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"ABSTRAKBerbagai studi terkini menunjukkan hubungan antara vitamin D dan sepsis. Vitamin D berperan sebagai stimulator produksi peptida antimikroba dan mencegah inflamasi yang berlebihan. Insufisiensi dan defisiensi vitamin D berhubungan dengan risiko terjadinya sepsis. Saat ini belum terdapat data mengenai hubungan status vitamin D dengan pasien infeksi tanpa sepsis, sepsis, dan sepsis berat. Tujuan penelitian ini dilakukan untuk mendapatkan hubungan antara proporsi status vitamin D dengan pasien infeksi tanpa sepsis, sepsis, dan sepsis berat.Desain penelitian potong lintang, terdiri dari 60 pasien infeksi terbagi menjadi kelompok infeksi tanpa sepsis, sepsis, dan sepsis berat masing-masing 20 pasien. Diagnosis sepsis berdasarkan modifikasi SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference 2001. Status vitamin D ditetapkan menurut rekomendasi Holick. Pada ketiga kelompok tersebut dicatat data karakteristik subjek dan dilakukan pemeriksaan 25(OH)D.Status vitamin D pada subjek penelitian ini didapatkan sebanyak 5 (8,33%) orang insufisiensi dan 55 (91,67%) orang defisiensi vitamin D Proporsi insufisiensi pada kelompok infeksi tanpa sepsis adalah 5%, sepsis 10%, dan sepsis berat 10%. Proporsi defisiensi pada kelompok infeksi tanpa sepsis adalah 95%, sepsis 90%, dan sepsis berat 90%. Didapatkan perbedaan tidak bermakna proporsi insufisiensi dan defisiensi vitamin D pada kelompok infeksi tanpa sepsis, sepsis, dan sepsis berat.Kami menyimpulkan status vitamin D tidak berhubungan dengan beratnya sepsis. Proporsi insufisiensi dan defisiensi pada pasien infeksi tanpa sepsis, sepsis, dan sepsis berat masing-masing didapatkan 5% dan 95%; 10% dan 90%; 10% dan 90%.

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ABSTRACTRecent studies have shown that there is a relationship between vitamin D and sepsis. Vitamin D has a a role as a potent stimulator of antimicrobial peptides and prevent an over reaction of the inflammatory response. Insufficiency and deficiency of vitamin D have been associated with sepsis event. Nevertheless, there is no data about the relationship between vitamin D status with infection without sepsis, sepsis, and severe sepsis patient. The aim of this study was to obtain the relationship between proportions of vitamin D with infection without sepsis, sepsis, and severe sepsis patient.This was a cross-sectional study, 60 patients with infection were divided into groups of infection without sepsis, sepsis, and severe sepsis, each consisted of 20 patients. Diagnosis of sepsis was based on modified SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference 2001. Vitamin D status was defined according to Holick recommendations. Baseline characteristics of subjects were recorded and 25(OH)D concentrations were measured in subjects of each groups.According to status of Vitamin D, 5 (8,33%) subjects were insufficiency and 55 (91,67%) were deficiency. The proportions of vitamin D insufficiency at infection without sepsis group were 5%, sepsis 10%, and severe sepsis 10%. The proportions of vitamin D deficiency at infection without sepsis group were 95%, sepsis 90%, and severe sepsis 90%. The proportions of insufficiency and deficiency at infection without sepsis, sepsis, and severe sepsis patient were not significantly different (p > 0.05).It is concluded that vitamin D status were not related to infection severity. The proportions of vitamin D insufficiency and deficiency at infection without sepsis, sepsis, and severe sepsis, i.e. 5% and 95%; 10% and 90%; 10% and 90%, respectively."

