LAPORAN JAGA COVID

HCU Kemuning
 Bed 1. Ny. Pipit Sofia/P/ 61 tahun / BB 60 kg/ 0001565185/HS 43/ HP 10
Objectives Assessment Planning
CNS : E4M6V5 Confirmed COVID-19 Severe Case dengan koinfeksi bakteri + DM 2, uncontrolled hyperglycemia + Hipertensi F : Diet DM 1500 kkal
dalam terapi
A : Paracetamol 500 mg/8 jam
CVS 27/02/21 S:-
Hb 11.1 Ht 31,7 Leu 9430 Tr 494.000 E3,79 TLC 850 NLCR 9,54 GDS 254 Ur 34.0 Cr 0.60 Na 135 K 4.1 Ca 5,13
T : 125/60 mmHg T : Fondaparinux 2.5 mg/24 jam SC
Mg 1.9 Cl 110 PT 10.90 APTT 21.00 INR 0.99 Alb 2.32 CRP 1.70 LDH 314 D-dimer 1.36 SGOT 23 SGPT 28
pH 7.414 pCO2 28.7 pO2 77.7 HCO3 18.5 tC02 19.4 BE -4.6 SatO2 94.4 P/F ratio 86,3 P/F ration 86,3 ROX H : Head up 30O
N : 71 kali per menit, reguler index 3,2-6,3 Diff.count 0/0/0/86/9/5 MCHC 35 MCH 29,3 MCV 83,6
U : Omeprazole 40 mg/ 12 jam
26/02/21 G : Insulin basal 1x18 IU SC, Insulin rapid 3x10
Hb 11.6 Ht 33.4 Leu 11.270 Tr 390.000 TLC 9.92 NLCR 12.56 GDS 315 Ur 30 Cr 0.66 Na 135 K 4.4 Ca 4.65 Mg IU SC
1.8 Cl 110 PT 13.0 APTT 30.1 INR 0.91 Alb 2.36 CRP 5.55 As.laktat 2.36
Respirasi pH 7.356 pCO2 25.1 pO2 77.6 HCO3 14.2 BE -9.0 SatO2 94.8 P/F ratio 77.6 Terapi :
16-30x/menit, WOB (-) - Remdesivir 100 mg/24 jam IV (6)
HFNC 60 lpm,FiO2 100% 25/02/21 - Dexamethasone 1x6mg IV (6)
SpO2 94-97% Hb 11.6 ht 33.4 Leu 11.270 Trom 390.000 DC 0/0/1/87/7/5 NLR 12.56 - Ceftriaxone 1 gram/ 12 jam IV (9)
ROX 3,2-6,3 PT 13.0 INR 0.91 APTT 30.10 CRP 5.55 alb 2.36 laktat 1.8 ur 30 cr 0.66 - Levofloxacin 1x750mg IV (3)
Na 135 K 4.4 Cl 110 Ca 4.65 Mg 1.8 - Vitamin C 1x1000mg IV
GIT
pH 7.356 pCO2 25.1 pO2 56.2 HCO3 14.2 BE -9.0 SaO2 94.8% - Vitamin D 1x5000IU PO
Datar, supel
- Omega 3 1x1caps PO
24/02/21 - N-asetilsistein 400mg/8jam PO
Hb 11.8 ht 34.1 Leu 11.600 Trom 337.000 DC 0/0/0/78/17/5 NLR 4,59 - Amlodipin 1x10 mg PO
PT 12,1 INR 0,85 APTT 25,8 CRP 1.24 LDH 301 SGOT 27 SGPT 45 - Zinc 20mg/12jam PO
Bil.tot 0.377 Bil.direk 0.137 Bil.indirek 0.24 alb 2,33 laktat 1.4 ur 43 cr 0.64 - TPK labu pertama telah selesai
Na 134 K 4,5 Cl 111 Ca 3,55 Mg 1,7 Fibrinogen 561 Ddimer - Actemra kedua telah selesai
pH 7.392 pCO2 28.3 pO2 56.2 HCO3 17.4 BE -5,7 SaO2 88,3% (P/F ratio 56,2)

23/02/21
Hb 11.9 Hct 34,6 Leu 5440 Tr 298.000 GD2PP 337 AGD: pH 7.411 pCO2 27.7 pO2 71.1 HCO3 17.7 tCo2 18.6
SB-b -5.5 SpO2 91.9

GUT : PCR swab 18/02/21: positif. Ct: 15.44 Kultur darah (24/2/21): Belum ada hasil
PCR swab 24/2/21: positif Ct : 23.39
UOP:1615/24 jam
Diuresis:1,12 cc/kgBB/jam

Balance: -235 cc/24 jam

Balans kumulatif : -2516 cc/5 hari
22/02/21
Hb 11.7 Ht 34.2 Leu 5990 Tr 229.000. CRP kuantitatif 2.94 GDS 270. AGD: pH 7.380 pCO2 30.9 pO2 70.7
HCO3 18.5 tCO2 19.4 SBE-b -5.0 SpO2 93.4 Procalcitonin 0.13

19/2/21
Hb 10.5 Ht 30.2 Leu 18600 Tr 286.000 HBA1C 11.0 AGD: pH 7.361 pCO2 36.0 pO2 149.5 HCO3 20.6 tCO2
21.7 SBE-b -3.7 SpO2 99.0

18/02/21
Hb 13.1 Hct 37.3 Leu 7730 Tr 273.000 PT 12.2 INR 0.85 APTT 25.6 Kolesterol total 160, HDL 52 LDL85 TR 109
CRP kuantitatif 2,27 GDS 465 LDH 170 SGOT 33 SGPT 58 Bil total 0.431 Bil direk 0.157 Bil indirek 0.274 Prot
total 3.62 Globulin 4.0 Ureum 44.5 Crea 1.12 Na 128 K 4,4 Ca Ion 4,21 Mg 2.0 Fibrinogen 373.0 D-Dimer
kuantitatif 0.63 Tropo I < 0.01 Ferritin 572.7 Procalcitonin 0.13
Ro thorax 26 Februari 2021

Rontgen thorax 26 Februari 2021

• Pneumonia bilateral bertambah
• Tidak tampak kardiomegali
Ro. Thorax 25/2/21
Ro Thorax 25/2/2021
• Pneumonia bilateral belum
perbaikan
• Tidak tampak kardiomegali
Ro. Thorax 24/2/21
Ro Thorax 24/2/2021
• Pneumonia bilateral belum
perbaikan
• Tidak tampak kardiomegali
Ro. Thorax 22/2/21
Ro Thorax 22/2/2021
- Pneumonia bilateral
- Tidak tampak kardiomegali.
Ro. Thorax 18/2/21
Ro Thorax 18/2/2021
Tidak tampak bronkopneumonia atau
pneumonia
Kardiomegali dd. Posisi
 Bed 2. Ny, Rina Amalia/P/ 58 tahun / 70 BB kg/ 0001904528/ HS 12/ HP 5
Objectives Assessment Planning
CNS : E4M6V5 Confirmed COVID-19 Severe Case + DM 2 dengan riwayat HONK + AKI F : Diet biasa

A : paracetamol 3 x 500mg po
CVS 26/02/2021 S:-
Hb 13.9 Ht 40.0 Leu 5.100 Tr 323.000 PT 15.6 INR 1.10 CRP 9.28 APTT 22.60 GDS 421 LDH 612
T : 151/78 mmHg SGOT 47 SGPT 19 Alb 1.88 As.laktat 2.8 Ur 32 Cr 0.43 Na 133 K 4.5 Cl 113 Ca 4.55 Mg 1.6 T : Arixtra 1 x 2.5 SC
N : 95-97 kali per menit, reguler Fibrinogen 550 D-dimer 4.41
H : Head up 30O
25/2/2021
Hb 14,3 Ht 42.3 Leu 4.700 Tr 264.000 TLC 0.28 NLR 15.43 U : Omeprazole 40 mg/ 12 jam
PT 15.9 INR 1.13 APTT 27.4 G : Insulin rapid 3 x 5 unit SC
pH 7.433 pCO2 26.2 pO2 55.4 tCO2 18.4 HCO3 17.6 be -4.3 SpO2 89.1
Respirasi Terapi :
24-25 x/menit 24/2/2021 - Levofloxacin 750mg/24 jam IV (6)
(WOB minimal) Hb 13,4 Ht 39,8 Leu 3.570 Tr 292.000 TLC 0.29 NLR 10.97 - Azithromicin 1x500mg/24 jam (5)
SpO2 94-95% HFNC 60lpm/95% PT 16,6 INR 1,17 APTT 31,2 D-dimer 4,48 Fibrinogen 738,0 - Ceftazidime 3x2gr IV (3)
Rox index 3.76-3.95 pH 7,420 pCO2 24,1 pO2 60,5 tCO2 16,5 HCO3 15,8 be -6,4 SpO2 90,9 PF rasio 63,68 - Remdesivir 200mg/24 jam (6)
- Methylprednisolone 3x125mg (3)
23/02/2021 - Vitamin C 1000mg/24 jam PO
GIT Hb 12.7 Hct 38.3 Leu 6540 Tr 294000 PT 13.00 APTT 20.8 INR 1.19 GDP 234 SGOT 234 SGPT 25 Bil - Vitamin D 5000 iu/ 24 jam PO
supel, datar total 0.497 Bil direk 0.220 Bil indirek 0.277 Protein total 5.2 Albumin 1.74 Asam laktat 1.8 Ureum 24.0 - Zinc 20mg /12jam PO
Crea 0.53 Na 133 K 4.7 Cl 112 Ca ion 4.49 Mg 1.3. AGD. pH 7.441 pCO2 25.0 pO2 50.SB-b –5.0 - NAC 3 x 400 mg PO
SpO2 85.9 - Ondansentron 4mg/8jam IV
- TPK sudah diberikan (24/2/21)
- Actemra sudah pemberian 2 kali

