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Farid Yudoyono
"[ABSTRAK
Latar Belakang: Cedera otak traumatika akibat kecelakaan lalu lintas masih merupakan salah satu penyebab kematian dan kecacatan utama pada kelompok usia produktif. Cedera otak sekunder dideskripsikan sebagai konsekuensi gangguan fisiologis, seperti iskemia, reperfusi, dan hipoksia pada area otak yang beresiko, beberapa saat setelah terjadinya cedera awal (cedera otak primer). Cedera otak sekunder sensitif terhadap terapi dan proses terjadinya dapat dicegah dan dimodifikasi. Metode: Penelitian kohort retrospektif dengan data primer rekam medis. Data yang terdiri dari beberapa variabel yang dikumpulkan secara retrospektif dari catatan medis pasien. RS. Hasan Sadikin, Bandung Jawa Barat, Indonesia. Pengambilan data dilakukan pada 2011-2014. Jumlah sampel yang diambil sebanyak 647 pasien. Analisis yang dilakukan meliputi analisis univariat, bivariat, dan analisis multivariate cox proportional hazard dengan model matematis yang
selanjutnya akan dibuat model skoring. Analisis roctab digunakan untuk menentukan nilai cut-off setiap variabel numerik. Hasil: Variabel perdarahan otak, tingkat kesadaran, dan edema serebri merupakan
faktor resiko outcome, sedangkan variabel peningkatan tekanan intrakranial, kadar elektrolit natrium dan klorida, serta terapi diuretik merupakan faktor resiko untuk terjadinya outcome kematian pada pasien ensefalitis anak. Berdasarkan hasil analisis multivariat skoring didapatkan urutan faktor prognostik yang dominan menyebabkan kematian, yaitu Variabel usia memilik HR sebesar 1,00, natrium
mempunyai HR 0,8, Perdarahan otak pada CT Scan kepala mempunyai HR sebesar 1,73, edema serebri mempunyai HR 2,53, hipoksia mempunyai HR sebesar 2,13, farktur maksillofascial mempunyai HR sebesar 0,6, hipotensi memiliki HR 0,7 dan pembedahan/trepanasi mempunyai HR 0,388 Berdasarkan analisis tersebut maka natrium, GCS, hipotensi, pembedahan dan MFS fraktur merupakan faktor proteksi outcome sedangkan usia, perdarahan otak pada CT Scan, edema serebri, hipoksia merupakan faktor resiko terjadinya outcome
kematian pada pasien cedera kepala berat. Dari hasil mulitvariat yang telah dilakukan sebelumnya apabila skor -69 s/d -47 mengalami resiko rendah untuk mengalami kematian, skor -46 s/d -20 mengalami resiko sedang untuk terjadinya kematian dan skor >-19 akan mengalami resiko tinggi terjadinya kematian. Kesimpulan: Model skoring prognosis yang telah terbentuk ini mampu memprediksi sebesar 84,75 % faktor faktor yang berhubungan dengan prognosis cedera otak traumatika berat. Apabila ada 100 pasien cedera kepala berat dengan adanya semua variabel maka 76 pasien akan meninggal dan bila 100 pasien
cedera kepala berat tanpa adanya semua variabel maka 25 pasien akan meninggal.

ABSTRACT
Background: Severe traumatic brain injury caused by traffic accidents is still one of the major causes of death and disability in the productive age group. Secondary brain injury is described as a physiological disorders, such as ischemia, reperfusion, and hypoxia in brain areas at risk, some time after the initial injury (primary brain injury). Secondary brain injury is sensitive to therapy it can be preventable and modifiable.
Methods: This cohort study with primary data medical records. The data consists of multiple variables collected retrospectively from patient medical records at Hasan Sadikin Hospital Bandung West Java, Indonesia. Data were collected in 2011-2014. The number of samples was 647 patients. Analysis was conducted on univariate, bivariate, and multivariate Cox proportional hazards analysis with a mathematical model which would then be created scoring models. Roctab analysis
is used to determine the cut-off value of any numeric variable.
