Background Heterogeneous respiratory system static compliance (CRS) values and levels of hypoxemia in patients with novel coronavirus disease (COVID-19) requiring mechanical ventilation have been reported in previous small-case series or studies conducted at a national level. Methods We designed a retrospective observational cohort study with rapid data gathering from the international COVID-19 Critical Care Consortium study to comprehensively describe CRS—calculated as: tidal volume/[airway plateau pressure-positive end-expiratory pressure (PEEP)]—and its association with ventilatory management and outcomes of COVID-19 patients on mechanical ventilation (MV), admitted to intensive care units (ICU) worldwide. Results We studied 745 patients from 22 countries, who required admission to the ICU and MV from January 14 to December 31, 2020, and presented at least one value of CRS within the first seven days of MV. Median (IQR) age was 62 (52–71), patients were predominantly males (68%) and from Europe/North and South America (88%). CRS, within 48 h from endotracheal intubation, was available in 649 patients and was neither associated with the duration from onset of symptoms to commencement of MV (p = 0.417) nor with PaO2/FiO2 (p = 0.100). Females presented lower CRS than males (95% CI of CRS difference between females-males: − 11.8 to − 7.4 mL/cmH2O p < 0.001), and although females presented higher body mass index (BMI), association of BMI with CRS was marginal (p = 0.139). Ventilatory management varied across CRS range, resulting in a significant association between CRS and driving pressure (estimated decrease − 0.31 cmH2O/L per mL/cmH20 of CRS, 95% CI − 0.48 to − 0.14, p < 0.001). Overall, 28-day ICU mortality, accounting for the competing risk of being discharged within the period, was 35.6% (SE 1.7). Cox proportional hazard analysis demonstrated that CRS (+ 10 mL/cm H2O) was only associated with being discharge from the ICU within 28 days (HR 1.14, 95% CI 1.02–1.28, p = 0.018). Conclusions This multicentre report provides a comprehensive account of CRS in COVID-19 patients on MV. CRS measured within 48 h from commencement of MV has marginal predictive value for 28-day mortality, but was associated with being discharged from ICU within the same period. Trial documentation: Available at https://www.covid-critical.com/study. Trial registration: ACTRN12620000421932.

Penyakit jantung bawaan (PJB) merupakan kelainan baik pada struktur jantung atau pembuluh darah besar maupun fungsi jantung yang didapat sejak masih berada dalam kandungan. PJB juga merupakan salah satu penyebab utama kematian pada tahun pertama kehidupan. Prevalensi kejadian PJB di seluruh dunia mencapai 9,4 per 1000 kelahiran hidup termasuk di Indonesia. Dari jumlah tersebut, sekitar 300.000 kasus dikategorikan sebagai PJB berat yang kadang membutuhkan operasi bertahap agar pasien dapat bertahan hidup. Tujuan penulisan ini adalah untuk meningkatkan pemahaman mengenai tanda dan gejala PJB oleh dokter umum dengan modalitas yang sederhana dan dapat digunakan dalam melakukan skrining awal PJB di daerah perifer. Deteksi dini PJB pada pelayanan kesehatan primer dapat dilakukan dengan anamnesis, pemeriksaan fisik dan modalitas sederhana seperti pulse oximetry, EKG, serta foto Rontgen dada secara cermat dan sistematis. Dengan deteksi dini PJB, diharapkan dapat angka morbiditas dan mortalitas PJB dapat menurun di Indonesia.

Background This study evaluated thiamine levels in Indonesian children with congenital heart diseases before and after cardiopulmonary bypass and their relationship with clinical and surgical outcomes. Method A prospective, single center cross-sectional study was conducted to evaluate thiamine levels in 25 children undergoing congenital heart diseases surgery with cardiopulmonary bypass procedure. Thiamine levels were quantified using a high-performance liquid chromatography method. Result Preoperative thiamine deficiency was observed in one subject. Thiamine levels did not differ statistically between nutritional status and clinical outcomes categories. There were no significant changes in thiamine levels before and after cardiopulmonary bypass (median pre versus post (P25–75): 50 ng/mL (59.00–116.00) and 83.00 ng/mL (70.00–101.00), p = 0.84), although a significant reduction in thiamine levels were observed with longer cardiopulmonary bypass duration ( p = 0.017, R = −0.472). Conclusion Thiamine levels were not significantly impacted by cardiac surgery except in patients undergoing extremely long cardiopulmonary bypass duration. However, clinical outcome was not affected by thiamine levels.

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Keterbatasan Metode Diagnostik Patologi Anatomik dalam bidang Transplantasi Ginjal di Indonesia