi dalam batas normal. Dalam berbagai literatur, anestesi umum selalu menjadi pilihan utama untuk pasien dengan massa abdomen yang besar. Periode praoperasi adalah periode yang paling penting pada pasien dengan massa abdomen yang besar. Anamnesis dan pemeriksaan fisik adalah langkah prosedur yang vital. Rapid Sequence Induction merupakan prosedur yang bertujuan untuk mengurangi kejadian aspirasi paru selama manajemen jalan napas. Hal ini dapat dicapai dengan meminimalkan waktu antara hilangnya refleks pelindung saluran napas akibat obat dan keberhasilan pemasangan serta penggembungan manset tabung trakea. Pengelolaan anestesi pada pasien kista ovarium permagna menggunakan teknik Rapid Sequence Induction memiliki keuntungan tersendiri, namun demikian tetap diperlukan pertimbangan dan pemahaman yang baik agar menghasilkan hasil keluaran yang optimal.
Anesthesia Management of Patients with Esophageal Atresia/Traceoesophageal Fistula undergoing Thoracostomy and Esophagostomy Procedures Marthendro, Triade; Irawan, Dino; Muharrami, Vera; Hidayat, Nopian; Ananda, Pratama
Journal La Medihealtico Vol. 5 No. 5 (2024): Journal La Medihealtico
Publisher : Newinera Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37899/journallamedihealtico.v5i5.1597

Abstract

Esophageal atresia is a congenital disorder characterized by a disruption in the continuity of the esophageal lumen. Esophageal atresia may be accompanied by tracheoesophageal fistula, which is a lumen connection between the proximal and or distal part of the esophagus and the airway (trachea). Type C atresia is the most prevalent, which is approximately 88.5% to 90% of cases, where there is proximal esophageal atresia with distal tracheoesophageal fistula. In this case, a 9-day-old infant was admitted to Arifin Ahmad Hospital for thoracostomy and esophagostomy surgery due to continuous mucus discharge. The patient underwent awake intubation and was positioned intraoperatively, with a tilt to the right when an orogastric tube was placed. During surgery, the patient maintained stable hemodynamic and was subsequently admitted to the NICU using a ventilator. Infants with esophageal atresia often show symptoms of hypersalivation and shortness of breath caused by aspiration pneumonia. When the nasogastric tube cannot pass through the esophagus, atresia can be suspected. Radiology studies play an important role in diagnosing esophageal atresia, confirming esophageal atresia with or without fistula and diagnosing other anomalies associated with VACTERL.
Total Intravenous Anaesthesia (TIVA) in Supratentorial Meningioma Undergoing Craniotomy Tumour Removal : A Case Report Herman, Awanda; Hidayat, Nopian; Anggraeni, Novita; Ananda, Pratama
Biomedika Vol 16, No 2 (2024): Biomedika Agustus 2024
Publisher : Universitas Muhammadiyah Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Meningiomas are tumours that grow inside the head cavity or intra-cranial tumours, The incidence of intra-cranial tumours in patients of all ages is approximately 4.2 - 5.4 /100,000. The brain uses 20% of the body's total oxygen. The brain uses most of its oxygen consumption (60%) to generate adenosine triphosphate (ATP), which supports the electrical activity of neurons. In cranitomy tumour removal, it is expected that good oxygen supply and oxygen consumption by the brain are reduced by reducing electrical activity in the brain with the aim of relaxing the brain, Selection of 4 intravenous anaesthetic agents in craniotomy tumour removal in this patient in the form of Tiopental, Fentanyl, Rocuronium and Dexmedetomidine because the use of these agents is the best in reducing cerebral metabolic rate (CMR) and cerebral blood flow (CBF) so as to reduce intracranial pressure (ICP) which appears in this case stable hemodynamics and adequate depth of anaesthesia during surgery.
Adverse Event : Myocardial Injury after Non-Cardiac Surgery (MINS) Post Craniectomy in Critical Care Fajri, Doni; Anggraeni, Novita; Hidayat, Nopian; Ananda, Pratama
Jurnal Neuroanestesi Indonesia Vol 14, No 2 (2025)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v14i2.664