"Tahun ini Indonesia akan menggelar dua perhelatan politik besar berskala nasional: Pileg dan Pilpres. Pileg untuk memilih wakil rakyat yang akan duduk di DPR, DPD dan DPRD. Sedangkan Pilpres untuk memilih pasangan calon presiden dan wakil presiden. Bagaimana hasil kedua pemilu itu untuk perjalanan Indonesia ke depan (2014-2019)? Pemilu memang tidak menjamin apa-apa kecuali kebebasan bagi rakyat untuk memilih. Namun, tentu saja selalu ada perubahan di balik pemilu. Yang kita tak tahu apakah perubahan itu positif atau negatif. Diprediksi hasil-hasil Pileg relatif tak berubah, dalam arti tidak membawa calon-calon wakil rakyat baru yang benar-benar berkualitas dan berintegritas. Sebab, sebagian dari mereka mengawali proses masuk ke lembaga legislatif itu dengan tahapan-tahapan yang sarat politik uang. Jika awalnya saja sudah kotor, maka ke depannya pun kerja-kerja politik mereka niscaya diwarnai dengan praktik-praktik busuk dan korup. Sementara hasil Pilpres mungkin agak berbeda, karena kali ini rakyat telah banyak belajar dari pengalaman masa lampau terkait seorang pemimpin yang lebih menekankan citra diri tapi sangat peragu dan kinerjanya mengecewakan. Apabila seiring waktu rakyat makin berani memerankan diri sebagai "pengawal-pengawas" bagi kinerja pemimpin mendatang. Rakyat akan bersuara terus-menerusmengkritisinya, terutama melalui jejaring sosial yang kian terbuka luas."

"Through the year 2006, there are many national happenings influence the progress of the national development. During this year, there were many street demonstrations and excessive actions performed by local community. It has influenced the process of recovery of tourism development in Indonesia. The Statistical Report of Visitor Arrivals to Indonesia published by Ministry of Culture and Tourism showed the total of foreign visitor arrival to Indonesia decreased significantly in 2006. In the other hand, the flow of Indonesian national travelling overseas has increased significantly. Based on the above matters, it is considered necessary to re-evaluate and formulate a better strategy to improve Indonesian image overseas. Corrective actions should be taken to develop good image through tourism promotional activities. The policy on budget allocation for promotional activities has to be re-evaluated, as Malaysia and Singapore have much more promotional budget. Innovative creation and ideas should be developed to meet the wants and the needs of tourists. Tourist destination should be developed in such a way related to local-based sustainable tourism. This efforts is expected to assure foreign visitor to Indonesia that Indonesia is in a fact a ideal place for visitation. The decision to set 2008 as the Visit Indonesia year should be set as a big momentum to improve Indonesia image to foreign tourists."

"ABSTRAKKorban bullying usia sekolah umumnya masih merasakan berbagai dampak negatif bullying hingga dewasa. Penyayang diri dan optimisme dapat menjadi strategi koping yang tepat bagi korban untuk berkembang positif secara psikologis. Studi ini berusaha untuk melihat hubungan antara belas kasihan diri dan optimisme pada orang dewasa baru yang selamat dari perundungan sekolah (SMP dan SMA). Partisipan dalam penelitian ini adalah orang dewasa baru berusia 18-25 tahun yang lolos seleksi instrumen Multidimensional Online and Offline Peer Victimization Scale (MOOPVS) berdasarkan tingkat keparahan bullying yang dialaminya. Belas kasihan diukur menggunakan Bentuk Bentuk Pendek Skala Belas Diri Sendiri (SCS-SF) dan optimisme diukur dengan Tes Orientasi Kehidupan-Revisi (LOT-R). Melalui teknik korelasi Pearson, ditemukan bahwa di antara orang dewasa baru yang selamat dari perundungan di sekolah, belas kasihan diri secara signifikan berhubungan positif dengan optimisme (r = 0,264, p <0,01, satu sisi). Temuan ini dapat menjadi pertimbangan bagi para praktisi psikologi, khususnya yang bergerak di bidang rehabilitasi pasca bullying, untuk melakukan intervensi welas asih dan / atau berbasis optimisme.ABSTRACTVictims of school age bullying generally still feel the various negative effects of bullying until adulthood. Self-compassion and optimism can be the right coping strategies for victims to develop positively psychologically. This study attempted to look at the relationship between self-compassion and optimism in new adults who survived school bullying (junior high and high school). Participants in this study were adults aged 18-25 years who passed the Multidimensional Online and Offline Peer Victimization Scale (MOOPVS) instrument selection based on the severity of the bullying they experienced. Compassion was measured using the Short Form of Self-Defense Scale (SCS-SF) and optimism measured by the Revised Life-Orientation Test (LOT-R). Through the Pearson correlation technique, it was found that among new adults who survived school bullying, self-compassion was significantly positively associated with optimism (r = 0.264, p <0.01, one hand). These findings can be a consideration for psychology practitioners, especially those engaged in post-bullying rehabilitation, to carry out compassionate and / or optimism-based interventions."

