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"Henti jantung adalah manifestasi umum yang paling fatal dari penyakit kardiovaskular dan menempati peringkat pertama dari penyebab kematian di seluruh dunia. Bantuan Hidup Dasar (BHD) merupakan bekal mendasar untuk menyelamatkan jiwa seseorang ketika terjadi henti jantung. Pengetahuan yang tepat tentang pemberian BHD sangat diperlukan bagi semua perawat untuk dapat mengidenfikasi serta memberikan pertolongan kepada pasien-pasien yang mengalami henti jantung. Penelitian ini bertujuan untuk mengetahui gambaran pengetahuan perawat tentang pemberian bantuan hidup dasar pada pasien henti jantung. Desain penelitian ini menggunakan desain penelitian deskriptif. Teknik sampling yang digunakan adalah dengan cara total sampling yaitu berjumlah 48 perawat yang bekerja di ruang Intensive Care. Dari hasil uji statistik univariat didapatkan bahwa pengetahuan perawat tentang pemberian Bantuan Hidup Dasar pada pasien henti jantung di ruang Intensive Care yaitu sebanyak 24 perawat (50 %) memiliki pengetahuan yang baik dan sebanyak 24 perawat (50 %) memiliki pengetahuan yang kurang.

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Cardiac arrest is the most common fatal manifestation of cardiovascular disease and is ranked first of the cause of death worldwide. Basic Life Support (BLS) is a fundamental provision to save lives in the event of cardiac arrest. Proper knowledge about the provision of BLS is necessary for all nurses to identify and provide right intervention to patients who suffered cardiac arrest. This study aimed to describe nurses' knowledge regarding the provision of basic life support in patients with cardiac arrest. The design of this study used a descriptive research design.. The sampling technique used the total sampling which amounted to 48 nurses working in Intensive Care Unit. From the results of univariate statistical tests showed that nurse’s knowledge about the provision of basic life support for cardiac arrest patients in the Intensive Care Unit as many as 24 nurses (50%) had good knowledge and as many as 24 nurses (50%) had less knowledge."

"Latar belakang: Operasi jantung membutuhkan larutan kardioplegia untuk menghentikan jantung. Saat ini sebagian besar larutan kardioplegia menggunakan mekanisme depolarisasi membran yang berisiko menyebabkan gangguan keseimbangan ion transmembran, aritmia, vasokonstriksi koroner, gangguan kontraktilitas, dan sindrom curah jantung rendah. Menunjukkan proteksi miokardium masih belum optimal. Henti jantung melalui polarisasi membran secara teori dapat memberikan proteksi miokardium yang lebih baik.Tujuan: Diketahui kualitas proteksi miokardium henti jantung terpolarisasi dibandingkan dengan henti jantung terdepolarisasi.Metode: Tinjauan sistematik dengan menerapkan protokol PRISMA-P. Data didapatkan melalui pencarian dalam basis data Cochrane Library, PubMed, Scopus, ScienceDirect, dan Embase.Hasil: Dari penelusuran diperoleh empat studi yang memenuhi kriteria. Tiga studi dengan desain uji acak terkontrol, satu studi dengan desain kohort retrospektif. Jumlah sampel bervariasi dari 60 sampai 1000 subjek. Kualitas proteksi miokardium dinilai dari kejadian aritmia pascaoperasi, infark miokardium pascaoperasi, dan sindrom curah jantung rendah pascaoperasi. Satu studi melaporkan angka kejadian aritmia pascaoperasi yang lebih rendah secara bermakna pada kelompok henti jantung terpolarisasi (p 0,010). Tidak ada perbedaan yang bermakna pada kejadian infark miokardium pascaoperasi. Tiga studi melaporkan angka kejadian sindrom curah jantung rendah pascaoperasi yang lebih rendah pada kelompok henti jantung terpolarisasi namun tidak bermakna secara statistik.Kesimpulan: Henti jantung terpolarisasi berpotensi memberikan kualitas proteksi miokardium yang lebih baik dibandingkan dengan henti jantung terdepolarisasi.