Results: Variable brain hemorrhage, level of consciousness and cerebral edema is a risk factor outcomes, while variable increased intracranial pressure, electrolyte levels of sodium and chloride, as well as diuretic therapy is a risk factor for the occurrence of mortality outcomes in patients with severe traumatic brain injury. Based on the results of the multivariate analysis of prognostic factors scoring sequence obtained the dominant cause of death, the age variable having an HR of 1.00, sodium has HR 0.8, brain hemorrhage on CT scan head has a HR of 1.73, had a cerebral edema HR 2,53, hypoxia has a HR of 2.13, fracture maxillofascial have HR of 0.6 and hypotension have HR 0.7, surgery / trepanation HR 0.388, based on the analysis of the sodium, GCS, hypotension, MFS fracture, surgery and outcome protection factor whereas age, brain hemorrhage on a CT scan, cerebral edema, hypoxia is a risk factor for mortality outcomes in patients with severe head injury. From the results multivariate analysis has score of -69 s/d -47
experiencing low risk to experience death, a score of -46 s / d -20 experiencing moderate risk for the occurrence of death and a score of > -19 will experience a high risk of death. Conclusions: This Prognostic model scoring has capable to predict 84.75% factors related to the prognosis of severe traumatic brain injury. If there were 100 patients with severe traumatic brain injury in the presence of all variables and 76 patients will die and when 100 patients with severe traumatic brain injury in the absence of all variables that 25 patients will die., Background: Severe traumatic brain injury caused by traffic accidents is still one
of the major causes of death and disability in the productive age group. Secondary
brain injury is described as a physiological disorders, such as ischemia,
reperfusion, and hypoxia in brain areas at risk, some time after the initial injury
(primary brain injury). Secondary brain injury is sensitive to therapy it can be
preventable and modifiable.
Methods: This cohort study with primary data medical records. The data consists
of multiple variables collected retrospectively from patient medical records at
Hasan Sadikin Hospital Bandung West Java, Indonesia. Data were collected in
2011-2014. The number of samples was 647 patients. Analysis was conducted on
univariate, bivariate, and multivariate Cox proportional hazards analysis with a
mathematical model which would then be created scoring models. Roctab analysis
is used to determine the cut-off value of any numeric variable.
Results: Variable brain hemorrhage, level of consciousness and cerebral edema is
a risk factor outcomes, while variable increased intracranial pressure, electrolyte
levels of sodium and chloride, as well as diuretic therapy is a risk factor for the
occurrence of mortality outcomes in patients with severe traumatic brain injury.
Based on the results of the multivariate analysis of prognostic factors scoring
sequence obtained the dominant cause of death, the age variable having an HR of
1.00, sodium has HR 0.8, brain hemorrhage on CT scan head has a HR of 1.73,
had a cerebral edema HR 2,53, hypoxia has a HR of 2.13, fracture maxillofascial have HR of 0.6 and hypotension have HR 0.7, surgery / trepanation HR 0.388,
based on the analysis of the sodium, GCS, hypotension, MFS fracture, surgery
and outcome protection factor whereas age, brain hemorrhage on a CT scan,
cerebral edema, hypoxia is a risk factor for mortality outcomes in patients with
severe head injury. From the results multivariate analysis has score of -69 s/d -47
experiencing low risk to experience death, a score of -46 s / d -20 experiencing
moderate risk for the occurrence of death and a score of > -19 will experience a
high risk of death.
