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Keberhasilan Resusitasi Jantung Paru Otak (RJPO) Dengan Posisi Telungkup Pada Pasien Pediatrik Saat Pengangkatan Tumor Infratentorial [Successfully of Cardio Pulmonary Cerebral Resuscitation (CPCR) In Prone Position on Pediatric Pa Tient During Infra Tentorial Tumor Surgery]
Infratentorial tumor is more frequent in children, with sign and symptom of ataxia, cranial nerve disorder, vomiting, headache, decrease of consciousness level and hydrocephalus. Infratentorial tumor usually requires surgical removal. Case report of a 3 year old boy with infratentorial tumor, which depressed the 4th ventricle, undergone craniotomy tumor removal with prone position. When tumor was removed, massive bleeding occurred and caused sudden change in hemodynamic and cardiac arrest. The operation and anesthetic agents were discontinued, followed by Gardio Pulmonary Gerebral Resuscitation (GPGR) in prone position with resuscitation drugs (i.e adrenalin and sulfas atropin), as well as blood and fluids to replace the intravascular volume. After approximately 10 minutes of GPGR, hemodynamic was stable. Operation was continued to close operation wound. Post operation, patient was admitted to IGU and being treated with mechanical ventilation under sedation with continues propofol and vecuronium. On the 3rd day, re-operation was conducted to establish the previous operation as planned. The patient was admitted to the IGU post operatively. During management in IGU, hemodynamic was stable and the patient woke up on the 4th day with motoric squele on his left body side.
ln conducting an infratentorial tumor removal, an anesthesiologist should be aware for the risk of massive bleeding durante operation which could manipulate hemodynamic. There for special preparation and tight monitoring are required during the operation. In this case, GPGR can be done in limited position (prone position).
Keyword: Gardio Pulmonary Gerebral Resuscitation, Infratentorial Tumor, Prone Position
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