GUT : PCR swab 22/02/21 Ct : 21 Kultur darah 24/2/21:Belum ada hasil

PCR Swab 24/2/21 : Positif Ct: 26.68
Diuresis : 1268 cc/23 jam (0,78
cc/kg/jam)
balans +86 cc/23 jam
Ro. Thorax 26/2/21
Ro Thorax 26/2/2021

• Pneumonia bilateral bertambah

• Kardiomegali dd/posisi
• Atherosclerosis aorta
Ro. Thorax 25/2/21
Ro Thorax 25/2/2021

• Pneumonia bilateral belum perbaikan

• Kardiomegali dd/posisi
• Atherosclerosis aorta
Ro. Thorax 24/2/21
Ro Thorax 24/2/2021

• Pneumonia bilateral
• Kardiomegali dd/posisi
• Atherosclerosis aorta
 Bed 5. Budy Setiabudi Zakaria, drg /L/ 57 tahun /0001902120/ BB 60 kg/ HS 23/ HP 15/HV 13

Objectives Assessment Planning

CNS : DPO (midazolam 10
mg/jam, fentanyl 30 mcg/jam iv)
CVS
T : 99/61 mmHg
N :121 x/ per menit, reguler
S: 36,80 C
Respirasi
RR actual 16 on venti mode Bilevel RR
14 Pins 26 PEEP 5 PS 26 I:E 1:1,5
FiO2 100% TV447 MV 7,4 SpO2 86-
90% EtCO2 44-47
GIT
distensi (-) , retensi (-)
GUT :
Diuresis: 1506 cc/23 jam (0,9
cc/kgBB/jam)
Balance: +1551 cc/23 jam
Respiratory Failure ec CAP ec Confirmed Covid 19 Severe Case + Stress Ulcer perbaikan + F : Diet cair 6x250 cc
trombositopenia
A : morfin 10 mcg/kg/jam iv
26/2/2021 S : midazolam 10 mg/jam, fentanyl 30
Hb 10.4 Ht 32.5 Leu 18.490 Tr 73.000 PT 13.4 APTT 30.90 INR 0.94 CRP 0.12 GDS 218 OT 47 PT mcg/jam IV
13.4 Alb 2,54 Laktat 5,7 Ur 82.5 Cr 0.94 Na 145 K 4.6 Cl 107 Ca 4.93 Mg 2,6 Fibrinogen 154.0 D- T : Nebu Heparin 25.000 U/ 8 jam
Dimer 2.02
pH 7.298 pCO2 72.0 HCO3 35.6 BE 7.6 SaO2 88.4 Procalcitonin 0.21 Feritin 712.9
H : Head up 30O
25/02/2021 U : Lansoprazole 30mg/12jam iv
Hb 9.9 Ht 29.7 L 15.900 Tr 66.000 TLC 0.16 NLR 97.38 GDS 232 Ur 93.0 Cr 0.96
Na 140 K 4.3 Cl 109 PT 16.9 INR 1.20 APTT 167.3 Alb 2.29 G:-
pH 7,423 pCO2 47.3 pO2 63.5 HCO3 31.1 BE 6.5 SatO2 91.0 Terapi :
- Tigecyclin 50 mg/12 jam IV loading
24/02/2021 dose (H6)
Hb 12,4 Ht 38,5 L 25.230 Tr 89.000 TLC 0,25 NLR 97,88 GDS 201 Ur 105,0 Cr 1,05 SGOT 41 SGPT - Vancomycin 1 gr/24 jam IV (H8)
83 Na 147 K 4,1 Cl 111 PT 14,9 INR 1,05 APTT 76,90 D-Dimer 3,89 Fibrinogen 154 LDH 552 Alb - Mycamin 100 mg/24 jam (H10)
2,97 pH 7,294 pCO2 80 pO2 71,1 HCO3 39,1 BE 10,1 SatO2 90,3 p/f ratio 79,00 - Vit C 1000 mg/24 jam iv
- Vit D 5000 iu/ 24 jam ngt
23/02/2021 - N-asetilsistein 400 mg/8 jam iv
Hb 12.2 Ht 38.1 Leu 19.810 Tr 86.000 TLC 0.20 NLCR 96.10 GDS 229 Ur 112 Cr 0.97 SGOT 37 - L-lysin 2 x 1 tab PO
SGPT 69 Na 143 K 4.0 Ca 4.39 Mg 2.7 Cl 116 PT 20 APTT >180 INR 1.43 D-dimer 4.40 Fibrinogen - Purtier Placenta 3x 5 tab
111 Alb 2.43 LDH 430 KOlesterol total 137 TG 147 - Omega 3 1x1 tab PO
pH 7.324 pCO2 63.8 pO2 74 HCO3 33.2 BE 7.0 SatO2 93 P/F ratio 77.8 - Zinc 2 x 20 mg PO
- Metilprednisolon 250 mg/8 jam (H9)
- Azithromycin 1 x 500mg IV (3)
- Cotrimoxazole 3 x 960 mg PO (7)
- Asam traneksamat 3x500mg iv
PCR swab (12/02/2021 di RS Al Islam): positif Sputum 22/2/21 : batang gram positif 2+,
PCR swab (05/02/2021 di RS Al Islam): positif batang gram negative 2+ coccus gram
PCR SWAB (15/02/2021) : Positif CT 22,6 positif 3+ yeast +
PCR SWAB (22/2/21): positif CT 31,8
22/2/21 (Post prone)
pH 7,425 pCO2 45,5 pO2 67,1 HCO3 30,2 BE 5,5 SaO2 93 p/f ratio 70,6

22/2/21
Hb 12.24 Hct 38.8 Leu 22.070 Tr 99.000 Ur 112 Cr 0,89
PT 12,9 APTT 51,29 INR 1313 NLCR 97.2 TLC 0.22 .
pH 7231 pCO2 93,5 pO2 108,6 HCO3 39,6 BE 9,3 SaO2 96,4 p/f ratio 98,42

21/2/21
Hb 13,34 Hct 40,6 Leu 22.050 Tr 128.000
Ur 112 Cr 0,89
PT 16,0 APTT 51.6 INR
pH7,298 pCO2 70,5 pO2 71,8 HCO3 39.6 BE 9.02 SaO2 90,3
20/2/2021 Kultur darah 14/2/2021
Hb 12.6 Ht 38.4 Leu 17.060 Tromb 105.000Total neutrofil 16.72Total limfosit 0.17 Neutrofil limfosit ratio 98.35
PT: 13,4 inr: 1.23 aptt: 30.3CRP : 0.59 Gds: 238 Ur: 93.6 Cr: 0.96. Na: 144 K: 4.4 Cl: 112 Ca: 4.33 Mg: 26 D-Dimer :
Isolate 1: staphylococcus
8.57 epirdermidis susceptibility
AGD 7.396/53.6/64,1/33,2/7.5/91.2% Troponon I : 0.04 Resisten: Ampiscilin/sulbactam,
ceftriaxone, gentamycin, amox+
19/02/21
Hb 12.8 Ht 38.5 L14.880 Tr 151.000 TLC 150 NLR97.20 CRP 1.16 clavulanic acid ,
Na 138 K 4.5 Ur 78.0 Cr 0.89 GDS 208 piperacillin/tazobactam,
PT 13.20 APTT 20.10 INR 1.21 Fib 221.1 D-Dimer 12.16 cefazolin, cefuroxime, cefadroxil,
pH 7.370 pCO2 61.2 pO2 84.4 HCO3 35.7 BE 8.8 SaO2 95.4
cefoperazone, cefotaxime,
18/02/21 ceftazidime, cefepime, cefixime,
Hb 13.3 Ht 39.8 L 19.040 Tr 179.000 TLC 0.38 NLR 48.61 CRP 6.97 ciprofloxacin, levofloxacin,
Na 143 K 3,9 UR 75 Cr 0.99 SGOT 41 SGPT 61 Alb 3.14 GDS 154 CRP 2.27 maxifloxacin, co-trimoxazole,
PT 14.7 APTT 25.90 INR 1.04 Fib 304.0
pH 7.4432 pCO2 63.4 pO2 69.1 HCO3 43.7 BE 17.1 SaO2 94.0 clindamycin, erythromycin
Sensitive : Tigecycline,
17/02/21 vancomycin
Hb 11.4 Ht 33.8 L 16.190 Tr 164.000 TLC 0.16 NLR 99.19 CRP 6.97
Na 134 K 4,2 Cl 105 Ca 4.50 UR 60.0 Cr 0.78 SGOT 25 SGPT 42 Alb 2.28 GDS 148
PT 16,0APTT 50.20 INR 1.13 Fib 335.0 D-dimer 8.17 Asam laktat 2,2 Procalcitonin 0.11
pH 7,382 pCO2 63.2 pO2 101.6 HCO3 37.9 BE 12.1 SaO2 96.3
AGD istat 18:09
pH 7.416 pCO2 62,2 pO2 56,9 HCO3 40 BE 15 Sat 88