Conclusions: This Prognostic model scoring has capable to predict 84.75%
factors related to the prognosis of severe traumatic brain injury. If there were 100
patients with severe traumatic brain injury in the presence of all variables and 76
patients will die and when 100 patients with severe traumatic brain injury in the
absence of all variables that 25 patients will die]"
Depok: Universitas Indonesia, 2015
T43808
UI - Tesis Membership  Universitas Indonesia Library
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Lorens Prasiddha
"Latar Belakang: Penyakit paru interstisial (ILD) merupakan salah satu manifestasi sklerosis sistemik (SSc) pada paru dan faktor mortalitas utama SSc. SSc-ILD meningkatkan angka mortalitas 5 tahun pasien SSc sebesar 3 kali lipat. Hampir dua pertiga pasien SSc-ILD dengan kelainan minimal pada high resolution computed tomography (HRCT) toraks memperlihatkan progresivitas signifikan dalam 2 tahun. Model prediksi progresivitas SSc-ILD yang tersedia, yakni GAP (gender, age, and lung physiology) dan SADL (smoking history, age, and diffusion capacity of the lung), terbukti memiliki nilai prognostik yang baik. Model prognostik yang melibatkan parameter HRCT toraks dan Modified Rodnan Skin Score (mRSS) diharapkan dapat membantu seleksi pasien SSc-ILD yang memerlukan pemantauan ketat atau terapi dini untuk mencegah progresivitas.
Metode: Studi ini melibatkan pasien SSc-ILD yang menjalani pemeriksaan HRCT toraks awal dan evaluasi di Rumah Sakit Umum Pusat Nasional Dokter Cipto Mangunkusumo pada periode Januari 2016 hingga Desember 2021. Dilakukan volumetri kuantitatif menggunakan piranti lunak 3DSlicer® pada HRCT toraks awal untuk menghasilkan persentase volume paru abnormal, high attenuation area (HAA), dan low attenuation area (LAA) yang selanjutnya dianalisa sebagai faktor prognostik. Pola ILD pada HRCT toraks awal dan nilai mRSS masing-masing subyek diidentifikasi dan dianalisa sebagai faktor prognostik progresivitas SSc-ILD. Progresivitas SSc-ILD dikategorikan menjadi progresif dan non-progresif berdasarkan selisih persentase volume paru abnormal antara HRCT toraks awal dan evaluasi.
Hasil: Perbedaan rerata yang bermakna ditemukan pada volume paru abnormal, volume HAA, dan volume LAA, nilai mRSS antara SSc-ILD progresif dan non-progresif (p < 0,001). Berdasarkan receiver operating characteristic curve, ditetapkan nilai titik potong dari masing-masing variabel. Nilai titik potong persentase volume paru abnormal ditetapkan sebesar 32,82% dengan nilai sensitivitas 100% dan spesifisitas 93,8%. Nilai titik potong persentase volume HAA ditetapkan sebesar 19,76% dengan nilai sensitivitas 93,8% dan spesifisitas 93,8%. Nilai titik potong persentase volume LAA ditetapkan sebesar 9,89% dengan nilai sensitivitas 62,5% dan spesifisitas 62,5%. Nilai titik potong mRSS ditetapkan sebesar 18,5 dengan sensitivitas 93,8% dan spesifisitas 100%. Tidak ada perbedaan proporsi pola ILD antara kedua kelompok tersebut (p 0,220).
Kesimpulan: Volume paru abnormal > 32,82%, volume HAA > 19,76%, volume LAA > 9,89%, dan/atau nilai mRSS > 18,5 merupakan prediktor progresivitas SSc-ILD. Hasil volumetri kuantitatif abnormalitas paru pada HRCT toraks dan nilai mRSS merupakan faktor prognostik progresivitas SSc-ILD yang mudah diperoleh dan diaplikasikan dalam praktik klinis sehari-hari.

Background: Interstitial pulmonary disease (ILD) is one of the manifestations of systemic sclerosis (SSc) in the lungs and the main mortality factor of SSc. SSc-ILD multiplies the 5-year mortality rate of SSc patients by 3 times. Nearly two-thirds of SSc-ILD patients with minimal abnormalities in chest high resolution computed tomography (HRCT) showed significant progressivity within 2 years. The available prediction models of SSc-ILD progression, namely GAP (gender, age, and lung physiology) and SADL (smoking history, age, and diffusion capacity of the lungs), have been proven to demonstrate excellent prognostic values. Prognostic models involving chest HRCT parameters and Modified Rodnan Skin Score (mRSS) are expected to aid the selection of SSc-ILD patients who require close monitoring or early therapy to prevent progression.