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Background: Cardioplegia is needed in cardiac surgery to arrest the heart to achieve a quiet and bloodless field. Depolarized cardiac arrest is widely used despite the risk of ionic imbalances, arrhythmias, coronary vasoconstriction, contractility dysfunction, and low cardiac output syndrome leading to suboptimal myocardial protection. Polarized cardiac arrest has a more physiological mechanism to arrest the heart, thus giving better cardioprotection qualities.

Objective: To assess the myocardial protection quality of polarized cardiac arrest compared with depolarized cardiac arrest.

Method: Systematic review with PRISMA-P protocol. The literature search was performed using Cochrane Library, PubMed, Scopus, ScienceDirect, and Embase databases.

Result: Three randomized controlled trials and one retrospective cohort study were identified, with sample sizes varied between 60 to 1000 subjects. The quality of myocardial protection was assessed from postoperative arrhythmias, postoperative myocardial infarction, and postoperative low cardiac output syndrome. One study reported significantly lower postoperative arrhythmias in the polarized arrest group (p 0.010). There were no differences in postoperative myocardial infarction between the two intervention groups. Three studies reported lower postoperative low cardiac output syndrome in the polarized arrest group although not statistically significant.

Conclusion: Polarized cardiac arrest may give better myocardial protection than depolarized cardiac arrest."

"Pendahuluan: Optimalisasi pelayanan resusitasi dapat dipadupadankan dengan teknologi yang berkembang saat ini, salah satunya adalah aplikasi seluler yang dapat diterapkan dengan mudah dalam sistem pelayanan resusitasi. Cardiac Arrest Resuscitation Mobile Application (CARMA) merupakan alat bantu dalam ACLS yang digunakan untuk membantu para praktisi dalam melakukan tindakan resusitasi. Penggunaan aplikasi dapat dimulai pada pelatihan berbasis simulasi. Metode: Penelitian ini adalah uji klinis acak pada simulasi henti jantung dengan menggunakan manekin fidelitas tinggi. Simulasi dengan durasi dua belas menit dan berupa lima rangkaian ritme. Sejumlah 26 kelompok mahasiswa kedokteran dibagi kedalam dua kelompok, yaitu kelompok menggunakan aplikasi dan standar. Tujuan utama penelitian adalah untuk membandingkan kepatuhan panduan klinis pada kedua kelompok. Penilaian kepatuhan berdasarkan persentase pemenuhan daftar tilik yang sudah tervalidasi dan sudah dilakukan uji realibilitas sebelumnya. Tujuan sekunder untuk menilai kualitas kompresi dada dan waktu pemberian epinefrin. Hasil: Terdapat perbedaan bermakna kepatuhan panduan klinis pada kelompok aplikasi dibandingkan dengan kelompok standar (88,95 ± 6,86 vs 73,98 ± 6,40, p < 0,001). Variabel yang tidak menunjukkan perbedaan bermakna pada penelitian ini antara lain adalah kedalaman kompresi dada dan interval waktu pemberian epinefrin.Simpulan: Penggunaan aplikasi seluler dapat meningkatkan kepatuhan panduan klinis pada simulasi kasus henti jantung.

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Background: The optimization of resuscitation services can be aligned with current technological advancements, including mobile applications that can be easily implemented in resuscitation services. The Cardiac Arrest Resuscitation Mobile Application (CARMA) is a tool in Advanced Cardiovascular Life Support (ACLS) designed to assist practitioners in performing resuscitation actions. The application's use can commence in simulation-based training.

Methods: This study is a randomized clinical trial on cardiac arrest simulation using a high-fidelity mannequin. The simulation lasted twelve minutes and included five rhythm sequences. Twenty-six groups of medical students were divided into two groups: one using the application and the other following standard procedures. The main objective of the study was to compare compliance with clinical guidelines in both groups. Compliance assessment was based on the percentage of validated checklist items, previously subjected to reliability testing. Secondary objectives included evaluating chest compression quality and epinephrine administration time. Results: There was a significant difference in compliance with clinical guidelines between the application group and the standard group (88.95 ± 6.86 vs. 73.98 ± 6.40, p < 0.001). Variables such as chest compression depth and epinephrine administration interval did not show significant differences in this study. Conclusion: The use of mobile applications can enhance compliance with clinical guidelines in cardiac arrest simulation cases."