16/02/21
Hb 11.4 Ht 33.8 L 16.190 Tr 164.000 TLC 0.16 NLR 99.19 CRP 6.97
Na 134 K 4,2 Cl 105 Ca 4.50 UR 60.0 Cr 0.78 SGOT 25 SGPT 42 Alb 2.28 GDS 148
PT 16,0APTT 50.20 INR 1.13 Fib 335.0 D-dimer 8.17 Asam laktat 2,2 Procalcitonin 0.11
pH 7,382 pCO2 63.2 pO2 101.6 HCO3 37.9 BE 12.1 SaO2 96.3
13/02/21
Hb 12,8 Ht 36,7 L 19.350 Tr 215.000 TLC 0,19 NLR 99,79 PT 13,6 APTT 22,2 INR 1,25 Kolesterol total 87 HDL
24 LDL 49 Trigliserida 121 HbA1c 6,1 CRP 2,29 GDS 135 LDH 675 SGOT 58 SGPT 53 GT 148 Biltot 0,528
Bildir 0,139 Bilindir 0,389 Alb 1,66 Laktat 2,5 Ur 82,0 Cr 1,20 AsUrat 5,8 Na 133 K 3,4 Cl 108 Ca 4,29 Mg 2,3
Fib 140,5 D-dimer 35,04
pH 7,506 pCO2 28,1 pO2 54,8 HCO3 22,4 BE 0,8 SaO2 90,0

13/02/21
Hb 12,8 Ht 36,7 L 19.350 Tr 215.000 TLC 0,19 NLR 99,79 PT 13,6 APTT 22,2 INR 1,25 Kolesterol total 87 HDL
24 LDL 49 Trigliserida 121 HbA1c 6,1 CRP 2,29 GDS 135 LDH 675 SGOT 58 SGPT 53 GT 148 Biltot 0,528
Bildir 0,139 Bilindir 0,389 Alb 1,66 Laktat 2,5 Ur 82,0 Cr 1,20 As. Urat 5,8 Na 133 K 3,4 Cl 108 Ca 4,29 Mg 2,3
Fib 140,5 D-dimer 35,04
pH 7,506 pCO2 28,1 pO2 54,8 HCO3 22,4 BE 0,8 SaO2 90,0
Ro Thorax 26/02/2021
- Efusi pleura kiri belum berkurang
- Pneumonia bilateral belum perbaikan.
- Kardiomegali tanpa bendungan paru.
- Atherosklerosis aorta
Ro Thorax 25/02/2021
- Pneumonia bilateral belum perbaikan.
- Kardiomegali tanpa bendungan paru.
- Atherosklerosis aorta
Ro Thorax 24/02/2021
- Pneumonia bilateral belum perbaikan.
- Kardiomegali tanpa bendungan paru.
- Atherosklerosis aorta
Rontgen Thoraks 23/2/2021
Rontgen Thoraks 22/2/2021
Ro.Thorax 21/2/21
Ro.Thorax 20/2/21
Ro.Thorax 18/2/21
Ro.Thorax 17/2/21
Ro. Thorax 15/2/2021
Ro thorax 14/02/2021
 Bed 6. Ny, Tuti/P/ 63 tahun / BB 60 kg/0000614446/ HS 25/ HP 11
Objectives Assessment Planning
CNS : compos mentis CAP ec Confirmed COVID-19 severe case + Hipertensi F : Diet lunak 3x/24 jam

A:-
CVS 26/2/2021 S:-
Hb 11.8 Ht 34.5 Leu 13.100 PT 12.4 APTT 26.60 INR 0.87 Laktat 3.7 Fibrinogen 307 D-Dimer 0.75
TD : 100/55 mmHg pH 7,453 pCO2 35.5 pO2 195.5 HCO3 25.0 tCO2 26.1 BE 2.0 SaO2 99.7 IL 6 16.6 T : Fondaparinux 1x5mg sc
N : 80-88 x /menit
25/2/2021 H : Head up 30O
Hb 12,3 Ht 36,9 Leu 11.320 Tromb 279.000
NLR 14.6 PT 12.2 INR 0.92 APTT 22.30 CRP 0,06 Alb 3.00 ur 37.0 cr 0.60 U : Lansoprazol 30mg/12 jam po
Na 131 k 5.3 Cl 102 Ca 4.75 Mg 2.2 G:-
Respirasi 24/2/2021 Terapi :
22 kali per menit, WOB (-), SpO2 98- - Meropenem 1gr/8 jam (10)
99% on NRM 10 lpm Hb 12,4 Ht 36,5 Leu 12.880 Tromb 279.000 DC 0/0/2/85/6/7
NLR 14,56PT 12.2 INR 0,86 APTT 27,3 CRP 0,02 GDS 120 LDH 429 - Vitamin C 1 x 1000 mg iv
ROX 5.5-5.6 - Vitamin D 1 x 5000 iu po
SGOT 15 SGPT 37 Alb 2,93 laktat 3,5 ur 36 cr 0,58 fibrinogen 410 Ddimer 1.23
Na 132 k 4,4 Cl 100 Ca 5.09 Mg 2,3 - Omega 3 1x1 PO
pH 7,438 pCO2 38,0 pO2 127,3 tCO2 27,1 HCO3 25,9 BE 2.4 SatO2 98,9 pf ratio 159,1 - Dexamethasone 1x6 mg IV (10)
Procalcitonin: 0,01feritin: 2053 - N-Asetilsistein 3x400 mg po
GIT - Cernevit 1 amp/24 jam
distensi (-) 23/02/2021 - Lisinopril 100 mg/24 jam po
Hb 11.7 Ht 34.6 Leu 11.170 Tr 272.000 TLC 0.56 NLRC 17.75 GDS 92 SGOT 13 SGPT 38 Na 129 K - Zinc 20 mg/12 jam po
4.4 Ca 4.56 Mg 2.1 Cl 104 PT 112.8 APTT 24.00 INR 0.90 D-dimer 3.00 Fibrinogen 397 Alb 2.71 - Amlodipin 1x10 mg

- Rencana :
- Prone position berkala
GUT : PCR swab 16/2/21 (RS Al-Islam) positif CT 1.6
PCR Swab 17/2/21 (RSHS) : Positif Ct gen: 34,74
Diuresis: 2435 cc/23 jam (1,3 PCR Swab 24/2/21 (RSHS) : Positif Ct 28.45
cc/kgBB/jam)
Balans: -695 cc/23 jam
22/02/21
Hb 11.9 Ht 33.9 Leu 16.550 Tr 282.000 TLC 510 NLCR 23.04 GDS 184
PT 13.60 APTT 30.0 INR 0.95 Ur 39.0 Cr 0.66 Alb 2.54 Laktat 5.2
Na 131 K 4.2 Ca 4.29 Mg 2.2 Cl 104
PH 7.403 PCO2 38.6 PO2 177.2 HCO3 24.3 BE 0.3 SPO2 99.5 Procalcitonin 0.02 Ferritin 1822

21/2/21
Hb 11,8 Hct 34,9 Leu 11.470 Tr 306.000 TLC 0.34 NLR 31.71 PT 11.0 INR 1.00 aPTT 20.70Gds 145 sgot 21 sgpt 49 alb 2.42 laktat 3.7 Ur 41 Cr 0.61 Na 130 / K 4.3/ Cl
103/ Ca 4.47 / Mg 2.0 CRP kuantitatif 0.34Fibrinogen 377.0 D-dimer 3.65

20/2/2021
Hb 11.8/Ht 34.9/Lc 14.740 /Tc 307.000 TLC 1030 ( kemarin 410)NLR 12.74 ( kemarin 31.95)PT 11.0 INR 1.00 aPTT 20.10Gds 90 sgot 19 sgpt 33 alb 2.42 laktat 2.4 Ur
40.3 Cr 0.91Na 136 / K 4.1/ Cl 106/ Ca 4.61 / Mg 2.1 CRP kuantitatif 0.68Fibrinogen 444.0 D-dimer 4.40

