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d r .   K e e s   d e   R o o d e  

J l . K p . C i l e m b e r N o . 4 1

R t 0 1 / R w 0 1 , K e c . C i s a r u a

B o g o r - 1 6 7 5 0

T l p : 0 8 1 2 - 8 3 8 1 7 0 1 5

E - m a i l : d e _ r o o d e @ y a h o o . c o m

C U R R I C U L U M V I T A E

I n f o r m a s i P r i b a d i

N a m a : K e e s d e R o o d e

T e m p a t , T g l L a h i r : C i a n j u r , 2 9 S e p t e m b e r 1 9 7 6

J e n i s K e l a m i n : L a k i - L a k i

K e w a r g a n e g a r a a n : I n d o n e s i a

A l a m a t : J l . K p . C i l e m b e r N o . 4 1

R t 0 1 / R w 0 1 , K e c . C i s a r u a

B o g o r - 1 6 7 5 0

T e l e p o n : 0 8 1 2 - 8 3 8 1 7 0 1 5

E - m a i l : d e _ r o o d e @ y a h o o . c o m

P e n d i d i k a n

F o r m a l

1 9 9 1 – 1 9 9 4 : S M A M a r d i Y u a n a – C i a n j u r

1 9 9 4 – 2 0 0 1 : F a k u l t a s K e d o k t e r a n U n i k a A t m a J a y a – J a k a r t a

P e l a t i h a n & S e m i n a r

2 0 1 1 : P e l a t i h a n H i p e r b a r i k S e r t i f i k a s i P E R D O K L A – R S J a k a r t a

2 0 1 2 : S e m i n a r T e r a p i H i p e r b a r i k p a d a K a s u s - k a s u s B e d a h –

R S G r h a K e d o y a , J a k a r t a

2 0 1 3 : S e m i n a r T e r a p i H i p e r b a r i k p a d a K a s u s S u d d e n D e a f n e s s –

R S K h u s u s T H T B S D , S e r p o n g – T a n g e r a n g

2 0 1 3 : K u r s u s T a t a L a k s a n a K e d a r u r a t a n T e r a p i O k s i g e n H i p e r b a r i k ,

S e r t if i k a s i L A K E S L A – S u r a b a y a

P e n g a l a m a n K e r j a

D e s e m b e r 2 0 1 2 – S e k a r a n g : A p o t e k & P r a k t i k D o k t e r A r d i n i , B u k i t G o l f – C i b u b u r

O k t o b e r 2 0 1 1 – F e b r u a r i 2 0 1 2 : I n s t a l a s i H i p e r b a r i k R S G r h a K e d o y a – J a k a r t a

M a r e t 2 0 1 2 – S e k a r a n g : I n s t a l a s i H i p e r b a r i k R S K h u s u s T H T P r o k l a m a s i – J a k a r t a

T O H B ? D E F I N I S I

TERAPI OKSIGEN HIPERBARIK (TOHB):

BENTUK TERAPI DENGAN PEMBERIAN OKSIGEN 100% DENGAN TEKANAN TINGGI > 1 ATM YANG DILAKSANAKAN DALAM RUBT

(MONOPLACE / MULTIPLACE).

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PRINSIP DASAR

FISIKA FISIOLOGI BIOKIMIA

FISIKA DASAR PENYELAMAN

•  Hukum BOYLE: VOLUME suatu gas berbanding terbalik dengan tekanannya pada temperatur tetap.

•  Hukum HENRY: Banyaknya gas yang LARUT dalam cairan berbanding lurus dengan tekanan gas tersebut pada temperatur tetap.

DASAR TOHB

v  MEMPERKECIL VOLUME GEL.GAS SEHINGGA MEMPERCEPAT RESOLUSI GEL.GAS.

v  DAERAH ISKEMIK / HIPOKSIK AKAN MENERIMA O2 SECARA MAKSIMAL.

v  MENINGKATKAN PEMBENTUKAN PEMBULUH KAPILER BARU (NEOVASKULARISASI).

v  MENEKAN PERTUMBUHAN KUMAN (BAKTERISID – ANAEROB; BAKTERIOSTATIK – AEROB).

v  MENINGKATKAN PEMBENTUKAN FIBROBLAS, MENINGKATKAN DAYA FAGOSITOSIS LEUKOSIT.

v  MENINGKATKAN KEBUGARAN, TUJUAN KECANTIKAN & GERIATRI.

Textbook of Hyperbaric Medicine by KK. Jain.

