@article {2273, title = {Can Ventilator Settings Influence Lung Damage Biomarkers KL-6 and CRP during One Lung Ventilation?}, journal = {Pharmacognosy Journal}, volume = {16}, year = {2024}, month = {April 2024}, pages = {455-459}, type = {Research Article}, chapter = {455}, abstract = {

Background: Volume-controlled (VCV) or pressure-controlled ventilation (PCV) modes are most often used during OLV. This is a prospective observational analytical study of patients undergoing thoracic surgery with OLV. Method: 40 patients underwent thoracic surgery using one lung ventilation (OLV) from December 2023 to February 2024. All patients received lung protective ventilation (PLV) with a tidal volume of 6 ml/ kgPBW during OLV with PEEP 5-7 cmH2O and were divided into two groups: one with a ventilator in volume-controlled mode (VCV) and the other with pressure-controlled mode (PCV). KL-6, CRP, and p/f ratio were measured before OLV, 2 hours after OLV, and 24 hours after the operation was completed. Respiratory variables during OLV were recorded. Results: KL-6 and CRP levels in PCV and VCV groups were significantly different. There were significant differences in the values of Ppeak (p \<0.001), PEEP (p = 0.008), Cstat (p = 0.004) and driving pressure (p \<0.001) in both groups. The correlation between changes in KL-6 and CRP levels and the P/F ratio were very weak and insignificant. Cytokines play an important role in the inflammatory response in the lungs. Several determining factors of blood flow are gravity, lung disease, surgery, and hypoxic pulmonary vasoconstriction. Duration of OLV may affect the pulmonary inflammatory response and is correlated with the duration of OLV. Conclusion: There is no association found between KL-6 and CRP in PCV and VCV mode during thoracotomy with OLV.

}, keywords = {CRP, KL-6, One lung ventilation, Thoracotomy, Ventilator}, doi = {10.5530/pj.2024.16.72}, author = {Novita Sari and Bambang Pujo Semedi and Prananda Surya Airlangga and Kohar Hari Santoso and Maulydia and Budi Utomo and Christrijogo Sumartono} } @article {2448, title = {Successful Practice of Massive Transfusion in Traumatic Amputation of Digit I-V Manus Dextra: A Case Report}, journal = {Pharmacognosy Journal}, volume = {16}, year = {2024}, month = {December 2024}, pages = {1436-1438}, type = {Case Report}, chapter = {1436}, abstract = {

Introduction: Massive blood is the main cause of mortality and morbidity in trauma patients, in which 6 out of 10 cases are reported to die. Case presentation: A 29-year-old man appears to have experienced an amputation of digit I-V manus dextra. Vital signs are in stable condition and the patient is also conscious (GCS of 15) with ASA PS 1. The patient underwent debridement and replantation for 18 hours. Post-first surgery, we found blood seepage in the surgical wound, which for 4 hours showed 2000 mL of blood. The patient experiences decreased consciousness (GCS of 9), hypotension (77/40 mmHg), HR of 130 {\texttimes}/min, and cold extremities. The patient received resuscitation with 1000 mL of crystalloid, 500 mL of colloid, 800 mL of WB, and 400 mL of PRC transfusion. Abnormal laboratory examination revealed Hb 4.6 g/dL, albumin 1.4 g/dL, and prolongation of hemostasis function 2 times. The patient underwent reoperation and was found to have ruptured muscles and veins for which musculorraphy and venorraphy were performed for 16 hours. On the 3rd day, the patient experienced breathing difficulties (RR of 30 {\texttimes}/ min and SO2 of 95\%) and the chest x-ray showed lung edema. The patient was placed on a ventilator using NIV and furosemide 20 mg/8 h. The patient regained consciousness on the 7th day. Discussion: The principle of managing massive bleeding is to stop the bleeding, restore blood circulation volume, and maintain peripheral vascularization. Conclusion: Massive transfusion is a management strategy for preventing death due to hemorrhagic shock.

}, keywords = {Bleeding, Blood massive protocol, Hemorrhagic shock, Trauma}, doi = {10.5530/pj.2024.16.231}, author = {Kashi Ameta Resijiadi Juwono and Maulydia and Prananda Surya Airlangga} }