19/02/21
Hb 11.80 Ht 34.50 Leu 13.650 Tr 315.000 TLC 410 NLCR 31.95 GDS 178
PT 14.7 APTT 30.70 INR 1.03 Laktat 3.6
Na 131 K 3.9 Ca 4.28 Mg 1.9 Cl 104
PH 7.439 PCO2 36.4 PO2 163.0 HCO3 24.9 BE 1.6 SpO2 99.5

18/02/21
Hb 11.40 Ht 33.1 Leu 16.550 Tr 305.000 TLC 500 NLCR 30.78 GDS 121
PT 14.60 APTT 28.20 INR 1.03 Ur 37.2 Cr 0.87 Alb 2.67 Laktat 1.8
Na 133 K 4.0 Ca 4.68 Mg 1.9 Cl 106
PH 7.464 PCO2 35.4 PO2 81.8 HCO3 25.7 BE 2.7 SPO2 96.3
Rontgen Thoraks 26/2/2021
Rontgen Thoraks 25/2/2021
Ro. Thorax 24/2/21
Rontgen Thoraks 23/2/2021
Rontgen Thoraks 22/2/2021
Ro. Thorax 21/2/21
Ro. Thorax 20/2/21
Ro. Thorax 19/2/21
Ro. Thorax 18/2/21
Ro. Thorax 17/2/21
Ro. Thorax 16/2/2021 (RS Al-Islam)
Kesan :
Bronkopneumonia bilateral tampak perbaikan.
Kardiomegali tanpa bendungan paru
Atherosclerosis aorta
RIKK
 2. Tn. Ahmad Rifai Shalahudin/ 46 tahun / 70 kg /0001904600/ H Sakit 9/ HP 2
Objectives Assessment Planning
CNS : E4M6V5 Confirmed COVID-19 Severe Case + Suspek meningitis TB + Suspek TB paru + DM F : Diet DM 6 x 200 cc
Tipe II + Anemia + ITP Sekunder dd/Primer
A : Paracetamol 1gr/ 8 jam IV
CVS 26/02/21 S:
Hb 12,7 Ht 36.9 Leu 11.300 Tr 66.000 TLC 0.68 NLR 15.49 PT 15,2 INR 1,07 aPTT 39.2 CRP 6,95
T : 101/72 mmHg GDS 348 LDH 625 SGOT 128 SGPT 119 Ur 42 Cr 0.79 Na 137 K 5.3 Cl 101 Ca 1,16 Mg 2,3 Fibrinogen T : Heparin 2 x 5000 IU
N : 120-130 x/m,reguler 614 d-dimer 3.48
pH 7.347 pCO2 31.0 pO2 107,8 HCO3 18,2 BE -5.3 SaO2 97.9 H : Head up 30O
25/02/21 U : Omeprazole 40mg/12 jam
Hb 11,6 Ht 32,8 Leu 8.850 Tr 50.000 G : Insulin rapid 6x3 unit sc
Na 124 k 4,3
Respirasi pH 7.475 pCO2 22,7 pO2 122,2 hco3 16,9 BE -4,4 satO2 98,6 Terapi :
30-40 x/menit (WOB minimal) • Ceftriaxone1gr/12 jam IV (3)
SpO2 94-95% % HFNC 50lpm/90% 24/02/21 • Levofloxacin 750mg/24 jam IV (3)
Rox index 3.1-3.3 Hb 10,7 Ht 30,2 Leu 9.940 Tr 48.000 • Remdesivir 100mg/24 jam (3)
ur 26 cr 0.75 Na 126 k 3.9 • Dexamethasone 4x5mg (3) selama 7 hari
pH 7,507 pCO2 23,6 pO2 70,4 hco3 18,9 BE -2,3 satO2 94,8 • Vitamin C 1000mg/24 jam PO
GIT • Vitamin D 5000 iu/ 24 jam PO
Datar, supel • Zinc 20 mg/12 jam PO
• Cernevit 1amp
• NAC 3 x 400 mg PO
• Zegavit 1x1 tab PO
• OAT kategori 1x1tab (2)

GUT : Swab PCR Ro thorax 24/2/21 : Pneumonia bilateral, tidak

- 25/2/2021 (RSHS)  NEGATIF tampak kardiomegali
Balans: -490 ml/22 jam -24/2/2021 (RSHS)  POSITIF Ct
diuresis: 1880 ml/ 22 jam (1,22 gen Helicase/ORF1b : 35.38 (terdeteksi)
cc/kg/jam) gen RdRP : 36.92 (terdeteksi)
Ro. Thorax 26/2/21
Ro. Thorax 24/2/21
Rontgen Thorax 21/2/2021

Objectives
CNS : DPO (Midazolam 5 mg/jam,
Rocuronium 40 mg/jam)
CVS
T : 155/70 mmHg (Vascon 0,05
mcg/kg/mnt)
N : 110-115 x/m,reguler
Respirasi
RR 30x/menit, SpO2 91-92% on venti
mode SIMV-PC Pins 28 peep 6 rr 30
fio2 100% IE : 1:2.5--> TV  390-420
MV 9.9 sd 10.8 Ppeak  33-34
GIT
Datar, distensi (-)
GUT :
Balans:
diuresis:
3. Dadih/ 68 tahun / 65 kg /0001903566/ H Sakit 15/ HP 8/ HV 7
Assessment Planning
Confirmed COVID-19 severe case + Hipertensi + AKI stage 2 + eletrolit imbalance F : Diet 6x100cc
(hiperkalemia)
A : Fentanil 0,5 mcg/kgBB/mnt
26/2/21 S : Midazolam 5 mg/jam
Hb 11.4 Ht 37.4 Leu 18.670 Tr 153.000 PT 12.8 INR 0.89 APTT 28.00 CRP 11.88 TLC 0.37 NLR 48.43
GDS 197 LDH 349 SGOT 41 SGPT 43 Alb 1.95 Ur 76.5 Cr 1.60 Na 132 K 5.4 Cl 101 Ca 5.23 Mg 1.9
T : Heparin 10 U/kgBB/24jam
Fibrinogen 513.0 D-Dimer 3.83
pH 7.244 pCO2 78.0 pO2 86.5 HCO3 34.0 BE 4.8 SaO2 93.4 Procalcitonin 0.80 Fe 1466 H : Head up 30O
25/2/21 U : Omeprazol 40mg/12jam
Na 134 K 4,9 pH 7,435 pCo2 52,1 pO2 99 HCO3 35 BE 11 SaO2 98 G : insulin 1unit/jam target GDS 140-180
Hb 10.2 Ht 37.8 Leu 16.310 Tr 154.000 TLC 0.49 NLCR 31.61 Ur 82.6 Cr 1.46 OT 25 PT 21 Na 137 K
5.5 Ca 5.29 Mg 1.8 Cl 109 PT 11.2 APTT 24.6 INR 1.1.02 Terapi :
pH 7.367 pCO2 59.9 pO2 40.7HCO3 34.7 tCO2 34.6 BE 8.4 SaO2 70.2 • Meropenem 3x1 gram (7)
• Mycamine 1x100 mg (6)
24/2/21 (15.00) • Vit C 1x1000 mg
pH 7.323 pCO2 59.5 pO2 135.9 HCO3 31.1 Be 4.4 Sat 98.6 • Vit D 1x5000 IU
K 6,1 • Cernevit 1 ampul dalam RL 500 cc/24 jam
• N-acetylsistein 3x400mg IV
24/2/21 • Zinc 2x20mg PO
Hb: 11,0 Ht 36,3 Leu: 22.150 tr: 212.000TLC 220Pt: 11,3 INR 1,03 aptt 19.3 *GDS 326 alb: 2.3 Ur: 81 • Rocuronium 40 mg/jam
Cr 1,57 Na: 146 K:6.9 Cl 110 Ca: 5.13 Mg2.0Fibrinogen 278Ddimer: 4.11Ph:
7.199/93.9/118.4/39.8/6.6/96.9 pf ratio: 118.4
PCR Swab (20/2/21): positif CT 32,71 Pewarnaan sputum 20/2/2021 : batang gram
positif : negatif, batang gram negative :
negatif, coccus gram positif : +1, coccus
gram negative : negative , Jamur : Hifa (+)
23/2/21
Hb 11.3 Ht 36.6 Leu 17.780 Tr 288.000 TKC 0.36 NLCR 46.92 Ur 92.0 Cr 1.87 OT 25 PT 35 Na 139 K 6.1 Ca 4.57 Mg 2.1 Cl 114 PT 14.60 APTT >180 INR 1.35 D-Dimer 3.45
Fibrinogen 269.4 Fe 3114.6
pH 7.382 pCO2 63.2 pO2 42.1 HCO3 38.0 tCO2 40.0 BE 11.2 SaO2 72.7

22/2/21
Hb 11.4 Ht 36.3 Leu 17.860 Tr 418.000 TLC 0.18 Ur 83.58.0 Cr 1.94 Na 143 K 5.0
Ca 4.92 Mg 2.1 Cl 120 PT 17.4 APTT 41.5 INR 1.24 D-dimer 4.08 Fibrinogen 329
pH 7,297 pCO2 56.9 pO2 88.7 HCO3 28.1 BE 29.8 SaO2 95.2