"Therapeutic hypothermia has emerged as a very important treatment option for patients with cardiac arrest as it provides significant protection from developing neurologic injury once the patient has been successfully resuscitated. Studies have demonstrated over 15% absolute risk reduction in death and neurologic injury using this therapy. Although hospitals and medical centers have become familiar with this important intervention it still remains greatly under utilized due to an experience and lack of resources to safely and effectively deploy such a program. The objective of this book is to educate and familiarize both providers and institutions as to how to develop and deploy and provide therapeutic hypothermia to their patients. The current knowledge for this is provided by speakers and national experts and also by literature review. There are several courses being provided on this as well throughout the US. These are good venues for people to come and see and get hands on experience, but there still needs to be a concrete book with references on how to go about getting this program started."

"Latar Belakang : Pasien anak merupakan pasien yang memiliki resiko tinggi mengalami penurunan kondisi klinis secara tiba-tiba yang disebabkan oleh gangguan pernapasan atau gangguan jantung (cardiac arrest) dan bisa menyebabkan kematian, tanggung jawab yang besar dimulai dari penerimaan, triase, penilaian awal, stabilisasi, kondisi akut, cedera, perawatan dan rujukan dan keperawatan berkelanjutan, Kematian anak di rumah sakit sering terjadi 24 jam pertama dalam penerimaan. Kematian dapat dicegah dengan identifikasi yang benar Salah satu strategi untuk mendeteksi kegawatan pasien seperti cardiac arrest pada anak saat masuk ke rumah sakit adalah dengan adanya instrumen yang baik dan akurat.Penelitian dilakukan untuk mengatehui perbandingan penggunaan Emergency Severity Index dan Emergency Department Paediatric Early Warning Score dalam mengidentifikasi kegawatan pasien anak Rumah Sakit.Metode : Penelitian menggunkaan desain cross sectional study rumus besar sampel komparatik kesesuain kategorik yang akan di uji dengan uji kappa ini melibatkan 174 anak yang dirawat dirumah sakit berusia 1 bulan hingga 18 tahun.Hasil : hasil uji menunjukan bahwa uji nilai p value < 0,05 (0,000) yang artinya terdapat kesepakatan antara penggunaan ESI dengan kegawatan anak di UGD Rumah Sakit Primaya Tangerang dan hasil yang di dapatkan nilai 1,000 yang artinya excellent agreement, dengan kesemuanya tidak ada yang menilai berbeda.Kesimpulan :Penggunaan Paediatric Early Warning Score masih perlu dikembangkan dan diperbaiki kembali untuk penyempurnaan. Penelitian memberikan implikasi supaya hasil penelitian dapat dijadikan evidence base dalampengelolaan asuhan keperawatan anak di Instalasi Gawat Darurat.

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Background : Pediatric patients are patients who have a risk of experiencing a sudden decline in clinical conditions caused by respiratory disorders or heart problems (cardiac arrest) and can cause death. The big responsibility starts from admission, triage, initial assessment, stabilization, acute conditions, injuries, care and referrals and ongoing nursing, Child mortality in hospital often occurs in the first 24 hours of admission. Death can be prevented by correct identification. One strategy to detect patient emergencies such as cardiac arrest in children upon admission to the hospital is to have good and accurate instruments. The study was conducted to determine the use of Emergency Severity Index and emergency department Paediatric Early Warning Score in identifying emergency pediatric hospital patients.

The research method used a cross-sectional study design. The formula for the comparative sample size of the categorical suitability to be tested with the kappa test involved 174 children who were hospitalized from 1 month to 18 years of age.

Results : the test results show that the test value of p value <0.05 (0.000) which means that there is an agreement between the use of ESI with pediatric emergencies in the Emergency Room of Primaya Hospital Tangerang and the results obtained are a value of 1,000 which means excellent agreement, with none of them rate differently.