Method: This study involved SSc-ILD patients who underwent initial and follow-up chest HRCT examination and evaluation at the National Central General Hospital of Doctor Cipto Mangunkusumo in the period from January 2016 to December 2021. Quantitative volumetric measurement was performed using 3DSlicer® software on the initial chest HRCT to yield abnormal pulmonary volume, high attenuation area (HAA) volume, and low attenuation area (LAA) volume percentage which were subsequently analyzed as prognostic factors. ILD patterns in the initial chest HRCT and mRSS values of each subject were identified and analyzed as prognostic factors of SSc-ILD progression. The progression of SSc-ILD is classified into progressive and non-progressive based on the abnormal pulmonary volume percentage difference between the initial and follow-up chest HRCT.
Result: Significant mean differences were found in abnormal lung volume percentage, HAA volume percentage, LAA volume percentage, and mRSS values between progressive and non-progressive SSc-ILD groups (p < 0.001). Based on the receiver operating characteristic curve, the cut-off point value of each variable is determined. The cut-off point value of the percentage of abnormal pulmonary volume was set at 32.82% with a sensitivity value of 100% and a specificity of 93.8%. The cut point value of the HAA volume percentage was set at 19.76% with a sensitivity value of 93.8% and a specificity of 93.8%. The LAA volume percentage cut point value was set at 9.89% with a sensitivity value of 62.5% and a specificity of 62.5%. The mRSS cut-off value was set at 18.5 with a sensitivity of 93.8% and a specificity of 100%. There was no significant in the proportion of ILD patterns between the two groups (p 0.220).
Conclusion: Abnormal lung volume > 32.82%, HAA volume > 19.76%, LAA volume > 9.89%, and/or mRSS value > 18.5 are predictors of SSc-ILD progression. Quantitative volumetric results of pulmonary abnormalities in chest HRCT and mRSS values are prognostic factors of SSc-ILD progression that are easily obtained and applied in daily clinical practice.
"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
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Beauty Rose Mawargany
"Latar belakang: Cedera kepala merupakan kegawatan di bidang Neurologi yang sering menyebabkan kematian dan kecacatan. Prognosis yang dapat dibuat diawal terjadinya cedera kepala akan membantu klinisi dalam memberikan tatalaksana yang tepat. Penelitian faktor prognostik pada cedera kepala dengan luaran skor GOSE yang dilakukan dalam tiga waktu pemantauan yang berbeda belum pernah dilakukan di RSUPN. Cipto Mangunkusumo.
Metode penelitian: Penelitian ini merupakan uji prognostik dengan disain kohort prospektif dan retrospektif untuk mengetahui faktor prognostik luaran GOSE pasien cedera kepala sedang dan berat pada hari 90 sebagai luaran primer, juga luaran pada hari 14 dan 30. Populasi yaitu pasien cedera kepala di RSUPN. Cipto Mangunkusumo selama bulan Oktober 2019- Maret 2021. Analisis data bivariat dengan chi-square dilanjutkan analisis multivariat dengan regresi logistik.
Hasil: Dari 139 sampel cedera kepala sedang dan berat didapatkan data demografik yaitu 81.3% sampel merupakan laki-laki dan usia rerata 40±44. Didapatkan sebaran klinis, SKG 3-8 16 sampel (11.5%), hipotensi 20 sampel (14.4%), Hipoksia sebanyak 11 sampel (7.9%), Anemia sebanyak 13 sampel (9.4%), hiperglikemi sebanyak 30 sampel ( 21.6%), skor ISS > 24 sebanyak 6 sampel (4.3%), skor Rotterdam > 4 sebanyak 56 sampel (45.2%). Pupil tidak reaktif bilateral 3.6%, reaktif unilateral 7.2%, reaktif bilateral 89.2%
Untuk luaran GOSE hari 90 sebagai luaran primer yaitu luaran baik 60.4% dan luaran buruk 39.6%. Luaran hari 30 luaran baik 46.8% dan luaran buruk 53.2%. Luaran fase awal yaitu hari 14 luaran baik 31.7% dan luara buruk 68.3%.