21/2/21
Hb 12.2 Ht 39.2 Leu 27.140 Tr 422.000 TLC 26.33 NLCR 97.52 GDS 242 Ur 88.0 Cr 1.84 Na 138 K 6.9
Ca 4.98 Mg 1.9 Cl 114 PT 12.60 APTT 56.70 INR 1.15 D-dimer 13.26 Fibrinogen 298.2
pH 7,308 pCO2 62,9 pO2 88,2VHCO3 31,8 BE 4.7 SaO2 95.4

20/02/2021
Hb 12,4 Ht 37,1 Leu 22.560 Tromb 356.000TLC 0.45 NLR 48.13

19/2/21
Hb 12.7 Ht 37.9 Leu 21.180 Tr 413.000 TLC 640 NLCR 31.44 GDS 134 Ur 88.3 Cr 1.65 Na 138 K 5.6
Ca 5.01 Mg 2.3 Cl 111 PT 14.50 APTT 24.00 INR 1.34 D-dimer 13.36 Fibrinogen 377.1
pH 7,448 pCO2 29.9 pO2 49 HCO3 20.7 BE -3.0 SaO2 86.0
Ro. Thorax 25/2/21
Ro. Thorax 24/2/21
Ro Thorax 24/2/2021
-Pneumonia bilateral perbaikan
-Kardiomegali dd/ posisi
Rontgen Thorax 23/2/2021
Rontgen Thorax 22/2/2021
Ro. Thorax 21/02/2021
Ro. Thorax 20/02/2021
GICU 2
 1. dr. Mulya A. Hasjym SP.B/ 69 tahun / 70 kg /0001383056/ H Sakit 23/ HP 9

Objectives Assessment Planning

CNS : Compos Mentis Confirmed COVID-19 moderate case + Hipertensi + DM Tipe 2+ Hipoalbumin F : Diet biasa 1500kkal

A : Paracetamol 3x500mg Po (prn)

CVS 26/2//21 S:
Hb 13.3 Ht 37.8 Leu 9.750 Tr 364.000 NLR 4.81
T : 165/76 mmHg PT 11.1 INR 1.01 APTT 22.30 T : Heparin 5000 iu/12 jam sc
N : 54 x/m,reguler Alb 2.62 Ur 37.6 Cr 0.76
Na 136 K 3.6 Cl 106 Ca 5.05 Mg 5.05 H : Head up 30O
pH 7.441 pCO2 32.9 pO2 81.5 HCO3 22.6 BE -0.3 SaO2 95.8 PF ratio 135
U : Lansoprazole 1x30mg
25/2/2021 G : Insulin rapid 3 x 5 unit, insulin basal 1 x 8
Hb 12.9 Ht 35.9 Leu 7.390 Tr 327.000 NLR 8.28 unit sc
PT 11.7 INR 1.07 APTT 25.9 CRP 1.29
Respirasi Alb 2.55 Ur 38.0 Cr 0,72 Terapi :
RR: 16-22x/menit Na 149 K 3.8 Cl 114 Ca 5.01 Mg 2.2 • Remdesivir 1x200mg (7)
SpO2: 97-100 % on NRM 12 lpm pH 7,452 pCO2 31.0 PO2 59.4 HCO3 21.9 BE -0.5 SaO2 91.5 • MP 1x62.5 mg (8)
Rox Index: 7.6 – 10.7 • Vit C 1000mg /24 jam
24/2/2021 • Vit D 1x500 IU
Hb 12.4 Ht 35.4 Leu 7.060 Tr 305.000 NLR 11.21 • Cernevit 1 ampul dalam RL 500 cc/24 jam
PT 15 INR 1.06 APTT 31.20 GDS 201 CRP 1.75 LDH 367 • N-acetylsistein 3x400mg IV
GIT
Sgot 23 sgpt 38 alb 2.51Ur 37 Cr 0,66 Fibrinogen 414,0D-Dimer 1.08 • Zinc 2x20mg PO
Datar, distensi (-)
Na 136 K 4.1 Cl 111 Ca 4,81 Mg 2.1 • Zegavit 1 x 1 PO
pH 7,440 pCO2 32.4 PO2 76.2 HCO3 22.2 BE -1.2 SaO2 90.8 pf rasio 101.6 Procalcitonin 0,03 Feritin • Amlodipin 5 mg/24 jam po
600.8 • Alprazolam 1-0-1
• Esbriet 3x267 mg (minggu ke 1 )
• Vip Albumin 1 caps/8jam

GUT :
Diuresis : 3810 cc/24 jam (1.98
cc/kg/jam)
Balance : -4335 cc/24 jam
PCR swab (19-2-2021) :Positif CT 20,32 Pewarnaan gram 22/2/21: Yeast (-)
PCR swab (22-2-2021) :positif CT 22,78 batang gr positif (-)
batang gr negatif (+1)
coccus gram positif (+2)
coccus gram negatif (-)
23/2/2021
Hb 13.3 Ht 38.1 Leu 8.710 Tr 310.000 TLC 0.78 NLCR 10.05 GDS
277 Ur 43 Cr 0.80 OT 35 PT 44 Na 134 K 3.7 Ca 4.73 Mg 2.1 Cl 113
PT 14.1 APTT 31.10 INR 0.99 D-Dimer 0.66 Fibrinogen 468.0
pH 7.401 pCO2 29.7 pO2 85.0 HCO3 18.6 tCO2 19. BE -4.4 SaO2
96.3

22/2/2021
Hb 13.2 Ht 37.4 Leu 6.660 Tr 298.000 Tot.limfosit 0.73 Tot.netrofil
5.73 NLR 7.85 CRP 64.26 GDS 136 LDH 429 SGOT 35 SGPT 50 alb
2,78 ur 45 cr 0,81 Na 141 K 4.0 Cl 109 Ca 5.0 Mg 2,4
pH 7,382 pCO2 40.2 pO2 41.3 HCO3 24.1 tCO2 25.4 BE -0.2 SatO2
72.1 (vena)

21/2/2021
Hb 12,9 Ht 36,4 Leu 3.990 Tr 231.000 Tot.limfosit 0.76Tot.netrofil
3.38 NLR 4.04 PT 10,9 INR 0,99 APTT 28,4 CRP 6,47 GDS 345 LDH
396 SGOT 40 SGPT 50 alb 2,73 ur 50 cr 0,87 Na 133 K 4,3 Cl 109 Ca
4,40 Mg 2,0 D-dimer 0.26 Fibrinogen 512,9
pH 7,475 pCO2 26,4 pO2 74,7 HCO3 19,6 tCO2 20,4 BE -2,7 SatO2
95,9
20/2/2021
Hb 13,3 Ht 37,4 Leu 3.980 Tr 200.000 Tot.limfosit 0.48Tot.netrofil
3.38 NLR 7,04 PT 10,4 INR 0,94 APTT 27,8 CRP 8,33 GDS 289 LDH
481 SGOT 60 SGPT 47 alb 2,64 ur 38 cr 0,78 Na 135 K 4,7 Cl 110 Ca
4,61 Mg 2,0 D-dimer 0.38 Fibrinogen 586,0 Procalcitonin 0,16
pH 7,386 pCO2 27,7 pO2 106,6 HCO3 16,8 tCO2 17,7 BE -6,6 SatO2
97,3
Ro thorax 26/02/2021
Ro. Thorax 25/2/21
Ro. Thorax 24/2/21
Ro Thorax 24/02/2021

- Pneumonia bilateral belum perbaikan

- Kardiomegali dd/ posisi
- Elevasi diafragma kanan dd/ posisi
Rontgen 23/2/2021
Rontgen 22/2/2021
Ro. Thorax 21/02/2021
Ro. Thorax 20/02/2021
Ro. Thorax 19/02/2021
 Objectives 2. Prof. Sudigdo Adi/ 71 tahun / 76 kg /0000737050/ H Sakit 20/ HP 17 Planning
CNS : GCS E4M6V5 Confirmed COVID-19 severe case + CAD F : Diet biasa 1500 kkal