"Latar belakang. Selama sepsis, terjadi penglepasan ICAM-1 yang dipercaya berperan dalam kerusakan otak. Sedangkan S100β telah diteliti sebagai penanda kerusakan sel otak. Tujuan. Mengetahui rerata nilai ICAM-1, protein S100β, korelasi antara ICAM-1 dengan skala koma Glasgow (GCS), korelasi antara protein S100β dengan GCS, dan korelasi antara ICAM-1 dengan S100β. Metode. Deskriptif analitik potong lintang pada 34 anak sepsis, pengukuran kadar ICAM-1 dan S100β dalam darah pada hari pertama dan ketiga sejak sepsis ditegakkan. Hasil. Median ICAM-1 hari pertama 548,1 (158,6 – 1256,1) ng/mL dan ketiga 596,5 (185,5 – 1264,5) ng/mL (p=0,164). Median S100β pada sepsis berat lebih tinggi secara signifikan dibandingkan sepsis ringan pada hari pertama maupun ketiga (p=0,008 dan p=0,021). Hari ketiga, kadar S100β berkorelasi negatif dengan GCS (r= - 0,452; p=0,003). Korelasi antara ICAM-1 dan S100β pada hari pertama r=0,146 (p=0,409) dan ketiga r=0,184 (p=0,298). Simpulan. Prevalens ensefalopati sepsis 5,9%. Median ICAM-1 hari ketiga sepsis lebih tinggi dibandingkan hari pertama. Median S100β pada sepsis berat lebih tinggi secara signifikan dibandingkan sepsis ringan. Tidak terdapat korelasi antara ICAM-1 dengan GCS pada kelompok sepsis ringan maupun berat. Terdapat korelasi negatif antara S100β dengan skor GCS pada hari ketiga sepsis. Tidak terdapat korelasi antara ICAM-1 dan S-100β pada hari I dan III sepsis.

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Background: ICAM-1 release during sepsis is perceived to be related to brain injury. Whereas S100β has been known as one of brain injury markers.

Objective: To measure mean value of ICAM-1, S100β, to find correlation between ICAM-1 and Glasgow Coma Scale (GCS), between S100β and GCS, also ICAM- 1 and S100β.

Methods. Analytical cross sectional study in 34 sepsis children, measurement of ICAM-1 and S100β plasma levels within day 1 and 3 since diagnosis of sepsis.

Results. Median level of ICAM-1 day one 548,1 (158,6 – 1256,1) ng/mL and day three 596,5 (185,5 – 1264,5) ng/mL (p=0,164). S100β median is significantly higher in severe than mild sepsis (p=0,008 dan p=0,021). On third day S100β was negatively related to GCS (r= - 0,452; p=0,003). The correlation observed between ICAM-1 and S100β on day one was r=0,146 (p=0,409) while on third day was r=0,184 (p=0,298).

Conclusion. The prevalence of encephalopathy sepsis is 5.9%, Median ICAM-1 is higher on day three. Median of S100β is higher in severe than mild sepsis.There is no correlation between ICAM-1 and GCS in both sepsis. There was negative correlation between S100β and GCS on 3rd day of sepsis. No correlation between ICAM-1 and S100β on both measurement days."