Conclusion : The use of ED PEWS still needs to be developed and improved again to refinement. The research has implications so that research results can be used as an evidence base in managing child nursing care in the Emergency Room

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"Penelitian ini bertujuan untuk menilai efektivitas early warning score terhadap kejadian henti jantung pasien di instalasi rawat inap rumah sakit tingkat IV TNI AD dr.Bratanata Jambi Tahun 2019. Penelitian dilaksanakan di bulan Desember 2018 sampai April 2019 di instalasi rawat inap dengan pendekatan kualitatif dengan metode studi kasus. Teknik untuk memperoleh data adalah dengan wawancara mendalam, telaah dokumen, dan observasi langsung. Hasil penelitian menunjukkan adanya kejadian yang tidak diharapkan berupa kejadian henti jantung mengarahkan kepada penerapan early warning score yang belum optimal. Ketidakpatuhan terhadap pengisian, pengkajian, dan pengaktifan protokol early warning score di lapangan antara lain dipengaruhi oleh maldistribusi perawat, beban kerja perawat yang tidak sesuai dengan kompetesinya, pengetahuan perawat, dan komunikasi antara perawat dengan dokter. Hambatan penerapan EWS di lapangan antara lain ketidaksesuaian jumlah perawat berbanding dengan pasien, beban kerja perawat di luar pelayanan kesehatan, dan kurangnya pengetahuan dari staf mengenai penurunan kondisi klinis pasien. Hal ini bermuara kepada standar operasional prosedur yang belum lengkap dan penyusunan pola ketenagaan yang masih belum efektif dan efisien, juga monitoring-evaluasi dan pelatihan berkesinambungan yang belum berjalan dengan baik sehingga implementasi early warning score tidak optimal. Rekruitmen pegawai sesuai dengan kompetensi dan profesionalitas, pembuatan kebijakan yang menggabungkan pola kebijakan top-down dan bottom-up, pengaturan ulang penempatan sumber daya perawat, pendidikan dan pelatihan berkelanjutan merupakan upaya yang dapat meningkatkan keberhasilan implementasi early warning score.

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This study aims to assess the effectiveness of the application of early warning score on patients cardiac arrest events in the inpatient at installation level IV Army Hospital Dr.Bratanata Jambi in 2019. The study was conducted in December 2018 to April 2019 in inpatient installations with a qualitative approach with a case study method. The technique for obtaining data is through in-depth interviews, document review, and direct observation. The results of the study show that the occurrence of adverse events such as cardiac arrests lead to an unoptimal implementation of an early warning score. Nurses noncompliance in filling, assessing and activating early warning score protocol in the field is influenced by nurses maldistribution, nurses workloads that are not in accordance with their competencies, nurses knowledge, and communication between nurses and doctors. Barriers to the application of EWS in the field include the mismatch of the number of nurses compared to patients, the workload of nurses outside of health services, and the lack of knowledge from staff regarding the decline in the patients clinical condition. This leads to incomplete operational standard procedures and the formulation of work patterns that are still ineffective and inefficient, as well as ongoing evaluations and training that have not run well so that the implementation of an early warning score is not optimal. Employee recruitment in accordance with competence and professionalism, policy making that combines topdown and bottom-up policy patterns, rearranging the placement of nurse resources, continuing education and training is an effort that can increase the success of the implementation of an early warning score."

