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CURRICULUM VITAE

Nama
Alamat
Jabatan

: Prof.Dr.TAMSIL SYAFIUDDIN Sp.P (K)


: Jln.Karsa No F 1 Kompleks Eks KOWILHAN I Sei.Agul Medan 20117
: Guru Besar Tetap FK- UISU / Luar Biasa FK- USU
Penasehat Perhimpunan Dokter Paru Indonesia Pusat
Anggota Dewan Asma Nasional
Anggota Kolegium Perhimpunan Dokter Paru Indonesia Pusat
Anggota Pokja Asma Perhimpunan Dokter Paru Indonesia Pusat
Anggota Pokja PPOK Perhimpunan Dokter Paru Indonesia Pusat
Anggota Tim Akreditasi Pendidikan Dokter Spesialis Paru Nasional
Ketua Perhimpunan Dokter Paru Indonesia Cabang Sumu
Ketua Departemen Pulmonologi dan Kedokteran Respirasi FK-UISU
Dewan Pembina Yayasan Asma Indonesia Wilayah Sumut

Riwayat Pendidikan:
- Dokter Umum, FK-USU Medan,1979
- Dokter Spesialis I Paru, FK-UI Jakarta, 1990
- Dokter Spesialis II Paru, Konsultan Asma/PPOK, Dewan Penilai Keahlian PDPI
Pusat, 1995
Pendidikan tambahan:
- Pelatihan Kanker Paru, TSUKAGUCHI Hospital, Kobe- Japan 1989
- Pelatihan PPOK, AMAGASAKI Hospital, Kobe- Japan 1990
- Pelatihan Respiratory Physiologi, JAPAN RESPIRATORY PHYSIOLOGIST
CLUB, Kyoto- Japan 1990
- Spirometry Training Course, Department of Respiratory Medicine,
National University Hospital Singapore, Singapore 1997

- Workshop on Transbronchial Lung Biopsy and Trasbronchial Needle Aspiration PDPI


Cabang Jakarta, RS Persahabatan Jakarta ,Jakarta 1997
- Workshop on Respiratory Physiology and Its Clinical Application, RS Pusat Angkatan
Darat Gatot Subroto Jakarta, Jakarta Juni 1997
- Workshop on Medical Thoracoscopy, The American College of Chest Physicians-The
Indonesian Association of Pulmonologist, RS Persahabatan Jakarta, Jakarta November
1997
- Workshop on Reformation of Higer Education System,HEDS-JICA, Jakarta 1998
- Pulmonary Infections Course, Postgraduate Medical Institute, Singapore General Hospital,
Singapore 2001
- Bronchoscopy &Thoracoscopy Workshop, Postgraduate Medical Institute, Singapore
General Hospital, Singapore 2005
- Workshop of Bronchoscopy and Autofluorecent Bronchoscopy, RS Persahabatan
Jakarta, Jakarta September 2005
- Training of the new interventional technique of bronchosfiberscopy(Optical Coherence
Tommograhy) , Department of Thoracic Surgery, Tokyo Medical University Hospital,
Tokyo - Japan 2007
- Workshop of the new technique of bronchoscopy, Postgradute Medical Institute,
Singapore General Hospital, Singapore 2008
- Respiratory Masterclass Asthma and COPD, Singapore 2011
- Asia Area PATHOS Speakers Summit, Jakarta September 2013

ACUTE RESPIRATORY FAILURE


DIAGNOSTIC
AND
MANAGEMENT
TAMSIL SYAFIUDDIN
DEPARTMENT OF PULMONARY AND RESPIRATORY
MEDICINE
FAKULTAS KEDOKTERAN UISU/USU
MEDAN 2014

Respiratory Assessment
Airway
Open and Clear
Needs Intervention

Breathing
Inspection
Palpation
Percussion
Pulse Oximetry
Auscultation

Circulation & Vital Signs


History

Initial Assessment

Airway open,no noises


Breathing 12-20 times per minute
Circulation warm, pink, dry, strong pulses
Disability mental status clear
Vital Signs

Respiratory failure

Impairment in O2 uptake
Impairment
Impairment in CO2 elimination
Impairment
Both

Abnormal arterial blood


gases

LUNG
ACUTE RESPIRATORY FAILURE

(SPECTRUM OF CAUSES OF ARTERIAL HYPOXEMIA)

OTHERS

Causes of Respiratory Emergencies


Failure of:
Ventilation : air in/ air out
Diffusion : movement of gases
Perfusion : movement of blood

Compounded by:
Inflammation/mucus production

Hypoxia low oxygen to cells


Causes of hypoxia
Hypoxic hypoxia not enough oxygen
Anemic hypoxia not enough hemoglobin
Stagnant hypoxia not enough perfusion
shock

Histotoxic hypoxia unable to download


Cyanide poisoning

Cyanosis blue discoloration


suggests hypoxia

ACUTE RESPIRATORY FAILURE

HYPOXIA
ALTITUDE
HYPOVENTILATION
DIFFUSION ABNORMALITTY
RIGHT to LEFT SHUNT
VENTILATION-PERFUSION ABNORMALITY

ALTITUDE
INCREASE IN
ALTITUDE

DECREASE IN BAROMETRIC PRESSURE

LOWERRING OF THE PO2 IN THE INSPIRED


AIR

HYPOVENTILATION
(DRUG OVERDOSE AND NEUROMUCULAR WEAKNESS)

ACCUMULATION OF CARBON DIOXIDE


IN THE ALVEOLI

DISPLACING ALVEOLAR OXYGEN

PO2 AND

PCO2

DIFFUSION
ABNORMALITY

PNEUMONIE
PO2 and PCO2

RIGHT TO LEFT SHUNT


CARDIAC and NONCARDIAC
PULMONARY EDEMA

ALVEOLUS IS PERFUSED
BUT NOT VENTILATED
(Extreme imbalance V/Q)

PO2

and

PCO2

Ventilation-Perfusion
Abnormality
( V/Q, 4/5 or 0.8 )

ASTHMA
COPD
EMBOLI

PO2

and

PCO2

Acute Respiratory Failure

Airway obstruction
COPD
Asthma
Heart failure

Restrictive defects
Pleural effusion
Pneumothorax
Infiltrative diseases
Atelectasis
Obesity
Abdominal distention of all types
Intertitial fibrosis of all types

Acute Respiratory Failure


( continue )

Central nervous system


depressions
Drugs
Head injury
Central nervous system infection

Chest wall abnormalities


Congenital and acquired deformities
Trauma (flail chest)
Neuromuscular disease or blockade

DIAGNOSTIC
SUBJECTIVE
OBJECTIVE

ACUTE RESPIRATORY FAILURE


SUBJECTIVE
Dyspnea
Headache
Confusion
Unconsciousnes
s
Restlessness

ACUTE RESPIRATORY FAILURE


Objective
ABGA

( hypoxemia and respiratory acidosis )

Underlying disease
( CX examination )

Tachycardia
Hypotention

BODY CELLS OF HEALTHY


AT REST REQUIRE
(OXYGEN CONSUMTION)

250 ml/minute
Oxygen
NORMAL CELLULAR AEROBIC RESPIRATION

Management
Acute respiratory failure
General management
( Improving the PaO2 )

Specific management
( Underlying disease )

THANK YOU

Arigato gozaimasu
Syafiuddin San : You are the Inspiring woman
Imah San
: You are the Wind beneath my wings

Arigato gozaimasu