"Mortalitas anak dengan sepsis masih tinggi dengan penyebab yang belum banyak diketahui patofisiologinya. Kerusakan lapisan glikokaliks pada permukaan endotel pembuluh darah dapat menyebabkan peningkatan permeabilitas pembuluh darah yang mengakibatkan syok sepsis dan disfungsi organ pada pasien sepsis. Peningkatan kadar syndecan-1 dalam darah merupakan salah satu penanda kerusakan lapisan glikokaliks. Penelitian ini bertujuan untuk mengetahui hubungan kadar syndecan-1 dengan disfungsi organ yang dinilai dengan skor PELOD-2 dan mortalitas 28 hari pada pasien anak dengan sepsis. Hubungan kadar syndecan-1 dengan skor PELOD-2 merupakan studi potong lintang, sementara hubungan syndecan-1 dengan mortalitas merupakan studi prospektif. Penelitian dilakukan pada 55 anak berusia 1 bulan-<18 tahun dengan sepsis yang dirawat di RSCM pada bulan Maret-Agustus 2019 dengan cara consecutive sampling. Evaluasi syndecan-1 dan skor PELOD-2 dilakukan pada hari pertama dan kelima setelah diagnosis sepsis. Pasien diikuti selama 28 hari untuk evaluasi mortalitas. Didapatkan peningkatan syndecan-1 pada seluruh pasien sepsisdengan peningkatan yang lebih tinggi pada pasien dengan syok sepsis (p=0,01). Terdapat korelasi positifantara kadar syndecan-1 dengan skor PELOD-2 pada 24 jam pertama setelah diagnosis sepsis dengan koefisien korelasi 0,32 (p=0,01). Terdapat korelasi positif antara perubahan kadar syndecan-1 dengan perubahan skor PELOD-2 dengan koefisien korelasi 0,469 (p=0,002). Tidak didapatkan hubungan antara kadar syndecan-1 dengan skor PELOD-2 pada hari kelima (p=0,6). Peningkatan kadar syndecan-1 didapatkan tidak berhubungan dengan mortalitas 28 hari (p=0,49).Nilai titik potongsyndecan-1 ≥688 ng/mLpada hari pertama dapat memprediksi skor PELOD-2 ≥8 dengan AUC 73,8%, sensitivitas 67%, spesifisitas 77%, NDP 44,4%, dan NDN 89,2% (p=0,012).

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Sepsis still contributes significantly to morbidity and mortality inpediatric patients. Disruption of glycocalyx layer on vascular endothelium has been described as one of the main pathophysiological events that leads to increased vascular permeability, contributing to organ failure and septic shock. The role of glycocalyx disruption in pediatric sepsis has not been widely studied. Increased syndecan level in blood marks disruption of glycocalyx integrity. This study was aimed to analyze the correlation ofserum syndecan-1 with organ dysfunction assessed by PELOD-2 score, and to evaluate its association with mortality in pediatric sepsis. Correlation of syndecan-1 and PELOD-2 score was a cross sectional study, while association of syndecan-1 with mortality was a prospective study. The study was conducted in pediatric intensive care unit, emergency unit, and pediatric ward of Cipto Mangunkusumo Hospital, Jakarta, on March-August 2019. The subjects were 55 patients aged 1-month to 18-year-old with sepsis that fulfilled the inclusion criteria consecutively. Serum syndecan-1 level and PELOD-2 score were evaluated on day 1 and 5 after diagnosis of sepsis. Survival was assessed after 28 days. There was increased level of syndecan-1 in all subjects, with significantly higher level found in patients with septic shock (p=0,01). There was positive correlation of syndecan-1 with PELOD-2 score in the first 24 hours after diagnosis of sepsis with correlation coefficient of 0.32 (p=0.01). Changes in syndecan-1 level within 5 days positively correlated with changes of PELOD-2 score with correlation coefficient of 0.469 (p=0.002). Syndecan-1 level and PELOD-2 score on day 5 was not significantly correlated (p=0.6). There was no association of increased syndecan-1 level with mortality in 28 days (p=0.49). Cut-off point of syndecan-1 ≥688 ng/mL in the first 24 hours can predictsignificant organ dysfunction (PELOD-2 score of ≥8) with AUC of 73.8%, sensitivity 67%,specificity 77%, positive predictive value 44.4%, and negative predictive value 89.2% (p=0.012)."