Analisis multivariat didapatkan faktor yang signifikan mempengaruhi luaran pada hari 14 yaitu usia di atas 60 tahun dan skor Rotterdam > 4. Analisis multivariat luaran hari 30 tidak didapatkan faktor yang signifikan mempengaruhi luaran GOSE. Pada hari 90 didapatkan faktor yang signifikan mempengaruhi luaran GOSE yaitu hipotensi < 100 mmHg.
Kesimpulan: Didapatkan faktor prognostik pada hari 14 yaitu usia dan skor Rotterdam dan faktor prognostik pada hari 90 yaitu hipotensi.

Background: Brain injury is an emergency in Neurology that often causes death and disability. Prognosis that can be made early in the occurrence of head injury will assist clinicians in providing appropriate management. The study of prognostic factors in head injury with GOSE score outcome that was conducted in three different monitoring times had never been done in RSUPN. Cipto Mangunkusumo.
Research method: Prognostic test with a prospective and retrospective cohort design to determine the prognostic factors for GOSE outcome in moderate and severe brain injury patients on day 90 as the primary outcome, as well as outcomes on days 14 and 30. The population was brain injury patients at the RSUPN. Cipto Mangunkusumo during October 2019-March 2021. Bivariat analysis with chi-square was followed by multivariate analysis with logistic regression.
Results: 139 samples of moderate and severe brain injury, demographic data were obtained, 81.3% of the sample were male and the mean age was 40±44. Obtained clinical distribution, SKG 3-8 16 samples (11.5%), hypotension 20 samples (14.4%), Hypoxia in 11 samples (7.9%), Anemia in 13 samples (9.4%), hyperglycemia in 30 samples (21.6%), ISS score > 24 for 6 samples (4.3%), Rotterdam score > 4 for 56 samples (45.2%). Bilateral unreactive pupils 3.6%, unilateral reactive 7.2%, bilaterally reactive 89.2%
For the 90 day GOSE outcome as the primary outcome, 60.4% good outcome and 39.6% bad outcome. The 30 day output is 46.8% good and 53.2% bad. The output of the initial phase was on day 14, good outcome was 31.7% and bad outcome was 68.3%.
Multivariate analysis found that the factors that significantly affected the outcome on day 14 were age over 60 years and Rotterdam score > 4. Multivariate analysis on day 30 did not find any significant factor influencing the outcome of GOSE. On day 90, it was found that a significant factor affecting the outcome of GOSE was hypotension < 100 mmHg.
Conclusion: In patients with moderate and severe brain injury, there were different prognostic factors for monitoring GOSE outcomes on days 14, 30 and 90.
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Depok: Fakultas Kedokteran Universitas Indonesia , 2021
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
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Deborah Theresia
"Sepsis didefinisikan sebagai suatu systemic inflammatory response syndrome SIRS disertai infeksi, terbukti ataupun tidak, dengan perkembangan penyakit hingga sepsis berat dan syok sepsis. Sepsis merupakan masalah kesehatan yang penting dengan angka mortalitas yang tinggi, mencapai 50 pada sepsis berat. Penelitian ini bertujuan untuk mengetahui peran saturasi oksigen vena sentral ScvO2. perbedaan tekanan parsial karbondioksida vena sentral dan arteri pCO2 gap. dan kadar laktat saat baseline dan pasca resusitasi, serta bersihan laktat sebagai penanda prognostik pada pasien sepsis berat. Desain penelitian adalah kohort retrospektif dengan 54 pasien sepsis berat, terdiri dari 27 pasien meninggal dalam 14 hari perawatan dan 27 pasien hidup. Pada penelitian ini didapatkan perbedaan bermakna pada kadar laktat pasca resusitasi dan bersihan laktat antara kedua kelompok, sedangkan pada ScvO2 baseline, ScvO2 pasca resusitasi, dan kadar laktat baseline tidak didapatkan perbedaan bermakna. Pada kadar laktat pasca resusitasi didapatkan besar area under the curve AUC untuk memprediksi mortalitas sebesar 84,4. dengan cutoff 1,45 mmol/L, sensitivitas 74,1 dan spesifisitas 85,2. Pada bersihan laktat didapatkan besar AUC untuk memprediksi pasien sepsis berat yang hidup sebesar 99,5. dengan cutoff 1,5. sensitivitas 100 dan spesifisitas 92,6. Angka mortalitas pada kelompok pCO2 gap baseline. 6 mmHg sebesar 59,5 dan ge;. mmHg sebesar 29,4. serta pada kelompok pCO2 gap pasca resusitasi. 6 mmHg sebesar 50,0 dan ge;. mmHg sebesar 50,0. Parameter kadar laktat pasca resusitasi dapat digunakan untuk memprediksi mortalitas dengan cutoff 1,45 mmol/L, dan bersihan laktat untuk memprediksi pasien yang hidup dengan cutoff 1,5.

