Background To evaluate the benefit of methylene blue as an adjunct treatment by assessing hemodynamic, morbidity rate, intensive care unit length of stay, and mortality rate outcomes in adult patients with vasoplegic syndrome. Methods A systematic search through electronic databases including Pubmed, Embase, Scopus, and Medline for studies assessing the use of methylene blue in patients with vasoplegic syndrome compared to control treatments. The Newcastle–Ottawa Scale tool was used for observational studies, and Jadad Scale was used for controlled trials to assess the risk of bias. Results This systematic review included six studies for qualitative synthesis and five studies for quantitative synthesis. Pooled analysis revealed that mean arterial pressure, systemic vascular resistance, heart rate, and hospital stay were not statistically significant in methylene blue administration compared to control. However, administration of methylene blue in vasoplegic syndrome patients significantly reduces renal failure (OR = 0.25; 95% CI = 0.08–0.75), development of multiple organ failure (OR = 0.09; 95% CI = 0.02–0.51), and mortality rate (OR = 0.12; 95% CI = 0.03–0.46). Conclusion Adjunct administration of methylene blue for vasoplegic syndrome patients significantly reduces renal failure, multiple organ failure, and mortality.

Introduction: Heart disease is one of the most common causes of maternal death. The incidence has increased since women with congenital and acquired heart disease reached fertile age. The circulation system changes during pregnancy which are induced by changes in the progesterone. The changes in progesterone levels increase heart work and cause death in pregnant women. Objective: This report aims to elaborate on the administration of nitrates as the management of labor in rheumatic heart disease (RHD). Case Report: A 27-year-old woman complained of shortness of breath and wanted to give birth. The patient was 38 weeks pregnant and had a history of heart disease. Antero-posterior chest radiography examination showed pulmonary edema and cardiomegaly. The patient was examined using echocardiography before spontaneous labor and was diagnosed as pregnant with rheumatic heart disease. As an emergency management, the patient was given painless spontaneous labor. The patient was given nitrates on the first day after delivery as a treatment for progesterone withdrawal syndrome in this case. After the delivery process was completed, the patient was admitted to the Intensive Care Unit (ICU). Discussion: Progesterone hormone produced by the corpus luteum and the placenta until the eighth week of pregnancy and before delivery, respectively, can reduce systemic vascular resistance. Progesterone hormone increase causes peripheral vasodilation by affecting the function of endothelial nitric oxide synthase (eNOS) and nitrite oxide (NO) production. Conclusion: A pregnant woman with rheumatic heart disease can be given exogenous nitrate. Administration of exogenous nitrates in this patient successfully prevent the reduction of peripheral vascular resistance and postpartum hemodynamic instability because it can replace the reduction in nitric oxide caused by progesterone withdrawal.

ABSTRAK

Introduction: The incidence of postoperative CABG AKI in Indonesia, one of which is in the city of Surabaya, is known to reach 69.8%. For this reason, this study was prepared with the aim of analyzing the risk factors of Acute Kidney Injury Incidence following coronary artery bypass graft with cardiopulmonary bypass. Method: The study conducted a prospective analytic study on CABG patients with the CPB technique without a history of previous kidney disease at a hospital in Indonesia in the period 2020. Results: Through the results of the study, it was found that 14 people were diagnosed as AKI after surgery, of which 11 were men. On the other hand, it is also known that AKI patients also experience a longer duration of CPB and also lower plasma osmolarity Conclusion: Of all the factors it is known that eGFR is an independent risk factor for AKI.

Predictions regarding damaged land access by a serial earthquake in Lombok, West Nusa Tenggara in 2018, was the background of the Rumah Sakit Terapung Ksatria Airlangga (RSTKA), being sent. RSTKA is phinisi ship with an operating theatre and other healthcare facilities. The earthquake was not accompanied by a tsunami, so the dock was suitable to be used for leaning. The study analyzes patient data in RSTKA, and as an evaluation of field hospitals. This study used observational descriptive design. Obtained 1601 patients with disease distribution classified as trauma and non-trauma. A number of patients who came to RSTKA were volatile. The number of cases recorded was more than the number of patients because some patients had more than one health problem. Trauma cases recorded 121 cases (6.7%) while non-trauma 1679 cases (93.3%). Non-trauma cases have increased rapidly since the fourth day. The trauma case was dominated by soft tissue injury 57.02%. Non-trauma cases were dominated by non-infectious diseases with 919 cases (54.8%) and 760 cases of infection (45.2%). Infectious diseases were dominated by respiratory infections (437 cases) followed by gastrointestinal infections (239 cases). Humanity mission of RSTKA has succeeded in making meaningful contributions to disaster-affected communities in Lombok, especially in North Lombok District.