Search

Gezy Giwangkancana,1 Ezra Oktaliansah,1 Andi Ade W Ramlan,2 Arie Utariani,3 Putu Kurniyanta,4 Hasanul Arifin,5 Yunita Widyastuti,6 Astrid Pratiwi,7 Rusmin Syukur8 1Department of Anesthesia and Intensive Care, Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin National Referral and Teaching Hospital, Bandung, Indonesia; 2Department of Anesthesia and Intensive Care, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo National Referral and Teaching Hospital, Jakarta, Indonesia; 3Department of Anesthesia and Intensive Care, Faculty of Medicine Universitas Airlangga/Dr. Soetomo Provincial Referral and Teaching Hospital, Surabaya, Indonesia; 4Department of Anesthesia and Intensive Care, Faculty of Medicine Universitas Udayana/ Prof Dr. I.G.N.G Ngoerah National Referral and Teaching Hospital, Bali, Indonesia; 5Department of Anesthesia and Intensive Care, Faculty of Medicine Universitas Sumatera Utara/Dr. Adam Malik National Referral and Teaching Hospital, Medan, Indonesia; 6Department of Anesthesia and Intensive Therapy, Faculty of Medicine, Public Health and Nursing Universitas Gajah Mada/Dr. Sardjito National Referral and Teaching Hospital, Yogyakarta, Indonesia; 7Department of Anesthesia and Intensive Care, Harapan Kita Mother and Child Hospital, Jakarta, Indonesia; 8Department of Anesthesia and Intensive Care Faculty of Medicine Universitas Hassanudin/ Dr. Wahidin Sudirohusodo National Referal and Teaching Hospital, Makassar, IndonesiaCorrespondence: Gezy Giwangkancana, Department of Anesthesia and Intensive Care, Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin National Referral and Teaching Hospital, RSUP Dr Hasan Sadikin, Bandung, Pasteur Street No. 38, Bandung, 40161, Indonesia, Tel +628122005952, Email Gezy.weita@unpad.ac.idBackground: The first wave of COVID-19 in 2020 created massive challenges in providing safe surgery for pediatric patients with COVID-19. Inevitably, emergency surgery and the unknown nature of the disease place a burden on the heavily challenged surgical services for pediatrics in a developing country. Lessons from the pandemic are important for future disaster planning.Aim: To describe the characteristics of pediatric surgical patients with COVID-19 undergoing emergency surgery during the first wave and its perioperative narrative in a developing country.Methods: The study was a multicenter retrospective descriptive study in eight Indonesian government-owned referral and teaching hospitals. The authors reviewed confirmed COVID-19 pediatric patients (≤ 18 years old) who underwent surgery. Institutional review board clearances were acquired, and data were evaluated in proportion and percentages. The writing of this paper follows the STROBE guidelines.Results: About 7791 pediatric surgical cases were collected, 73 matched the study criteria and 24 confirmed cases were found. Cases were more common in females (58.3%), who were above 12 years old (37.5%) and who were asymptomatic (62.5%). Laparotomy (33.3%), general anesthesia (90.4%) and intubation (80.8%) were common, while use of video laryngoscopy (40%) and rapid sequence intubation (28.8%) were rare. The mean length of stay was 12 ± 13.3 days, and in-hospital mortality was 8.3%.Discussions: Lockdown and school closure were successful in protecting children, hence the low incidence of pediatric surgical cases with COVID-19 during the first wave. Many hospitals were unprepared to perform surgery for a droplet or airborne infectious disease, and COVID-19 testing was not available nationally in the early pandemic, hence the use of protective protection equipment during these early pandemic times are often not efficient.Conclusion: The incidence of COVID-19 in pediatric surgical patients is low. The rapidity and availability of preoperative testing for a new emerging disease are essential in a pandemic.Keywords: COVID-19, emergency surgery, operating room, pandemic, pediatric anesthesia, pediatric surgery, perioperative

Peat soil is poor soil to become subgrade. Therefore, it is necessary to load first using the preloading method. The purpose of this initial loading is to reduce the initial settlement and increase the soil bearing capacity parameter. One method of improvement is preloading the peat soil. This research was conducted through a modeling test in the laboratory using a test tub measuring 150 cm × 180 cm × 70 cm. The main medium used is peat soil. Prior to loading, first the CBR assessment test and the unconfined compressive strength of peat soil. The load used for preloading is nako iron measuring 4 cm × 1.9 cm × 1.9 cm. The compilation of expenses is carried out with pressures of 3.02 kPa, 6.05 kPa, 9.07 kPa, and 12.09 kPa. Time respectively 1 day and 1 week. After the preloading is done, the CBR value and unconfined compressive strength are tested on the surface that has been given the initial load. The results show that preloading can increase the value of the unconfined compressive strength and the CBR value of peat soil. The greater the pressure and time given for preloading, the greater the unconfined compressive value of peat soil and its CBR value. Keywords: peat soil, preloading, pressures, time, CBR, unconfined compressive strength Tanah gambut merupakan tanah yang kurang baik untuk dijadikan tanah dasar. Oleh sebab itu, perlu dilakukan pembembebanan terlebih dahulu dengan menggunakan metode preloading. Tujuan pembebanan awal ini dilakukan untuk mengurangi penurunan konsolidasi awal, mengetahui peningkatan parameter daya dukung tanah. Salah satu metode perbaikan adalah melakukan pembebanan awal (preloading) pada tanah gambut. Penelitian ini dilakukan melalui uji permodelan di Laboratorium dengan menggunakan bak uji berukuran 150 cm × 180 cm × 70 cm. Media utama yang digunakan adalah tanah gambut. Sebelum melakukan pembebanan terlebih dahulu diuji nilai CBR dan kuat tekan bebas tanah gambut tersebut. Beban yang digunakan untuk preloading berupa besi nako berukuran 4 cm × 1,9 cm × 1,9 cm. Penyusunan beban dilakukan dengan tekanan sebesar 3,02 kPa, 6,05 kPa,9,07 kPa, dan 12,09 kPa. Waktu masing-masing 1 hari dan 1 minggu. Setelah selesai preloading dilakukan pengujian nilai CBR dan kuat tekan bebas di atas permukaan yang telah diberi beban awal.Hasil penelitian menujukan bahwa preloading dapat meningkatkan nilai kuat tekan bebas dan nilai CBR tanah gambut. Semakin besar tekanan dan lamanya waktu yang diberikan sebagai preloading, maka semakin besar nilai kuat tekan bebas tanah gambut dan nilai CBR nya. Kata kunci: Tanah gambut, preloading, tekanan, waktu, CBR,kuat tekan bebas.