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"ABSTRAK Hemodialisis merupakan tatalaksana renal replacement yang tersering pada pasien gagal ginjal kronik stadium 5, Akses vaskular dan morbiditas sebagai akibat komplikasi akses merupakanpenyebab utama perawatan di rumah sakit. Kegagalan maturitas merupakan hambatan utamapenggunaan arteriovenous fistula. Tujuan dari penelitian ini adalah untuk mengkaji korelasi peaksistolik velocity arteri brakialis dan volume flow draining vein intraoperatif denganmenggunakan ultrasonografi doppler untuk memprediksi maturasi AVF. Uji statistik yangdigunakan adalah uji Mann Whitney dan uji Chi Squere. Hasil yang didapatkan tidak ditemukankorelasi antara PSV arteri brakialis dengan maturitas. Rerata nilai titik potong volume flowdraining vein intraoperatif 259,43 ml/min dan paska operatif 679,22 ± 65,36 ml/mindihubungkan dengan maturitas, ini dapat menjadi acuan menetukan perlu tidaknya melakukantindakan revisi saat intraoperatif, yang pada akhirnya diharapkan dapat menurunkan angkakegagalan maturasi AVF. ABSTRACT Hemodialisis as treatment for renal replacement often patient chronic renal disease grade 5.Vascular access for hemodialysis its associated problems is the leading cause for hospitaladmission and morbidity.Maturation failure is impeded by issues of maturation. The result fromthis study showed that correlation peak sistolik velocity brakial artery and bloodflow ratemeasured using Doppler ultrasonogaphy right creation of the brachiocephalic fistula can predictAVF maturation. Statistic analisis use Mann Whithey and Chi Squere. Result no correlation PSVwith maturation, The intraoperative Bloodflow rate 259,43 ml/min and post operative 6 week679,22 ± 65,36 ml/min, maybe used as a guide to decide whether or not a corrective procedurewas needed to repair the brachiochephalic and consequently help in reducing the rate of AVFmaturation failure.;Hemodialisis as treatment for renal replacement often patient chronic renal disease grade 5.Vascular access for hemodialysis its associated problems is the leading cause for hospitaladmission and morbidity.Maturation failure is impeded by issues of maturation. The result fromthis study showed that correlation peak sistolik velocity brakial artery and bloodflow ratemeasured using Doppler ultrasonogaphy right creation of the brachiocephalic fistula can predictAVF maturation. Statistic analisis use Mann Whithey and Chi Squere. Result no correlation PSVwith maturation, The intraoperative Bloodflow rate 259,43 ml/min and post operative 6 week679,22 ± 65,36 ml/min, maybe used as a guide to decide whether or not a corrective procedurewas needed to repair the brachiochephalic and consequently help in reducing the rate of AVFmaturation failure.;Hemodialisis as treatment for renal replacement often patient chronic renal disease grade 5.Vascular access for hemodialysis its associated problems is the leading cause for hospitaladmission and morbidity.Maturation failure is impeded by issues of maturation. The result fromthis study showed that correlation peak sistolik velocity brakial artery and bloodflow ratemeasured using Doppler ultrasonogaphy right creation of the brachiocephalic fistula can predictAVF maturation. Statistic analisis use Mann Whithey and Chi Squere. Result no correlation PSVwith maturation, The intraoperative Bloodflow rate 259,43 ml/min and post operative 6 week679,22 ± 65,36 ml/min, maybe used as a guide to decide whether or not a corrective procedurewas needed to repair the brachiochephalic and consequently help in reducing the rate of AVFmaturation failure.;Hemodialisis as treatment for renal replacement often patient chronic renal disease grade 5.Vascular access for hemodialysis its associated problems is the leading cause for hospitaladmission and morbidity.Maturation failure is impeded by issues of maturation. The result fromthis study showed that correlation peak sistolik velocity brakial artery and bloodflow ratemeasured using Doppler ultrasonogaphy right creation of the brachiocephalic fistula can predictAVF maturation. Statistic analisis use Mann Whithey and Chi Squere. Result no correlation