A : Paracetamol 500mg/ 8 jam prn

CVS 26/2/21 S :-
Hb 16.9 Ht 49.3 Leu 12.590 Tr 247.000 TLC 1.13 NLCR 9.58 GDS 110 Ur 55.5 Cr 0.91 Na 135 K 4.1
T:  110/64 mmHg Ca 5.25 Mg 2.4 Cl 105 PT 12.3 APTT 25.00 INR 1.12 D-dimer 1.66 Fibrinogen 159.4 Alb 2.90 CRP 0.50 T : Lovenox 1x0,4 cc
Hr: 56-62 x/menit Procalcitonin 0.03 Laktat 1.6
pH 7.472 pCO2 33.4 pO2 157.1 HCO3 24.6 tCO2 25.7 BE 2.3 SaO2 99.6 PF ratio 157.1 H : Head up 30O
25/2/21 U: Ranitidin 2x50 mg iv
Hb 16.8 Ht 48.6 Leu 12.380 Tr 266.000 TLC 0,99 NLCR 11.0 GDS 88 Ur 55 Cr 0,83 Na 143 K 4.4 Cl G :-
107 Ca 5.29 PT 15.6 INR 1.44 APTT 30.6 CRP 0.74 Alb 2.98
Respirasi pH 7.456 pCO2 33.5 pO2 131.4 HCO3 24.3 BE 1.8 SaO2 99.3 Terapi :
Rr: 16-22 x/menit, WOB (-) 24/2/21 • Remdesivir 1x100mg iv (11)
Spo2: 97 % dengan simple mask 8 lpm Hb 16,2 Ht 47,9 Leu 12.750 Tr 225.000 TLC 0,89 NLCR 12,90 GDS 96 Ur 57 Cr 0,82 Na 133 K 4,5 Cl • Dexametashone 6mg/jam iv (8)
Rox index 8.01-11.02 104 Ca 5,01 PT 16,5 INR 1,17 APTT 28,70 CRP 0,98 Albumin 2,63 Fibrinogen 97 D-Dimer 5,13 • Benadryl 3x 1 C po
• Cernevit 1 ampul/24 jam iv
23/2/21 • Zinc 20mg/12jam po
Hb 15.0 Ht 43.3 Leu 11.290 Tr 250.000 TLC 0.79 NLCR 13.00 GDS 106 Ur 53.0 Cr 1.00 Na 131 K 4.2 • Rosuvastatin 1x10 mg po
GIT
Ca 4.37 Mg 1.9 Cl 108 PT 12.70 APTT 23.40 INR 1.16 D-Dimer 5.10 Fibrinogen 153.8 • Purtier plasenta 3x2 cap po
Distensi (-), retensi (-)
pH 7.468 pCO2 36.4 pO2 68.3 HCO3 26.7 BE 3.7 SaO2 94.3 IL-6 349.9 • Lbio 2x1 sach
• Vit D 1x5000 u
22/2/21 • Zinc 1x20 mg
Hb 15.3 Ht 43.1 Leu 10.67 Tr 254.000 TLC 0.65 NLRC 15.38 Ur 61 Cr 0.98 Na 131 K 4.1 • Omega 3 1 tab/24 jam po
Ca 4.69 Mg 2.2 Cl 108 PT 17.00 APTT 31.30 INR 1.21 D-dimer 3.57 Fibrinogen 232.0 Laktat 2.1 • Aripripazole 2,5 mg/24 jam ( jika tidak
Feritin 2016 pH 7.496 pCO2 32.3 pO2 149.1 HCO3 25.2 BE 3.1 SaO2 99.7 bisa tidur)
• Mycamin 100 mg/24 jam iv (3)
• Antasid syr 3 x 1 cth
GUT : PCR swab (10/2/21) positif CT 27,34 Ro thorax 22/2/21 Pneumonia bilateral • Alprazolam 1 x 0,25 mg PO PRN
Diuresis : 2250 cc23 jam (1.39 PCR swab (13/2/21) positif CT 20.45 Ro thorax 21/2/21 Pneumonia bilateral belum
cc/kg/jam) PCR swab (18/2/21) positif CT 23,09 perbaikan
PCR swab (22/2/21) positif CT 26,88 Ro thorax 20/2/21 Pneumonia bilateral bertambah
Balans: -667 cc/23 jam Gram 23/2/21 : belum ada hasil ; kardiomegali tanpa bendungan paru
Kultur 13/1/21 : tidak terdapat pertumbuhan
mikroorganisme
21/2/21
Hb 15,0 Hct 43,1 Leu 13.690 Tr 250.000
Na 131/K 4,62/Ca 4,62/Mg 2,2
pH 7,465 pCo2 38,1 pO2 71,0 HCO3 27,7 tCO2 28,9 BE 4,4 SaO2 95

20/02/21
Hb 15,2 Ht 43.4 Leu 13.360 Tromb 239.000Hitung Jenis Leu: 0/0/1/95/3/1TNC: 12.83 TLC: 0,40 NLR: 32.08Pt 11.9 inr 1.09 aPTT 25.8
pH 7.442 pCO2 32 PO2 77.1 HcO3 22 BE 23 Sat O2 95.8

19/2/21
Hb 15.3 Ht 44.2 Leu 14.240 Tr 239.000 TLC 430 NLRC 31.14 GDS 134 Ur 55 Cr 1.03 Na 134 K 4.2
PT 12.00 APTT 25.20 INR 1.10 D-dimer 1.09 Alb 2.74 LDH 537
CRP 4.79

18/2/21
Hb 15.3 Ht 43.4 Leu 10.830 Tr 205.000 TLC 540 NLRC 18.44 GDS 150 Ur 57 Cr 0,93 Na 134 K 4.0
Cl 112 PT 13.00 APTT 27.10 INR 1.19 D-dimer 0.31 Fibrinogen 435.9 Alb 2.55 Laktat 1.77 LDH 414
CRP 8.95 Feritin 3077,1 pH 7.408 pCO2 27.0 pO2 79.1 HCO3 17.2 BE -5.3 SaO2 95.8 PCT 0,61

17/2/21
Hb 15.9 Ht 46.4 Leu 4.990 Tr 180.000 TLC 500 NLRC 8.78 GDS 132 Ur 45.6 Cr 1.01 Na 128 K 4.2
Ca 4.81 Mg 2.3 Cl 107 PT 13.00 APTT 27.10 INR 1.19 D-dimer 0.42 Fibrinogen 339.9 Albumin 2.67
CRP 20.74 Laktat 1.6 Feritin 1802,1 pH 7.417 pCO2 26.4 pO2 63.7 HCO3 17.2 BE -5.5 SaO2 92.5
16/2/21
Hb 14.7 Ht 42.7 Leu 6.450 Tr 164.000 TLC 0.84 NLRC 6.37 GDS 92 Ur 50.5 Cr 1.28 Na 127 K 4,0
Ca 4.93 Mg 2.1 Cl 106 PT 11.50 APTT 30.80 INR 1.05 D-dimer 0.45 Fibrinogen 444.0 Albumin 2.77
CRP 15.74 Laktat 1.4 pH 7.456 pCO2 24.4 pO2 82.3 HCO3 17.4 BE -4.5 SaO2 96.5

15/2/21
Hb 14.9 Ht 43,6 Leu 6.680 Tr 161.000 TLC 1.110 NLRC 4.95 GDS 98 Ur 57,0 Cr 1,28 Na 131 K 4,2
Ca 4.97 Mg 1,9 Cl 110 PT 11,70 APTT 29.30 INR 1,06 D-dimer < 0.19 Fibrinogen 303,9 Albumin 2.88
LDH 191 CRP 8.37 Laktat 1.1 pH 7.458 pCO2 24.3 pO2 70.7 HCO3 13.3 BE -4.1 SaO2 95.0

14/2/21
Hb 15,6 Ht 45,2 Leu 8.610 Tr 161.000 TLC 1.120 NLRC 6,38 Ur 54,0 Cr 1,27 Na 136 K 4,3 Ca 5,08 Mg 1,8 Cl 111 PT 16,70 APTT 27,INR 1,55 D-
dimer 0,24 Fibrinogen 273,9 LDH 179 CRP 2,47

13/2/21
Hb 16,3 Ht 48,7 Leu 4.990 Tr 162.000 TLC 1.150 NLRC 3,08 Ur 59,3 Cr 1,23 Na 131 K 4,3 Ca 4,97 Mg 2,1 Cl 110 PT 11,10 APTT 28,2 INR 1,01 D-
dimer <0,19 Fibrinogen 228,2 LDH 179 CRP 3,40 HDL 34 LDL 116 Kolesterol total 159 Trigliserida 74
pH 7,338 pCO2 28,6 pO2 101,6 HCO3 17,4 BE -5,5 SaO2 98s

12/2/21
Hb 17.5 ht 51.8 Leu 7.410 Tro 170.000 Total Neutrofil 4.00 Total Limfosit 2.52 NLR 1.59
PT 11,3 INR 1,03 APTT 25.3 GDS 85 Ur 47.0 Cr 1,37 Fibrinogen 283.1 Na 134 K 3,8 D-Dimer 0,24 pH 7.394 pCO2 31,9 pO2 66.2 HCO3 19,6 tCO2
20.6 BE -3,5 Sat O2 92.7%

11/2/21
Hb 16,6/ht 48,7/Leu 7.110/Tro 153.000 Total Neutrofil 4.91 Total Limfosit 1.49 NLR 3,3
PT 11,5/INR 1,05/APTT 24,4 GDS 107 Ur 53,7/Cr 1,36 Fibrinogen 214,4 Na 135/K 4,1 D-Dimer 0,21 pH 7.410/pCO2 36,9/pO2 35,3/HCO3
23,6/tCO2 24,7/ BE -0.1/66,4%
Ro. Thorax 26/2/21

Ro Thorax 26/02/2021
- Pneumonia bilateral perbaikan
-Tidak tampak kardiomegali
Ro. Thorax 25/2/21
Ro. Thorax 24/2/21
Ro Thorax 24/02/2021

