Background: Magnetic Resonance Imaging (MRI) and Computerized Tomography (CT) Scans might be challenging for children or patients with anxiety or claustrophobia. The use of general anesthesia aims to increase the success rate, but inadequate management can result in longer length of stay. Purpose: To analyze patients' length of stay on MRI and CT-scan with intravenous anesthesia. Methods: A descriptive observational study. The datas were collected retrospectively from the medical records in General Diagnostic Center. Total of 721 patients who underwent MRI or CT Scan procedures with intravenous anesthesia during 2017-2018. The data obtained were patients' age, sex, the type of procedure, physical status, comorbid, type of anesthesia drug, diagnostic procedure duration, length of observation in the Post Anesthesia Care Unit (PACU), and overall length of stay. Results: All MRI procedures used midazolam-propofol combination, and only one CT scan procedure used this combination, while the other used only propofol. Patients undergoing MRI had length of stay with a mean duration of 6,6,3±1,26 hours, compared to CT scans with 5,20 ±1,38 hours, due to the more prolonged procedure and observation duration in the PACU. Conclusion: Patients undergoing MRI had a longer length of stay than the ones doing CT scans.
Vein thrombosis may occur both in deep and superficial vein of all extremities. Ninety percent of vein thrombosis may progress into pulmonary embolism which is lethal. Deep vein thrombosis (DVT) is frequently found in critically ill patients in ICU, especially patients who are treated for a long time. This study aims to analyse the comparison between length of stay and DVT incidents in critically ill patients. A cross-sectional study was employed. We include all patients who were 18 years or older and were treated in ICU of Dr Soetomo public hospital for at least 7 days. The patients were examined with Sonosite USG to look for any thrombosis in iliac, femoral, popliteal, and tibial veins and Well’s criteria were also taken. This study showed that length of stay is not the only risk factor for DVT in patients treated in ICU. In our data, we found out that the length of treatment did not significantly cause DVT. Other risk factors such as age and comorbidities in patients who are risk factors may support the incidence of DVT events. The diagnosis of DVT is enforced using an ultrasound performed by an expert in the use of ultrasound to locate thrombus in a vein. Length of treatment is not a significant risk factor for DVT. Several other factors still need to be investigated in order for DVT events to be detected early and prevented.
Sepsis neonatorum masih menjadi penyebab tingginya insiden kematian dan tingkat keparahan penyakit neonatus. Manifestasi klinis sepsis neonatorum dapat bervariasi dan belum ada satu tes yang sensitif dan spesifik untuk mendiagnosis sepsis neonatorum dalam waktu yang cepat. Oleh karena itu, identifikasi faktor risiko sepsis neonatorum pada pasien menjadi penting untuk dilakukan karena memiliki indeks kecurigaan yang tinggi dan berperan dalam keberhasilan tata laksana pasien. Tujuan penelitian ini adalah untuk mengetahui faktor risiko mayor pada pasien sepsis neonatorum di NICU RSUD Dr. Soetomo tahun 2019. Penelitian ini bersifat deskriptif observasional dengan metode retrospektif cross-sectional menggunakan data rekam medik pasien sepsis neonatorum di bulan Januari-Desember 2019. Dari 161 pasien yang diteliti, mayoritas sampel adalah pasien early onset sepsis (EOS), neonatus prematur dan lakilaki. Faktor risiko neonatus sepsis neonatorum mayor, baik pada pasien EOS maupun late onset sepsis (LOS), adalah berat badan lahir rendah (BBLR), prematur, skor APGAR yang rendah dan jenis kelamin laki -laki. Adanya kelainan atau penyakit selain sepsis merupakan faktor risiko neonatus sepsis neonatorum mayor yang ditemukan pada pasien LOS. Baik pasien EOS maupun LOS memiliki faktor risiko maternal mayor yang sama, yaitu persalinan melalui sectio caesarea (SC). Hipotonus, sianosis, asfiksia, respiratory distress syndrome (RDS) dan gerak tangis lemah adalah manifestasi klinis terbanyak yang ditemukan pada pasien sepsis neonatorum. Strategi khusus dalam pencegahan dan pengobatan sepsis neonatorum yang menyesuaikan kondisi suatu negara diperlukan untuk mencegah angka kematian neonatus yang tinggi. Penelitian ini diharapkan dapat menjadi acuan untuk penelitian selanjutnya dengan jumlah sampel yang lebih banyak dan karakteristik yang lebih beragam.
Introduction: AKI (Acute Kidney Injury) complications in sepsis patients generally occur 24 hours after admission to ICU. Creatine Serum Concentration is a standard parameter to diagnose AKI. Unfortunately, the changes in creatine serum concentration will only be seen several days after the decrease of renal function to 50%. The low detection ability has been linked with time loss before preventive therapy is commenced. Furthermore, this instigates the need for biomarkers to ensure early detection. Objective: This study aimed to identify cut-off points of urine syndecan-1 and to measure the prediction ability of urine syndecan-1 towards the AKI occurrence in pediatric sepsis patients. Materials and methods: This study was a prospective cohort study performed at a single center in Dr. Soetomo General Hospital, Surabaya. The inclusion criterion was all children admitted to the resuscitation room from October until December 2019. Furthermore, urine sampling is carried out at 0, 6, 12, and 24 hours for a syndecan-1 urine examination, and every procedure performed on the patient will be recorded. This action was continued up to the third day and aimed to evaluate some factors related to AKI at 48-72 hours of admission. Result and Discussion: Out of 41 pediatric sepsis patients, 30 patients fulfilled the inclusion criteria and 57% had AKI. The value of urine syndecan-1 at hour-0 and hour-6 was significantly featured a cut-off point. Conclusion: The value of urine syndecan-1 at hour-0 and hour-6 are valid parameters to predict the occurrence of AKI grades 1, 2, and 3 in pediatric septic patients at 48-72 hours after their hospital admission. The best cut-off value of urine syndecan-1 at the 0th hour was 0.67 ng/ml.
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