"Latar belakang: luka bakar berat dapat disertai dengan trauma inhalasi, yang akan memicu respons lokal dan sistemik, sehingga menyebabkan berbagai komplikasi, termasuk systemic inflammatory response syndrome (SIRS) dan sepsis. Berbagai kondisi ini menyebabkan hipermetabolime dan hiperkatabolisme, yang membutuhkan tatalaksana nutrisi adekuat untuk membantu proses penyembuhan pasien. Berbagai kelompok ahli telah memberikan rekomendasi tatalaksana nutrisi pada luka bakar berat dan sakit kritis. Namun, akibat keterbatasan sarana dan prasarana, tidak semua rekomendasi dapat dilaksanakan, sehingga tatalaksana nutrisi diberikan secara optimal. Metode: serial kasus ini terdiri atas empat pasien luka bakar berat, yang disebabkan oleh api, dan disertai trauma inhalasi, yang menyebabkan berbagai komplikasi, sepsis, multiple organ dysfunction syndrome (MODS) dan multiple organ failure (MOF). Tatalaksana nutrisi diberikan secara bertahap sesuai dengan keadaan pasien. Pemberian nutrisi diawali dengan nutrisi enteral dini (NED) dalam waktu 2448 jam setelah luka bakar, sebesar 10 kkal/kg BB, menggunakan drip intermiten. Selanjutnya, nutrisi diberikan sebesar 2025 kkal/kg BB pada fase akut dan 2530 kkal/kg BB/hari pada fase anabolik. Setelah pasien keluar dari intensive care unit (ICU), target kebutuhan energi menggunakan persamaan Xie, dengan protein 1,52,0 g/kg BB/hari, lemak 2530%, dan karbohidrat (KH) 5565%. Mikronutrien diberikan berupa multivitamin antioksidan, vitamin B, asam folat, dan vitamin D. Pasien dalam serial kasus ini juga mendapatkan nutrisi spesifik glutamin sebesar 0,3 g/kg BB/hari, selama 510 hari. Hasil: tiga pasien mengalami perbaikan klinis, kapasitas fungsional, dan laboratorium. Pasien selamat dan dipulangkan untuk rawat jalan. Masa rawat pasien yang selamat berturut-turut 33 hari, 70 hari, dan 43 hari. Seorang pasien mengalami perburukan dan MOF, hingga meninggal dunia setelah dirawat selama 23 hari di ICU. Kesimpulan: tatalaksana nutrisi optimal dapat menunjang penyembuhan luka serta menurunkan angka morbiditas dan mortalitas pasien luka bakar berat dengan trauma inhalasi dan sepsis.

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;Background: severe burn trauma combined with inhalation injury initiates local and systemic response, resulting in various complications such as systemic inflammatory response syndrome (SIRS) and sepsis. These conditions stimulate hypercatabolic process, leading to the increase of nutrition requirement. Adequate nutritional support is necessary in order to control both inflammatory and metabolic response, and also to improve healing process. To date, nutritional recommendations specific for severe burn trauma and critical illness have been established. However, many problems including patient?s condition and lack of resources exist, so optimal nutritional support that fits our settings was delivered. Method: this serial case focused on four severely burned patients caused by flame. Subjects with inhalation trauma and complications such as sepsis, multiple organ dysfunction syndrome (MODS), and multiple organ failure (MOF) were included in this study. Nutritional support was delivered according to clinical conditions, patient?s tolerance, and laboratory findings. Early enteral nutrition was initiated within 2448 hours post burns, starting from 10 kcal/kg BW/day with intermittent gravity drip method. Nutrition was gradually increased in order to reach the target of energy for critically ill patients, which is 2025 kcal/kg BW/day in acute phase or 2530 kcal/kg BW/day in anabolic recovery phase. Xie Equation was used to calculate target of total energy for burned patient. Protein requirement was 1.52.0 g/kg BW/day. Lipid and carbohydrate given were 2530% and 5565% from calorie intake, respectively. Micronutrient supplementation including antioxidants, vitamin B, folic acid, and vitamin D was also provided. Glutamin as specific nutrient was delivered by 0.3 g/kg BW/day in 510 days. Results: improvement of clinical condition, functional capacity, and laboratory parameters was observed in three patients, who could be discharged from hospital and asked to come back for outpatient care. Their lengths of stay were 33 days, 70 days, and 43 days, respectively. However, one patient experienced worsening of condition and died after 22 days of care in Intensive Care Unit (ICU). Conclusions: optimal nutritional support for severely burned patients with inhalation trauma and sepsis is necessary in order to improve healing process, as well as decrease morbidity and mortality."