PSVwith maturation, The intraoperative Bloodflow rate 259,43 ml/min and post operative 6 week679,22 ± 65,36 ml/min, maybe used as a guide to decide whether or not a corrective procedurewas needed to repair the brachiochephalic and consequently help in reducing the rate of AVFmaturation failure.;Hemodialisis as treatment for renal replacement often patient chronic renal disease grade 5.Vascular access for hemodialysis its associated problems is the leading cause for hospitaladmission and morbidity.Maturation failure is impeded by issues of maturation. The result fromthis study showed that correlation peak sistolik velocity brakial artery and bloodflow ratemeasured using Doppler ultrasonogaphy right creation of the brachiocephalic fistula can predictAVF maturation. Statistic analisis use Mann Whithey and Chi Squere. Result no correlation PSVwith maturation, The intraoperative Bloodflow rate 259,43 ml/min and post operative 6 week679,22 ± 65,36 ml/min, maybe used as a guide to decide whether or not a corrective procedurewas needed to repair the brachiochephalic and consequently help in reducing the rate of AVFmaturation failure.;Hemodialisis as treatment for renal replacement often patient chronic renal disease grade 5.Vascular access for hemodialysis its associated problems is the leading cause for hospitaladmission and morbidity.Maturation failure is impeded by issues of maturation. The result fromthis study showed that correlation peak sistolik velocity brakial artery and bloodflow ratemeasured using Doppler ultrasonogaphy right creation of the brachiocephalic fistula can predictAVF maturation. Statistic analisis use Mann Whithey and Chi Squere. Result no correlation PSVwith maturation, The intraoperative Bloodflow rate 259,43 ml/min and post operative 6 week679,22 ± 65,36 ml/min, maybe used as a guide to decide whether or not a corrective procedurewas needed to repair the brachiochephalic and consequently help in reducing the rate of AVFmaturation failure.;Hemodialisis as treatment for renal replacement often patient chronic renal disease grade 5.Vascular access for hemodialysis its associated problems is the leading cause for hospitaladmission and morbidity.Maturation failure is impeded by issues of maturation. The result fromthis study showed that correlation peak sistolik velocity brakial artery and bloodflow ratemeasured using Doppler ultrasonogaphy right creation of the brachiocephalic fistula can predictAVF maturation. Statistic analisis use Mann Whithey and Chi Squere. Result no correlation PSVwith maturation, The intraoperative Bloodflow rate 259,43 ml/min and post operative 6 week679,22 ± 65,36 ml/min, maybe used as a guide to decide whether or not a corrective procedurewas needed to repair the brachiochephalic and consequently help in reducing the rate of AVFmaturation failure."

"Hemodialisis merupakan tatalaksana renal replacement yang tersering pada pasien gagal ginjal kronik stadium 5, Akses vaskular dan morbiditas sebagai akibat komplikasi akses merupakan penyebab utama perawatan di rumah sakit. Pada tahun 1989 sampai sekarang posisi tip pada pemasangan kateter double lumen masih belum ada keseragaman. Inti dari perbedaan ini adalah kepentingan terhadap keselamatan pasien dan keinginan untuk kinerja kateter yang optimal dalam hal ini untuk akses hemodialisa yang adekuat. Rancangan penelitian adalah sebuah penelitian prospektif potong lintang terhadap pasien gagal ginjal yang menjalani hemodialisa dengan menggunakan CDL tunneling. Penelitian ini merupakan penelitian analitikkorelatif, mencari korelasi antara posisi tip CDL tunneling dengan lancar atau tidak lancarnya selang CDL dan kekuatan tarikan quick blood saat hemodialisa. Hasil yang didapatkan posisi rontgen thorax CAJ lebih memberikan kenyamanan pada pasien dibandingkan dengan posisiSVC. Uji statistic menunjukkan bahwa terdapat hubungan yang signifikan antara Ro Thorax dengan kenyamanan (p<0.05). Posisi tip di SVC memiliki blood flow <300 mL. sedangkan pada pasien dengan posisi tip di CAJ memiliki blood flow >300 mL. Uji statistic menunjukkan hubungan yang tidak signifikan antara ro thorax dengan blood flow (p>0.05).