Abstract

Intracerebral hemorrhage (ICH) describes the non-traumatic parenchymal hemorrhage caused by the rupture of cerebral vessels, accounting for 2030% of all strokes. ICH will cause compression on the surrounding brain tissues, eventually giving rise to increased intracranial pressure. Decompressive craniectomy (DC) effectively reduce intracranial pressure. Myocardial injury is defined as an elevation of cardiac troponin levels with or without associated ischemic symptoms. Case a male, 66 years old patient was admitted to the ICU after undergoing Emergency Craniectomy Hematoma Evacuation due to Spontaneous ICH. After 52 hours of treatment, the patient was found to have ventricular tachycardia (VT) on the monitor and restlessness. The patient was also found to have comorbid hypertension. On a 12-Lead ECG we found NSTEMI, and Troponin I level was measured at 453.0 ng/L (positive). This patient was treated with anticoagulants, antiplatelet and statin, with monitoring of the ECG daily. On The 6th day patient was moved to High Care Unit (HCU). Myocardial Injury after Noncardiac Surgery is defined by elevated postoperative cardiac troponin concentrations, with or without accompanying symptoms or signs. It typically occurs within 30 days after surgery. The management of MINS involves the use of anticoagulants and antiplatelet therapy. Anticoagulant therapy should be considered between benefit and risk of re-bleeding post operative. MINS is a rare condition but is associated with an increased risk of 30-day mortality. A multidisciplinary treatment approach and a coordinated team effort are essential for improving the outcomes of patients with this condition.
Malignant Hyperthermia Fajri, Doni; Hidayat, Nopian; Masjkur, Diana
JAI (Jurnal Anestesiologi Indonesia) Vol 17, No 2 (2025): Jurnal Anestesiologi Indonesia (Issue in Progress)
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.62676

Abstract

Malignant hyperthermia (MH) is a life-threatening clinical syndrome caused by hypermetabolism involving skeletal muscle. MH is very rare, but it is one of the causes of death in the operating room. MH is an autosomal dominant disease and can be triggered when exposed to certain anesthetic drugs. Genetic tests can help diagnose, but the gold standard is the caffeine halothane contracture test (CHCT). Initial symptoms are a decrease in pH and oxygen, as well as an increase in CO2, lactate, potassium, and temperature. The increase in lactate reflects tissue hypoxia. Dantrolene is an antidote to MH, by reducing calcium loss from the sarcoplasmic reticulum in skeletal muscle and returning metabolism to normal conditions. Immediate detection and treatment can improve MH outcomes.
Myocardial Injury after Noncardiac Surgery: A Case Report of Acute Chest Pain and Elevated Troponin Levels, Challenges and Management Strategies Ton, Yori Yarson; Anggraeni, Novita; Irawan, Dino; Hidayat, Nopian
JAI (Jurnal Anestesiologi Indonesia) Publication In-Press
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.68386

Abstract

Background: Perioperative myocardial injury is a common complication following noncardiac surgery, linked to significant morbidity and mortality. With over 300 million surgeries performed worldwide annually, this number has increased by more than 100 million in the past two decades.Case: A 42-year-old woman underwent elective craniotomy for a right cerebellar hemangioblastoma and was admitted to the ICU postoperatively. On day three, she developed typical chest pain, inferior ST-elevation myocardial infarction (STEMI), and cardiogenic shock. Her medical history included the use of euthyrox following a total thyroidectomy 15 years prior, with no prior cardiac issues. Upon examination, she was conscious but had low blood pressure (58/41 mmHg), an elevated heart rate (103 bpm), and cold extremities. Her troponin I level was elevated at 9383.0 ng/mL. The diagnosis was major postoperative myocardial infarction.Therapy: The patient received aspirin, atorvastatin, heparin, norepinephrine, and dobutamine for shock management, with close hemodynamic monitoring. By day six, her condition improved, and her electrocardiogram (ECG) was normal. By day nine, she was transferred to the high care unit.Discussion: Myocardial injury after noncardiac surgery (MINS) includes both myocardial infarction and ischemic myocardial injury, which may not meet the Universal Definition of Myocardial Infarction. MINS usually occurs within 30 days of surgery, especially within the first 72 hours. Its causes are multifactorial, including plaque rupture, oxygen supply-demand imbalance, arrhythmias, and pulmonary embolism. Studies suggest that cardiovascular therapy, including aspirin and statins, is effective. Aspirin reduces 30-day mortality, while statins offer long-term benefits through anti-inflammatory effects. Low-dose aspirin, statins, and Renin-Angiotensin System inhibitors are recommended.Conclusion: MINS is a serious postoperative complication, even in patients without a history of cardiovascular disease, as demonstrated in this case. Prompt recognition and appropriate therapy with aspirin, heparin, and statins, along with close monitoring, can lead to significant clinical improvement.
Co-Authors Ananda, Pratama Awanda Herman Bambang Suryono, Bambang Dewi Anggraini Dino Irawan Fajri, Doni Fauzia Andrini Gusti Yulindra, Utari Marthendro, Triade Masjkur, Diana Maya Savira Muharrami, Vera Novita Anggraeni Pardede, Annisaa Shafira Ton, Yori Yarson Yusmein Uyun