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1. Air or Gas Embolism 2. CO Poisoning (CO Poisoning Complicated By Cyanide Poisoning) 3. Clostridial Myositis and Myonecrosis (Gas Gangrene) 4. Crush Injury, Compartment Syndrome & Other Acute Traumatic Ischemias 5. Decompression Sickness 6. Arterial Insufficiencies:

•  Central Retinal Artery Occlusion •  Enhancement of Healing In Selected Problem Wounds

7. Severe Anemia 8. Intracranial Abscess 9. Necrotizing Soft Tissue Infections 10. Osteomyelitis (Refractory) 11. Delayed Radiation Injury (Soft Tissue & BonyNecrosis) 12. Compromised Grafts and Flaps 13. Acute Thermal Burn Injury 14. Idiopathic Sudden Sensorineural Hearing Loss

(NEW! Approved on October 8, 2011 by the UHMS Board of Directors)

Source: http://membership.uhms.org/?page=indications

HBOT INDICATIONS (UHMS):

KONTRAINDIKASI

ABSOLUT

RELATIF

ISPA SINUSITIS

ASMA KLAUSTROFOBIA DEMAM TINGGI

PACEMAKER KEHAMILAN

OPERASI TELINGA / TORAKS

KOMPLIKASI: � Barotrauma: telinga, sinus, gigi, paru-paru � Temporer Myopia � Kejang karena Intoksikasi O2 � Klaustrofobia EFEK SAMPING: � Mual � Keringat � Batuk � Sakit dada � Kedutan � Alternobaric Vertigo

RATIONALE TOHB pada ISSHL:

“The cochlea and the structures within it require a high oxygen supply. The direct vascular supply, particularly to the organ of Corti, is minimal. Tissue oxygenation to the structures within the cochlea occurs via oxygen diffusion from cochlear capillary networks into the perilymph and the cortilymph. The perilymph is the primary oxygen source for these intracochlear structures.  Unfortunately, perilymph oxygen tension is decreased significantly in patients with ISSHL. To achieve a consistent rise of perilymph oxygen content, the arterial-perilymphatic oxygen concentration difference must be extremely high. This can be restored with hyperbaric oxygen therapy.” UHMS http://membership.uhms.org/?page=ISSHL

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PENELITIAN

THE COCHRANE COLLABORATION 2012 Review on HBO for ISSHL & Tinnitus: §  Mengambil 7 Penelitian (total 392 partisipan) dari 91 Penelitian. §  Pilgramm 1985; Hoffmann 1995a; Hoffmann 1995b; Cavallazzi 1996Schwab 1998; Fattori 2001; Topuz 2004. §  Ongoing: Barthelemy 2002; Bennett 2010.

RISK OF BIAS: In general the methodology of these trials was poorly reported.

AUTHOR’S CONCLUSIONS: We found some evidence from seven small trials of generally poor quality, that hearing may be improved in people with ISSHL and possibly that tinnitus may also be improved. This may only be true if HBOT is used within two weeks of the onset of problems and there is no evidence that HBOT can help people who have been deaf for some months. Further research is needed.

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DATA PASIEN ISSHL RS KHUSUS THT – BEDAH KL PROKLAMASI

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• Evaluasi lengkap oleh Dokter Spesialis THT untuk menentukan derajat ISSHL & kemungkinan

penyebab.

• Konsultasi Dokter Hiperbarik untuk menentukan pasien layak menjalani TOHB untuk memperoleh penjelasan tentang teknik

pelaksanaan TOHB. • Direkomendasikan untuk tetap melakukan Follow-up

Consultation dengan Dokter Spesialis THT.

RECOMMENDED HBOT PROFILE:

100% O2 at 2.0 to 2.5 ATA for 90 minutes daily for 10 to 20 treatments. 

(The 2.4 ATA treatment pressure is probably most practical, especially for facilities with multiplace chamber operations)

UHMS http://membership.uhms.org/?page=ISSHL

E V A L U A S I

Jumlah sesi TOHB yang dilakukan akan sangat bervariasi pada setiap pasien, tergantung berat / ringan gejala serta onset penyakit. Evaluasi pasien direkomendasikan dapat dilakukan setiap 10 sesi TOHB.

KESIMPULAN

“The best evidence supports the use of HBO2 within TWO WEEKS of

symptom onset.”

- UHMS

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INSTALASI HIPERBARIK RS KHUSUS THT – BEDAH KL PROKLAMASI

INSTALASI HIPERBARIK RS KHUSUS THT – BEDAH KL PROKLAMASI

INSTALASI HIPERBARIK RS KHUSUS THT – BEDAH KL PROKLAMASI

INSTALASI HIPERBARIK RS KHUSUS THT – BEDAH KL B S D

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THANK YOU &

Have a HYPERBARIC night!