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Hemodialysis is the most common procedure of renal replacement in patients with stage 5 chronic renal failure, vascular access complications and morbidity as a result of access is a major cause of hospitalization. In 1989 to the present position of the tip of double lumen catheter is still no uniformity. The core of this difference is of interest to patient safety and the desire for optimal performance in terms of catheters for hemodialysis access adequate. The study design was a prospective cross-sectional study of patients with renal failure undergoing hemodialysis using tunneling CDL. This research is a correlative analytic, looking for a correlation between the position of the tunneling tip CDL smoothly or not smooth hose pull quick CDL and force of blood when hemodialysis. The results obtained CAJ thorax X-ray positioning more comfortable for patients compared to the SVC. Statistical test shows that there is a significant relationship between Ro Thorax with comfort (p <0.05). Position tip at SVC have blood flow <300 mL. whereas in patients with tip position in the CAJ have blood flow> 300 mL. Statistical tests showed no significant association between ro thorax with blood flow (p> 0.05).

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"ABSTRAK Objektif : Penyakit arteri periper PAP atau periperal artery Disease PAD merupakan penyakit obstruktif pda extremitas bawah yang dihubungkan dengan kondisi kritis iskemik exremitas bawah dengan resiko amputasi. Kegagalan pada penyembuhan luka operasi pasca below knee amputasi adalah multi faktorial, salah satunya ditekankan kepada penilaian kualitas aliran darah pada tingkat level amputasi.Ultrasonografi merupakan alat pemeriksaan yang cukup ideal untuk menilai kondisi arteri pada extermitas, oleh karena itu penelitian ini dilakukan untuk mencari hubungan antara hasil pemeriksaan ultrasonografi dengan kesembuhan luka operasi below knee amputasi extermitas yang nantinya di jadikan indikator prediktif kesembuhan. Metode : Penelitian ini menggunakan studi case control retrospektif untuk mencari hubungan hasil pemeriksaan ultrasonografi peak systolic, diameter, volume flow, spectral wave arteri poplitea, arteri tibia anterior dan arteri tibia posterior pada pasien yang menderita penyakit arteri periper PAP di RSUPN Cipto Mangunkusumo, RSUP Fatmawati dan RSUD Tangerang dari tahun 2015-2017 dengan kesembuhan luka operasi below knee amputasi. Hasil : Dari penelitian yang dilakukan pada 58 pasien pada Arteri Poplitea memiliki nilai mean Peak Systolic Velocity PSV 72,22 11,5 cm/s , diameter 0,52 0,008 cm. dan volume flow 109,3 30 ml/min. Arteri Tibia Anterior memiliki Peak Systolic Velocity PSV rata-rata 45,65 3,5 cm/s, diameter 0,25 0,01 cm dan 47,9 5,2 ml/min. Arteri Tibia Posterior memiliki Peak Systolic Velocity PSV rata-rata 42,6 2,76 cm/s, diameter 0,25 0,01 cm dan 34,07 3,7 ml/menit. Semua hasil pemeriksaan ultrasonografi menujukan hasil yang signifikan dengan kesembuhan p ABSTRACT Objective Peripheral artery disease PAD is an obstructive disease of lower extremity associated with critical ischemic condition of the lower exremitas with the risk of amputation. Failure in wound healing operations after below knee amputation is multi factorial, one of which is emphasized on the assessment of the quality of blood flow at the level of amputation levels. Ultrasonography is an ideal examination tool to assess the condition of the arteries in the extermitas, therefore this study was conducted to find the relationship between ultrasonografy examination results with wound healing operations below knee amputation extermitas which later on make predictive indicator of healing. Metode This study used a retrospective case control study to investigate the relationship of ultrasound examination results peak systolic, diameter, volume flow, spectral wave popliteal artery, anterior tibial artery and posterior tibial artery in patients with peripheral artery disease PAP at RSUPN Cipto Mangunkusumo, RSUP Fatmawati and RSUD Tangerang from 2015 2017 with wound healing operation below knee amputation. Result From the research conducted on 58 patients in Poplitea Artery has mean value of Peak Systolic Velocity PSV 72,22 11,5 cm s, diameter 0,52 0,008 cm. And the flow volume is 109.3 30 ml min. Anterior Tibia Artery has Peak Systolic Velocity PSV averaging 45.65 3.5 cm s, diameter 0.25 0.01 cm and 47.9 5.2 ml min. Tibia Posterior Artery has Peak Systolic Velocity PSV averaging 42.6 2.76 cm s, diameter 0.25 0.01 cm and 34.07 3.7 ml min. All ultrasound examination results showed significant results with a growth rate of p "