"Doxorubicin (DOX) dilemahkan oleh toksisitas jantung dan ginjal meskipun efektif melawan kanker. Walaupun dexrazoxane tersedia untuk mengatasi toksisitas DOX, efektivitasnya terbatas, begitu pula obat konvensional seperti beta-blocker dan statin. Penelitian ini menyelidiki efek perlindungan ekstrak etanol daun Andrographis panikulata (EEAP) terhadap toksisitas jantung dan ginjal yang diinduksi oleh DOX pada tikus sehat dengan fokus pada mekanisme anti-inflamasi dan mitokondria. Sebanyak 30 ekor (5 kelompok) tikus Sprague Dawley diaklimatisasi selama 2 minggu. Kelompok normal mendapat saline (ip) selama 4 minggu. Kelompok DOX menerima doxorubicin (4mg/kg/minggu). Kelompok perlakuan (DOX+EEAP) menerima doksorubisin dan ekstrak daun Andrographis Paniculata dengan dosis bervariasi (125, 250, 500 mg/kg/hari) secara oral selama 4 minggu. Setelah darah dan organ (jantung, ginjal) dikumpulkan, darah dianalisis untuk elektrolit (kalsium dan natrium). Jaringan dianalisis sebagai penanda inflamasi (NF-κB, IL-1β, NLRP-3), fungsi mitokondria (PGC1-α, TFAM), dan gambaran histopatologis yang menggunakan pewarnaan hematoxylin dan eosin (H&E) serta pewarnaan trikrom Masson. Kadar kalsium jantung juga diukur. Pengobatan bersama EEAP menurunkan natrium dan kalsium plasma dan kadar penanda inflamasi IL-1β dan NLRP-3 di jaringan jantung dan ginjal tetapi tidak menunjukkan efek signifikan pada ekspresi PGC1-α dan TFAM dibandingkan dengan kelompok DOX. Selain itu, kadar kalsium jantung berkurang. Lebih lanjut, konsentrasi NF-кB berkurang sedikit oleh EEAP dibandingkan dengan kelompok DOX saja. EEAP kemungkinan besar terlindungi dari peradangan yang disebabkan oleh DOX yang mengarah pada pemulihan histologi jantung dan ginjal menjadi normal. Efek perlindungan EEAP dalam penelitian ini dimediasi, setidaknya sebagian, oleh modulasi jalur NF-ĸB/NLRP3/IL-1β.

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Doxorubicin (DOX), despite its effectiveness against cancer, is compromised by cardiac and renal toxicity. While dexrazoxane exists for DOX toxicity, its effectiveness is limited, as are conventional drugs like beta-blockers and statins. This study investigates the protective effects of an ethanolic extract of Andrographis paniculata leaves (EEAP) against DOX-induced cardiac and renal toxicity in healthy rats, focusing on anti-inflammatory and mitochondrial mechanisms. 30 Sprague Dawley rats (5 groups) were acclimatized for 2 weeks. The normal group received saline (ip) for 4 weeks. The DOX group received only doxorubicin (4mg/kg/week). Treatment groups (DOX+EEAP) received doxorubicin and varying doses (125, 250, 500 mg/kg/day) of Andrographis paniculata leaf extract orally for 4 weeks. After sacrifice, blood and organs (heart, kidneys) were collected. Blood was analysed for electrolytes (calcium and sodium). Tissues were analysed for inflammatory markers (NF-κB, IL-1β, NLRP-3), mitochondrial function (PGC1-α, TFAM), and histopathological features using hematoxylin and eosin (H&E) or Masson’s trichrome stain. Cardiac calcium levels were also measured. EEAP co-treatment lowered plasma sodium and calcium, decreased levels of inflammatory markers (IL-1β and NLRP-3) in heart and kidney tissues, but showed no significant effect on PGC1-α and TFAM expression compared to the DOX group. Additionally, cardiac calcium levels were reduced. Further, NF-кB concentration was slightly reduced by EEAP compared to the DOX only group. EEAP likely protected against DOX-induced inflammation, leading to a restoration of normal heart and kidney histology. EEAP's protective effects in this study were mediated, at least in part, by modulation of the NF-ĸB/NLRP3/IL-1β pathway."