- Pneumonia bilateral perbaikan

-Tidak tampak kardiomegali
Ro. Thorax 23/2/21
Ro Thorax 23/02/2021

- Pneumonia bilateral belum perbaikan

-Tidak tampak kardiomegali
Rontgen Thoraks 22/2/2021
Ro. Thorax Tgl 21/2/2021
Ro. Thorax Tgl 20/2/2021
Ro. Thorax Tgl 19/2/2021
Ro. Thorax Tgl 18/2/2021
Ro. Thorax Tgl 17/2/2021
Ro. Thorax 16/2/2021
Ro. Thorax 15/2/2021
Ro Thorax 14/02/2021
Ro Thorax 11/02/2021
Scan Thorax 15/2/2021
 3. Ny. Eet Suheti/ 67 tahun / 65 kg /0001092832/ H Sakit 19/ HP 6 /HV 6
Objectives Assessment Planning
CNS : DPO (Midazolam 8mg/jam) Respiratory failure ec CAP ec Confirmed COVID-19 Severe Case + Riwayat AF + F : diet cair 6x200cc
Rhematoid arthritis
A : Fentanil 30 mcg/jam iv
CVS 26/2/2021 S : Miloz 3 mg/jam
Hb 10.7 Ht 32.4 Leu 20.190 Tr 315.000 TLC 0.81 NLCR 23.19 GDS 216 Ur 57.3 Cr 0.71 Na 131 K 4.6
T : 124/61 mmhg Ca 4.58 Mg 2.3 Cl 106 PT 11.50 APTT 23.00 INR 1.05 D-Dimer 3.68 Fibrinogen 547.7 Alb 1.94 CRP T : Fondaparinoux 1x5mg SC
N : 78-86 x/m,reguler 9.91 Procalcitonin 0.31 Laktat 2.7
pH 7.453 pCO2 37.4 pO2 66.9 HCO3 26.4 tCO2 27.6 BE 3.1 SaO2 93.2 PF ratio 66.9 H : Head up 30O
25/2/2021 U : Lansoprazol 30mg/12 jam
Hb 10.8 Ht 33.6 Leu 17.010 Tr 425.000 NLCR 46.3 G :-
PT 10.7 INR 0.97 APTT 21.5 CRP 3.61 Gds 293 LDH 379 Alb 22.33 Laktat 3.5 ur 57.0 Cr 0,61
Respirasi Na 4.3K 4.3 Cl 111 Ca 4.68 Mg 2.4 Terapi :
24-26 x/menit pH 7,404 pCO2 41.3 pO2 85.6 HCO3 26.1 BE 2.0 SaO2 96% • Meropenem 1gram/8jam (11)
SpO2: 91-93%Dengan ventilator mode • Levofloxacin 750mg/24jam (13)
PSimv RR 12 Pins 26, PEEP 8, FiO2 24/2/2021 • Amikasin 1gr/24 jam iv (3)
100, I:E= 1:2 Vte 430-526 MV 10.4 Hb 10,7 Ht 33.5 Leu 10.590 Tr 433.000 NLCR 23.45 • Vankomisin 1gr/24 jam (3)
PT 13.8 INR 0.97 APTT 28 CRP 5.12Gds 314 LDH 379 Alb 2,44 Laktat 1,3 ur 77 Cr 0,67 • Mikamin 100mg/24 jam (4)
Na 140 K 4.3 Cl 114 Ca 4,73 Mg 2.8 D-Dimer 2.36 Fibrinogen 583 • Remdesivir 1x100mg (11)
GIT
pH 7,351 pCO2 49.1 pO2 124.1 HCO3 27.5 BE 2.0 SaO2 98%Pf rasio 124 • Dexamethason 1x6mg (25)
Datar, distensi (-)
Procalcitonin 0.18 Feritin 1013.9 • Vit D 1x5000 IU
• Nacetylsistein 3x400mg IV
• Zinc 2x20mg PO
• Omega 3 1x1 caps
• Perdipine 2 mcg/kg/mnt

GUT : Swab di RSUD Kota Bandung 15/2/21 dan 16/2/21 Ro thorax 22/2/21 Pneumonia bilateral
Poaitif
Balans:
Swab tanggal (22/2/21) Ct 29.55
diuresis: Sputum 22/2 : jamur yeast +, coccus gram positif 3+
Kultur darah dan sputum 22/2 belum ada hasil
23/2/21
Hb 10.1 Hct 30.9 Leu 9380 Tr 417000 PT11.3 INR 1.03 APTT
22.3 GDS 181 LDH 454 SGOT 26 SGPT 32 Alb 2.45 As laktat
1.3 Ureum 72.0 crea 0.81Na 138 K 4.1 Cl 113 Ca ion 4.17 Mg
2.5 TIBC 129 Fibrinogen 512.9 D-dimer 3.78 Trop I 0.20. AGD
pH 7.485 pCO2 36.7 pO2 53.9 HCO3 27.9 tCO2 29.1 SB-b 5.1
SpO2 90.0 Procalcitonin 042

22/2/21
Hb 10,7 Ht 33.7 Leu 16.590 Tr 486.000 TLC 0,66 NLCR 23.12
GDS 213 Ur 60 Cr 0,61 Na 138 K 4.3
Ca 4,67 Mg 2,3 Cl PT 13,70 APTT 23,7 INR 1,26 D-dimer
1.09 Fibrinogen 538.9
pH 7,380 pCO2 50,1 pO2 69,8 HCO3 29.9 BE 4,5 SaO2 92.1
LDH 510 Albumin 1,96
Ro. Thorax 26/2/21
Ro Thorax 26/02/2021
- Pneumonia bilateral bertambah
- Tidak tampak kardiomegali
Ro. Thorax 25/2/21
Ro. Thorax 24/2/21
Ro Thorax 24/02/2021

- Pneumonia bilateral sedikit perbaikan

- Tidak tampak kardiomegali
Ro. Thorax 23/2/21
Ro Thorax 23/02/2021

- Pneumonia bilateral belum perbaikan

- Tidak tampak kardiomegali
Rontgen Thorax 22/2/2021
Ro. Thorax 18/02/2021(RSUD Kota
Bandung)
• Foto thorax dan expertise (tgl
18/02/2021) : Hasil
(dibandingkan dengan hasil tgl
13/02/2021 Cor membesar
sinesus dan diagfragma normal,
Pulmo infiltrasi di parakardial
kanan saat ini tampak infiltrasi
di lapang atas tengah kanan,
lapang atas tengah- bawah kiri.
Kesimpulan: Broncho
pneumonia dengan infiltrasi
bertambah).
 4. Ny. Hanurani/ 54 tahun / 80 kg /0001903671/ H Sakit 9/ HP 7/ HV 7
Objectives Assessment Planning
CNS : DPO (midazolam 10 mg/jam Post Craniotomy evakuasi ec. Spontaneus ICH ec hipertensi emergency + Confirmed F : Diet cair
+Rocuronium 40mg/jam) COVID-19
A : Morfin 20 mcg/kg/jam paracetamol
1gr/6jam
CVS 26/2/21 S : Midazolam 10mg/jam
Hb 12.1 Ht 34.6 Leu 15.790 Tr 258.000 TLC 2.53 NLCR 4.68 GDS 315 Ur 43.1 Cr 1.05 Na 147 K 4.5
T : 133/76 mmHg (perdipine 7 Ca 5.00 Mg 2.7 Cl 114 PT 12.20 APTT 25.30 INR 1.11 D-dimer 1.12 Fibrinogen 556.8 Alb 2.40 CRP
mcg/kg/mnt) T:-
28.92 Procalcitonin 2.01 Laktat 2.1
N : 113-119 x/m,reguler pH 7.237 PCO2 72.4 pO2 80.4 HCO3 31.1 tCO2 33.3 BE 2.6 SaO2 92.3 PF ratio 72.4 H : Head up 30O
25/02/21 U : Lansoprazol 30mg/12 jam
Hb 12.4 Ht 34.4 Leu 22.080 Tr 251.000 G :-
Pt 11.40 INR 1.04 aPTT 25.2 GDS 331 Alb 2.72 laktat 2.3 ur 29.6 cr 0.80
Respirasi Na 157 k 3.8 cl 117 ca 4.88 mg 2.1 Terapi :
RR 26x/menit pH 7.353 pCO2 48.6 pO2 88.0 hco3 27.2 BE 1.7 satO2 98.3 • Rocuronium 40mg/jam
SpO2 89-92% on venti mode PCV Pins • Remdesivir 1x100 mg (6)
26 PEEP 7 FiO2 100%, I:E=1:2 24/02/21 • Perdipin 7 mcg/kg/mnt
Ppeak 26-27 Hb 12.4 Ht 34.1 Leu 15.440 Tr 195.000 CRP 23.01 • Meropenem 3x1 gr (2)
Vte 212-288 Pt 14.8 INR 1.05 aPTT 29.40 GDS 191 LDH 287 Sgot 86 sgpt 154 • Levofloxacin 750 mg/24 jam (2)
MV 5.1-5.7 Alb 3.26 laktat 1.7 ur 20 cr 0.74Na 145 k 3.3 cl 113 ca 5.09 mg 2.5 fibrinogen 405 d dimer 1.47 • Vitamin C 1000mg/24 jam
pH 7.392 pCO2 42.8 pO2 76.5 hco3 26.2 BE 1.7 satO2 94.6 pf ratio 85 • Vitamin D 5000 iu/ 24 jam PO
GIT • Zinc 20 mg/12 jam PO
Datar, distensi (-) • Omega 3 1x1 caps
• NAC 3 x 400 mg PO
• Fentoin 100mg/8jam iv
• Manitol 125cc/6jam iv
• Vitamin K 3x10mg iv
• Asam Tranexamat 3x500mg iv
• Actemra 400mg/12 jam (2)
GUT : PCR gen expert (20/2/21) Positif Ro thorax 22/2/21 Kardiomegali tanpa bendungan
PCR swab (22/2/21): Positif CT 32,46 paru ; susp bronkopneumonia kanan ; elevasi
Balans:+292 cc/20 jam
Kultur darah (22/2/21) : belum ada hasil diafragma kanan
diuresis: 3510 cc/20 jam (2,3 Ro thorax 19/2/21 Kardiomegali tanpa bendungan
cc/kg/jam) paru ; susp bronkopneumonia kanan ; elevasi
diafragma kanan
23/2/21
Hb 9,4 Ht 26,6 Leu 12.360 Tr 169.000 PT 11.00 APTT 20.50 INR 1.00 Kol Total 161 HDL 28 LDL 105 TG 206 CRP 16.44
GDS 135 OT 127 PT 94 Alb 3.14 Ur 26.0 Cr 0.89 Na 141 K 3.2 Cl 119 Ca 4.49 Mg 2.2 Fibrinogen 293.0 D-dimer 2.64 Trop I
0.07
pH 7.388 pCO2 39.1 pO2 81.3 HCO3 23.8 tCO2 25.0 BE -0.4 SaO2 94.6 Procalcitonin 0.49 Fe 496.9