"ABSTRAK Aterosklerosis adalah penyakit sistemik, Peripheral artery disease PAD dan Carotid artery stenosis CS secara luas mencakup penyakit vaskular yang keduanya dikenal sebagai manifestasi spesifik aterosklerosis. Mengingat etiologi umum aterosklerosis perifer yang bisa terjadi di lokasi vaskular yang berbeda, keberadaan penyakit di satu tempat meningkatkan frekuensi penyakit simptomatik dan asimtomatik di tempat lain. Karena keduanya memiliki penyebab yang sama, maka terdapat hipotesis bahwa keduanya berkorelasi satu sama lain. Tujuan penelitian adalah untuk mengetahui faktor-faktor risiko yang berhubungan dengan Carotid artery stenosis CS pada pasien lower extremityPeripheral artery disease PAD berat serta mengetahui prevalensi Carotid artery stenosis CS dan ketebalan Intimal media thicknes IMT pada pasien dengan penyakit lower extremity Peripheral artery disease PAD berat. Penelitian ini dilakukan di RSUPN Cipto Mangunkusumo selama Februari-Mei 2018. Penelitian ini bersifat prospektif, data diambil dari data sekunder berdasarkan anamnesis dan hasil laboratorium sedangkan derajat stenosis dan intimal media thickness dilakukan carotid duplex ultrasound DUS dengan United imaging ultrasound menggunakan probe 8,5 Mhz. Data dikumpulkan, direvisi, dikodekan dan dimasukkan ke paket statistik untuk ilmu sosial SPSS versi 20 dan yang berikut ini dilakukan : Data kualitatif disajikan sebagai jumlah dan persentase sementara data kuantitatif disajikan sebagai rata-rata, standar deviasi, rentang median dan interkuartil. Kurva karakteristik operasi penerima digunakan untuk menilai titik potong terbaik dengan sensitivitas, spesifisitas, nilai prediksi positif dan nilai prediktif negatif. Interval kepercayaan ditetapkan 95 dan margin kesalahan ditetapkan hingga 5 sehingga p-value dianggap signifikan sebagai P> 0,05. Hasil penelitiandidapatkan 50 subjek dengan rentang umur antara 49-80 tahun 63,8 8,8 tahun , dimana yang berjenis kelamin laki-laki sebanyak 31 62 , dan perempuan sebanyak 19 38 . Didapatkan korelasi antara hiperkolesterol dan riwayat merokok dengan derajat Carotid Stenosis dengan nilai ABSTRACT Atherosclerosis is a systemic disease, Peripheral arterial disease PAD and Carotid artery stenosis CS widely include vascular disease bothh known as specific manifestation of atheroscleroris. Given the common etiology of peripheral atherosclerosis that can occur in different vascular sites, the presence of disease in one place increases the frequency of symptomatic and asymptomatic disease elsewhere. Since both have the same cause, there is a hypothesis that the two are correlated with each other. The objective of the study were to investigate the risk factor associated with Carotid artery stenosis CS in patients with severe lower extremity Peripheral arterial disease PAD and to know the prevalence of Carotid artery stenosis CS and degree of Intimal media thickness IMT in patients with severe lower extremity Peripheral arterial disease PAD . This research was conducted at Cipto Mangunkusumo General Hospital during February-May 2018. This is prospective research, the data was taken from secondary data based on hystory taking and laboratory result while the degree of stenosis and intimal media thickness is carotid duplex ultrasound DUS with United imaging ultrasound, using linier probe 8,5 Mhz. Data are collected, revised, encoded and fed into statistical package for social-science SPSS version 20, and the following are performed : Qualitative data are presented as quantities and percentages while quantitative data are presented as mean, standart deviation, median and interquartile range. The reciever operating characteristic curve is use to asses the best ctoff point with sensitivity, specificity, positive predictive value and negative predictive value. The confidence interval is set 95 and the margin error is set to 5 so p-value is considered significant as p"