"ABSTRAKLatar belakang: Kardioplegia merupakan komponen penting dalam proteksi miokard operasi jantung. Meskipun telah banyak penelitian yang mencoba membuktikan keunggulan kardioplegia darah dibanding kardioplegia kristaloid, namun kesepakatan kardioplegia terbaik untuk operasi jantung bawaan asianotik belum tercapai. Metode: Penelitian eksperimental dengan simple randomization pada 54 populasi pasien VSD, AVSD dan gangguan katup mitral yang dibagi menjadi dua kelompok, yaitu 24 pasien kelompok crystalloid cardioplegia CC sebagai kontrol, dan 30 pasien kelompok blood cardioplegia BC . Dilakukan pemeriksaan selisih kadar laktat darah arteri dan sinus koronarius, serta ekstraksi oksigen koroner segera, menit ke-15 dan menit ke-30 setelah CPB dihentikan. Dilakukan observasi terhadap durasi ventilasi mekanik, penggunaan inotropik, aritmia jantung, lama rawat icu dan lama rawat rumah sakit. Hasil: Selisih kadar laktat darah dan ekstraksi oksigen koroner tidak berbeda bermakna p>0,05 . Pada pasien tutup VSD, penggunaan intoropik lebih sedikit pada kelompok BC. Pasien tanpa inotropik kelompok BC dan CC yaitu 9/25 dan 2/22, 1 jenis inotropik 12/25 dan 13/22, dan lebih dari satu jenis inotropik 4/25 dan 7/22

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ABSTRACTBackgrounds Cardioplegia is an important myocardial protection in cardiac surgery. Many studies conducted to prove blood cardioplegia rsquo s superiority to crystalloid cardioplegia, but no agreement established for which cardioplegia is the best for acyanotic cardiac surgery. Methods Experimental study with simple randomization in 54 VSD, AVSD, and mitral valve disease patients, 24 crystalloid cardioplegia CC , and 30 blood cardioplegia BC . Lactate levels in arterial blood and coronary sinus, also coronary oxygen extractions were measured immediate, 15 and 30 minutes after CPB deactivated. Postoperative mechanical ventilation durations, inotropic administrations, arrhytmias, ICU and hospital length of stay were observed. Results No significant difference in the difference of lactate levels and coronary oxygen extractions immediate, 15 and 30 minutes after CPB P 0.05 . Less inotropics needed in VSD closure patients in BC group. No inotropic needed in 9 25 BC group to 2 22 in CC group, 1 inotropic needed in 12 25 BC group to 13 22 in CC group, and more than 1 intropic needed in 4 25 BC group to 7 22 in CC group p"

"ABSTRAKPendahuluan. RJP merupakan usaha paling mendasar untuk menyelamatkan nyawa dari henti jantung. Selain mampu melakukan RJP kualitas tinggi, seorang dokter juga dituntut untuk mampu mengidentifikasi dan melakukan koreksi jika anggota tim tidak melakukan RJP dengan benar. Metode pembelajaran Self Deliberate Practice (SDP) dan Directed Learning(DL)umum digunakan pada pendidikan dokter di Indonesia, khususnya di FKUI. Fokus penelitian ini adalah analisis perbandingan kedua metode pembelajaran tersebut berdasarkan kemampuan mahasiswa dalam memahami dan melakukan RJP kualitas tinggi, mengidentifikasi dan mengoreksi kesalahan dalam tindakan RJP, sekaligus menilai kualitas kepemimpinan mahasiswa. Metode. Sebanyak 40 mahasiswa sampel dari FKUI diberikan pelatihan dan praktek bantuan hidup dasar. Selanjutnya, sampel dibagi secara acak dan tersamar menjadi kelompok treatment dan control untuk menjalani dua metode pembelajaran berbeda selama tiga bulan. Empat alat ukur digunakan untuk menilai hasil pembelajaran: kemampuan koreksi RJP; pengetahuan; keterampilan melakukan RJP kualitas tinggi; dan kualitas kepemimpinan. Uji perbandingan rerata terhadap dua kelompok tidak berpasangan menggunakan uji t-test independen dan uji Mann-Whitney. Hasil. Tidak ada perbedaan rerata yang signifikan secara statistik pada semua alat ukur yang digunakan. Perbandingan rerata nilai setelah retensi adalah: kemampuan koreksi RJP p = 0.576; pengetahuan p = 0.778; keterampilan RJP p = 0.459; dan kepemimpinan p = 0.932. Simpulan. Metode SDP dan DL sama baiknya dalam meningkatkan kemampuan koreksi, pengetahuan, dan keterampilan RJP mahasiswa FKUI. Kedua metode tidak berpengaruh terhadap kualitas kepemimpinan mahasiswa. Tidak ditemukan perbedaan yang signifikan secara statistik pada luaran kedua metode pembelajaran.