"Latar belakang Hiperglikemia pada anak sepsis dan syok septik merupakan keadaan yang sering ditemukan serta mempunyai luaran yang buruk. Patofisiologinya belum jelas mungkin berbeda dengan dewasa yaitu terdapatnya hipofungsi sel beta pankreas dibandingkan dengan resistensi insulin.Tujuan Mengetahui adanya hipofungsi sel beta pankreas dengan didapatnya penurunan kadar insulin melalui pemeriksaan kadar C peptida pada anak sepsis dan syok septik dengan hiperglikemiaMetode. Penelitian dilakukan di PICU Pediatric Intensive Care Unit dan IGD Instalasi Gawat Darurat. Penelitian ini merupakan suatu uji deskriptif analitik dengan memeriksa kadar C peptida pada anak sepsis dan syok septik dengan hiperglikemia Kadar gula darah dan C peptida diperiksa secara periodik selama 48 jamHasil Hiperglikemia dan penurunan kadar C peptida ditemukan pada 59 dan 52 pasien anak dengan sepsis dan syok septik Keadaan hiperglikemia hanya ditemukan pada 12 jam pertama perawatan. Perbedaan kadar gula darah dan C peptide tampak pada 1 jam pertama yaitu 229 vs 192 mg dl dan 0 5 vs 1 5 ng ml nilai p 0 409 p 0 025 Skor PELOD lebih tinggi pada kadar C peptida rendah 11 vs 1. Penggunaan ventilator inotrops kortikosteroid dan lama rawat PICU tidak terdapat perbedaan pada kedua kelompok.Simpulan Terdapat penurunan kadar C peptida di bawah normal pada anak sepsis dan syok septik dengan hiperglikemia dan meningkat ke normal dalam 48 jam Penurunan gula darah terjadi 12 jam pertama hal ini menunjukkan perlunya infus glukosa pada keadaan akut sepsis. Apakah hiperglikemia merupakan respons normal tubuh dan hipofungsi sel beta pankreas akibat beratnya penyakit pada anak sepsis perlu dilakukan penelitian lebih lanjut

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Background Hyperglycemia in children sepsis is a condition that is often found Pathophysiology is unclear may differ from the adult that the presence of hypofunction of pancreatic beta cells compared with insulin resistance.Objective To determine the hypofunction pancreatic beta cells with decreased levels of C peptide insulin in children with sepsis hyperglycemiaMethods The study was conducted in the PICU and ER. This study was a descriptive analytic test by examining the levels of C peptide in children with sepsis hyperglycemia Checked blood sugar levels and C peptide during 48 hours on a periodic basis.Results Hyperglycemia and decreased levels of C peptide were 59 and 52 in children with sepsis respectively Hyperglycemia was found only in the first 12 hours Differences in blood sugar levels 229 vs 192 mg dl p value 0 409 and C peptide 0 5 vs 1 5 ng ml p value 0 025 appeared at the first 1 hour. Further analysis between normal and low C peptide showed PELOD score was higher in low C peptide level 11 vs 1. Ventilators inotrops corticosteroids and PICU LOS was should no difference in the two groups.Conclusions There was a decrease in C peptide level below normal in children with sepsis hyperglycemia and increased to normal within 48 hour. The decrease in blood sugar occurs in the first 12 hours which demonstrates the need for infusions of glucose in acute sepsis Further research whether hyperglycemia was a normal response of the body and hypofunction pancreatic beta cells due to the severity of the disease in children sepsis."