Sepsis is defined as systemic inflammatory response syndrome SIRS accompanied with infection, proven or not, that can progress to severe sepsis or septic shock. Sepsis is an important health problem with high mortality rate, reaching 50 in severe sepsis. This study aims to find out the role of central venous oxygen saturation ScvO2. carbondioxide partial pressure gap of central venous and arterial pCO2 gap. and lactate at baseline and post resuscitation, and lactate clearance as prognostic markers in severe sepsis. The study design is retrospective cohort with 54 severe sepsis patients, consists of 27 patients that died within 14 days of stay and 27 patients that survived. This study found significant difference in post resuscitation lactate and lactate clearance between both groups, while baseline ScvO2, post resuscitation ScvO2, and baseline lactate was not significantly different. The size of area under the curve AUC for post resuscitation lactate to predict mortality is 84,4. with cutoff 1,45 mmol L, sensitivity 74,1 and specificity 85,2. The size of AUC for lactate clearance to predict severe sepsis patients that survived is 99,5. with cutoff 1,5. sensitivity 100 and specificity 92,6. Mortality rate in baseline pCO2 gap group. mmHg is 59,5 and ge. mmHg is 29,4. and in post resuscitation pCO2 gap group. mmHg is 50,0 and ge. mmHg is 50,0. Post resuscitation lactate can be used to predict mortality with cutoff 1,45 mmol L, and lactate clearance to predict survivor with cutoff 1,5.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2017
T55723
UI - Tesis Membership  Universitas Indonesia Library
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Fritz Sumantri
"Latar belakang : Proses yang mengikuti setelah terjadinya cedera kranioserebral berat ada 2 , yaitu kerusakan primer dan sekunder . Disfungsi pernafasan adalah salah satu hal yang terjadi pada kerusakan otak sekunder dan dapat kita ketahui dari pemeriksaan analisa gas darah yang kita lakukan . Dari hasil pemeriksaan analisa gas darah tersebut, kita dapati PaO2 dan PaCO2 . Tekanan tekanan oksigen dan karbondioksida tersebut ternyata memiliki pengaruh terhadap perubahan laju aliran darah kcotak . Di mana peningkatan PaCO2 dan penurunan PaO2 akan meningkatkan laju aliran darah ke otak , sehingga dapat meningkatkan tekanan intrakranial. Sedangkan penurunan PaCO2 dan peningkatan PaO2 dapat menurunkan laju aliran darah ke otak yang akan mengancam terjadinya proses iskemik . Perubahan perubahan tekanan gas diatas disinyalir memiliki hubungan dengan hasil akhir yang didapat pada cedera kranioserebral. Oleh sebab itu kami melakukan penelitian untuk mengeksplorasi hubungan antara tekanan gas gas tersebut terhadap hasil akhir , khususnya PaCO2 yang tinggi (> 45 mmHg) dan PaO2 yang rendah ( < 85 mmHg ) terhadap hasil akhir setelah perawatan selama 3 hari .
Obyektif : mengetahui peranan PaCO2 tinggi dan PaO2 rendah terhadap hasil akhir setelah 3 hari perawatan pada pasien pasien cedera kranioserebral berat .
Metade : cross sectional, dengan membandingkan nilai PaO2 dan PaCO2 pads waktu pasien datang dengan hasil akhir yang terjadi setelah 3 hari perawatan.