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Introduction.CPR is the most basic effort to save lives from cardiac arrest. In addition to being able to perform a high-quality CPR, a doctor is also required to be able to identify and make corrections if a team member does not perform the CPR correctly. The Self Deliberate Practice (SDP) and Directed Learning (DL) are common learning methods used in medical education in Indonesia, especially in FKUI. This study is a comparative analysis of the two learning methods based on students' ability to understand and perform high quality CPR, identify and correct errors in CPR, as well as assess the quality of student leadership. Methods. A total of 40 students from FKUI were taken as sample and given basic life support training. After the training, the sample were randomly and blindly divided into a treatment and control group to undergo two different learning methods for three months of retention. Four types of measurement are used to assess learning outcomes: the ability to correct CPR; knowledge; the ability to perform high quality CPR; and leadership. Comparative analysis of four types of measurements was carried out on two unpaired groups using the independent t-test and the Mann-Whitney test. Results. There were no statistically significant mean differences in all measuring instruments used. The p value of comparison of mean after retention is: CPR correction ability p = 0.576; knowledge p = 0.778; CPR performing skills p = 0.459; and leadership p = 0.932. Conclusions. Both SDP and DL methods are equally good in improving students' ability to perform high-quality CPR, and correcting CPR. Both methods play little role in increasing students' understanding of basic life support, and do not affect the quality of student leadership. No statistically significant differences were found in the two outcomes of the learning method."

"Latar Belakang. Lama rawat intensif pasien pascabedah jantung yang memanjang mempengaruhi alur pasien bedah jantung berikutnya. Pengaturan pasien berdasarkan lama rawat diperlukan agar alur pasien lancar. Tujuan. Membuat prediksi lama rawat intensif 48 jam berdasarkan nilai skor dari model EuroSCORE dan model yang dimodifikasi dari faktor-faktor EuroSCORE. Metode. Penelitian restrospektif dilakukan pada Januari 2012 - Desember 2013 pada 249 pasien yang menjalani bedah jantung di Unit Pelayanan Jantung RSUPN Dr Cipto Mangunkusumo Jakarta. Analisis survival dan regresi Cox dilakukan untuk membuat prediksi lama rawat intensif 48 jam. Hasil. Median kesintasan lama rawat intensif 43 jam. Nilai skor EuroSCORE tidak memenuhi asumsi hazard proporsional. Model baru telah dibuat dari 7 variabel EuroSCORE yang secara substansi berhubungan dengan lama rawat intensif (AUC 0,67). Kesimpulan. Model baru dari tujuh faktor EuroSCORE cukup dapat memprediksi lama rawat intensif 48 jam.

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Background. Prolonged intensive care unit length of stay (ICU-LOS) in a postcardiac surgery may shortage of ICU beds due to clog of patient flow. Improving ICU-LOS may lead to better patient flow.

Objectives. To predict 48-hour ICU-LOS based on EuroSCORE model and to create a modified EuroSCORE factors model.

Methods. A retrospective study was conducted from January 2012 to December 2013 among 249 patients who underwent cardiac surgery at Integrated Cardiac Services, Cipto Mangunkusumo Hospital, Jakarta. Survival analysis and Cox?s regression were performed to make a prediction model for 48-hour ICU-LOS.

Results. Median survival of ICU-LOS was 43-hour. The EuroSCORE model did not meet the proporsional hazard assumption. A new substantial model from 7- EuroSCORE factors was created to predict 48 hours ICU-LOS (AUC 0.67).

Conclusions. Seven EuroSCORE factors was sufficient as a new model to predict the 48-hour ICU-LOS."