"Latar Belakang : Sepsis adalah penyebab utama kematian pasien dengan penyakit kritis. Uji fungsi hati memiliki nilai prognostik untuk menentukan terjadinya kolestasis terkait sepsis (KTS). Antioksidan diduga berpengaruh dalam KTS sehingga perlu dibuktikan.Tujuan : Mengetahui gambaran umum penderita KTS neonatorum di Departemen IKA FKUI-RSCM. Mengetahui apakah antioksidan (seng, vitamin A dan vitamin D) dan nilai parameter biokimia hati (bilirubin, AST, ALT dan GGT) memiliki nilai prognostik untuk luaran (baik dan buruk) pada KTS.Metode: Penelitian uji prognostik dengan metode kohort prospektif periode Desember 2011-Desember 2012. Subjek penelitian kali ini adalah neonatus cukup bulan usia 0-28 hari atau kurang bulan sampai 42 minggu usia koreksi. Data dilakukan tabulasi untuk melihat karakteristik dan distribusi data kadar antioksidan dan parameter biokimia hati. Analisis statistik menggunakan analisis bivariat (uji Kai kuardat atau Fisher) dan multivariat (uji regresi logistik).Hasil : Penelitian sejak Desember 2011-Desember 2012 terdapat 1052 neonatus, 332 tersangka sepsis, 225 proven sepsis. Penelitian dilakukan pada 80 subjek (50 KTS dan 30 sepsis tanpa kolestasis). Sebagian besar subjek lelaki (61%), berat lahir <2500 gram (41%), usia gestasi cukup bulan (63%). Manifestasi klinis tersering adalah instabilitas suhu (55%), letargis (51%),dan distres pernapasan (45%). Bakteri utama penyebab sepsis adalah Staphylococcus epidermidis (31%), Acinetobacter sp. (16%), dan Enterobacter cloacae (14%). Faktor yang memiliki nilai prognostik untuk memprediksi luaran pada KTS adalah defisiensi vitamin A (RR 0,2; IK95%=0,06-0,78; p=0,020) dan kadar GGT (RR 10; IK95%=1,72-58,31; p=0,010).Simpulan :. Antioksidan, defisiensi vitamin A terbukti sebagai faktor prognostic unutk luaran baik pada KTS neonatorum. Parameter biokimia hati dalam hal ini GGT terbukti sebagai faktor prognosis untuk luaran buruk pada KTS neonatorum.

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Background: Sepsis is the leading cause of death in critically ill patients. Liver plays a role in multiorgan failure during sepsis. Biochemical liver parameters have prognostic value for determining the occurrence of Neonatal sepsis-associated cholestasis (NSAC). Micronutrients thought to play a role in NSAC so it is necessary to prove its contribution to the NSAC.

Objective: To determine the characteristics of patients in the NSAC Child Health Department Faculty of medicine-RSCM in the period December 2011 - December 2012. Knowing the characteristics of the levels of substances such as zinc, vitamin A, and vitamin D and levels of liver function tests such as bilirubin, AST, ALT and GGT which has prognostic value for the occurrence of NSAC outcomes.

Methods: This is a prognostic study with cohort prospective method during December 2011-December 2012. Subjects were full-term neonates aged 0-28 days or preterm neonates until 42 weeks of age correction, has proven sepsis and clinical sepsis. The data was then tabulated to see the characteristics of the data subject and the distribution of antioxidant and biochemical liver parameters. Statistical analysis was performed to search for prognostic factors associated with NSAC with Chi-Square or Fisher (bivariate analysis) and logistic regression (multivariate analysis).

Results: Patients treated in the period December 2011 - December 2012 as many as 1052 patients, 332 subjects suspected sepsis, with 225 proven sepsis. The study was conducted on 80 subjects, consisting of 50 subjects and 30 subjects NSAC sepsis, neonatal majority of subjects were male (61%), gestational age at term (63%) and birth weight < 2500 gram. The clinical manifestations of sepsis are the most temperature instability (55%), followed by symptoms letargis (51%) and respiratory distress (45%). Based on the data, blood culture results obtained with the major bacterial cause of neonatal sepsis in a row is Staphylococcus epidermidis (31%), Acinetobacter sp (16%), and Enterobacter cloacae (14%). Based on logistic regression, micronutrients: deficiency vitamin A (p = 0.020; RR0,2 (95% CI = 0.06 to 0.78) and liver function tests: GGT (p = 0.010; RR10 (95% CI =1.72 to 58.31) has a prognostic value to predict outcomes in NSAC.

Conclusion: Vitamin A deficiency has been demonstrated to have a good prognostic factor for the outcome of NSAC. While low GGT level has been demonstrated to have a poor prognostic factor for the outcome of NSAC."