22/2/21
Hb 10,7 Ht 30,7 Leu 17.560 Tr 230.000 TLC 2.11NLCR 6.57 GDS 176 Ur 29,9 Cr 0.87 Na 141 K 3.4
Ca 5.33 Mg 2.3 Cl 117 PT 14.10 APTT 19.10 INR 1.30 D-dimer 3.49 Fibrinogen 256.4 SGOT 49 SGPT 42
pH 7,418 pCO2 32.2 pO2 96,5 HCO3 21.0 BE -2.4 SaO2 96.5

21/2/21
Hb 13,2 Ht 37.3 Leu 18.050 Tr 328.000 TLC 2.53NLCR 5.57 GDPS 207 Ur 34 Cr 0.84 Na 145 K 3.5
Ca 4.81 Mg 2.0 Cl 118 PT APTT INR D-dimer Fibrinogen SGOT 48 SGPT 45 LDH 339
pH 7,447 pCO2 28.9 pO2 83,8 HCO3 20.2 BE -2.1 SaO2 96.6
Ro. Thorax 26/2/21

Ro Thorax 26/02/2021

- Pneumonia bilateral bertambah

- Kardiomegali dd/ posisi
Ro. Thorax 25/2/21
Ro. Thorax 24/2/21
Ro Thorax 24/02/2021

- Pneumonia kanan
- Tidak tampak lagi efusi pleura
- Kardiomegali tanpa bendungan paru
Rontgen Thorax 23/2/2021
Rontgen Thorax 22/2/2021
Ro. Thorax 19/02/2021
TERIMA KASIH
 7. Dadi/ 61 tahun / 80 kg /0001302941/ H Sakit 17/ HP 7
Objectives Assessment Planning
CNS : Compos Mentis Confirmed COVID-19 moderate case + Hipertensi F : Diet biasa 1500kkal

A: -
CVS 26/02/2021 S:-
Hb11.1 Ht 35.5 Leu 6.79 Tr 495.000 PT 15.6 APTT 30.30 INR 1.10 GDS 97 LDH 236 SGOT 32 SGPT
T :103/57 mmHg 86 Alb 3.14 Laktat 1.7 Ur 34.5 Cr 0.75 Na 137 K 4.2 Cl 107 Ca 5.25 Mg 2.3 Fibrinogen 353 D-Dimer T : Fondaparinux 1 x 2,5 mg
N : 76 x/m,regular 0.70
pH 7.440 pCO2 33.2 pO2 70.7 HCO3 22.8 tCO2 23.8 BE -0.2 SaO2 93.8 Procalcitonin 0.02 Feritin 1070 H : Head up 30O
S : 36 ,4
25/2/2021 U : Lansoprazole 1x30mg
Hb 11,2 Ht 35,5 Leu 6.080 Tr 544.000 G :-
NLR 2.86 PT 16.2 INR 1.14 APTT 32.4 Laktat 2.1 ur 34.0 cr 0.69
Respirasi Na 135 K 4.4 Ca 4.92 Mg 2.2 Terapi :
RR: 18-20 x/menit pH 7,421 pCO2 34.9 pO2 86.9 tCO2 24.0 HCO3 22.9 be -0.4 SaO2 98.6 • Remdesivir 1x200mg (6)
SpO2: 99% dengan nasal kanul 2 pm • Dexamethasone 6 mg/24 ham iv (8)
Rox Index: 16,5 • Vit D 1x500 IU
24/2/2021 (15.03)
pH 7,442 pCO2 38,7 pO2 84,0 tCO2 28 HCO3 26,4 BE 2 SatO2 97% • Cernevit 1 ampul dalam RL 500 cc/24 jam
• N-acetylsistein 3x400mg IV
24/2/2021 • Zinc 2x20mg PO
GIT
Hb 11,8 Ht 37,5 Leu 6.710 Tr 559.000 • Amlodipin 5 mg/24 jam po
Datar, distensi (-)
NLR 3.7PT 15,5 INR 1,09 APTT 33,1 CRP 0,7 GDS 119 • Candesartan 8mg/24jam po
LDH 190 SGOT 30 SGPT 114 Laktat 3,0 ur 36 cr 0,79 • Atorvastatin 10mg/24jam po
Na 137 K 4,3 Cl 107 Ca 5,33 Mg 2,3 Fibrinogen 449,0 D-dimer 0,44 • Aspilet 1x80 mg po
pH 7,409 pCO2 32,8 pO2 134,3 tCO2 21,9 HCO3 20,9 be -2,4 SaO2 98,8

GUT : PCR swab (20-2-2021) :Positif Ct 32.7 IL6: 0,7

PCR Swab (19/2/2021) : Positif Ct: 28.06
Diuresis :
Balance:
23/02/2021
Hb 11.4 Ht 37.3 Leu 7.430 Tr 557.000 TLC 1.26 NLCR 4.30 GDS 87 Ur 39 Cr 0.80 SGOT 44 SGPT 109 Na 134 K 3,3 X
4.66 Mg 2.1 Cl 111 PT 15.7 APTT 32.20 INR 1.11 D-dimer 0.49 Fibrinogen 432 Alb 3.24 LDH 218 CRP 0.53 As.laktqt 2.2
pH 7.465 pCO2 27.2 pO2 117.6 HCO3 19.8 BE -2.1 SatO2 98.6

22/2/2021
Hb 10.8 Ht 35.2 Leu 5.770 Tr 512.000 Tot.limfosit 0.81 Tot.netrofil 4.44 NLR 5.48
GDS 94 LDH 241 SGOT 23 SGPT 31 alb 3.31 ur 43 cr 0.66 Na 137 K 4.9 Cl 110 Ca 5.0 Mg 2.3
pH 7,407 pCO2 36.9 pO2 169.2 HCO3 23.4 tCO2 24.5 BE -0.3 SatO2 99,2

21/2/2021
Hb 12,2 Ht 39,2 Leu 27.140 Tr 422.000 Tot.limfosit 0.27Tot.netrofil 26.33 NLR 97,6 PT 12,6 INR 1,15 APTT 56,70 GDS
242LDH 590 SGOT 23 SGPT 31 alb 2,84 ur 88 cr 1,84 Na 138 K 6,9 Cl 114 Ca 4,98 Mg 2,0 D-dimer 0.26 Fibrinogen
512,9
pH 7,308 pCO2 62,9 pO2 88,2,7 HCO3 31,8 tCO2 33,7 BE 4,7 SatO2 95,4
Ro. Thorax 26/2/21

Ro Thorax 26/02/2021
- Bronkopneumonia belum perbaikan
- Tidak tampak kardiomegali
Ro. Thorax 25/2/21
Ro. Thorax 24/2/21
Ro Thorax 24/2/2021
• Pneumonia bilateral perbaikan
• Kardiomegali DD/ posisi
Ro. Thorax 23/02/2021
Ro. Thorax 22/02/2021
Ro. Thorax 21/02/2021