Hasil : dari 84 sampel yang terkumpul , dilakukan pemeriksaan analisa gas darah sewaktu pasien datang, kemudian dilihat hasil akhir setelah 3 hari perawatan . Didapatkan suatu hasil bahwa PaO2 yang rendah akan mempunyai kecenderungan resiko kematian dalam 3 hari yang lebih besar, dibanding penderita yang PaO2 nya normal (p
Kesimpulan : PaO2 dan PaCO2 dapat dijadikan sebagai salah satu bahan pertimbangan dalam usaha untuk mengetahui basil keluaran pasien pasien cedera kranioserebral berat.

Background: Two processes following a severe craniocerebral injury are primary and secondary damage. Respiratory dysfunction is one of the secondary damage which can be detected by blood gas analysis revealing 02 and CO2 arterial pressure (Pa02 and PaCO2). These arterial PaO2 and PaCO2 influence the blood flow velocity to the brain, whereas elevation of PaCO2 and reduction of PaO2 will increase the blood flow velocity to the brain and thus increase intracranial pressure. On the contrary, reduction of PaCO2 and elevation of PaO2 will decrease the blood flow velocity to the brain and could be a thread for ischemic process. The alteration of blood gas above is suggested to have a correlation with the outcome of craniocerebral injury patients. In this study, we explored the correlation of blood gas pressure especially high PaCO2 (>45 mmHg) and low Pa02 (<85 mmHg) with patient's outcome after 3 days of hospital care.
Objective: To know the correlation of high PaCO2 and low PaO2 with the outcome of severe craniocerebral injury patients after 3 days of hospital care.
Methods: This is a cross-sectional study. Patient's initial arterial PaO2 and PaCO2 was compared with patients arterial Pa02 and PaCO2 after 3 days of hospital care.
Results: Blood gas analysis was done in 84 samples at their initial admission and compared with the blood gas analysis taken after 3 days of hospital case_ It was shown that patients with low PaO2 have a tendency for higher risk of death within 3 days, if compared with patients with normal Pa02 (p<0,05); patients with high PaCO2 have a tendency for higher risk of death within 3 days, if compared with patients with normal PaCO2 (p<0,05); and patients with low PaCO2 have a tendency for higher risk of death within 3 days, if compared with patients with normal PaCO2 (p<0,05).
Conclusion: Arterial PaO2 and PCaO2 can be used as one of the consideration for predicting the outcome of severe craniocerebral injury patients.
"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2005
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
cover
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Reynolds, Cecil R., editor
"The second edition of Detection of Malingering during Head Injury Litigation offers the latest detection tools and techniques for veteran and novice alike. As in its initial incarnation, this practical revision demonstrates how to combine clinical expertise, carefully-gathered data, and the use of actuarial models as well as common sense in making sound evaluations and reducing ambiguous results. And, the book navigates the reader through the many caveats that come with the job, beginning with the scenario that an individual may be malingering despite having an actual brain injury."
New York: [Springer, ], 2012
e20410723
eBooks  Universitas Indonesia Library
cover
Sundstrom, Terje
"In order to reduce the number of deaths from severe head injuries, systematic management is essential. This book is a practical, comprehensive guide to the treatment of patients (both adults and children) with such injuries, from the time of initial contact through to the rehabilitation center. Sections are devoted to prehospital treatment, admission and diagnostics, acute management, and neurointensive care and rehabilitation. Evidence-based recommendations are presented for each diagnostic and therapeutic measure, and tips, tricks, and pitfalls are highlighted. Throughout, the emphasis is on the provision of sound clinical advice that will maximize the likelihood of an optimal outcome. Helpful flowcharts designed for use in daily routine are also provided. The authors are all members of the Scandinavian Neurotrauma Committee and have extensive practical experience in the areas they write about."
Berlin : Springer, 2012
e20426111
eBooks  Universitas Indonesia Library
cover
D de G Jones
Texas : NACE, 1976
669.586/JON
Buku Teks  Universitas Indonesia Library
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