Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
ABSTRAK
Latar Belakang Mortalitas pasien dengan kandidiasis invasif cukup tinggi berkisar 30 ndash; 70 . Perbedaan angka mortalitas pada tiap tiap studi erat kaitannya dengan desain penelitian dan sampel penelitian. Data tentang profil dan faktor faktor yang berhubungan dengan mortalitas pada pasien sakit kritis dengan kandidiasis invasif yang ada di Indonesia belum ada.Tujuan Memberikan informasi profil kandidiasis invasif pada pasien sakit kritis beserta faktor faktor yang berpengaruh terhadap mortalitas sebagai upaya untuk meningkatkan kualitas tata laksana pasien sakit kritis dengan kandidiasis invasif. Metode Desain penelitian adalah cross sectional, mengumpulkan data dari rekam medis pada seratus dua pasien sakit kritis dengan diagnosa kandidiasis invasif. Pasien kandidiasis invasif adalah pasien dengan hasil kultur darah dan atau kultur cairan tubuh normal steril positif jamur spesies Candida. Data yang dikumpulkan meliputi data usia, spesies jamur candida penyebab infeksi, faktor risiko kandidiasis invasif, serta faktor faktor yang diduga berpengaruh terhadap mortalitas yaitu ada tidaknya kondisi sepsis, nilai APACHE, ada tidaknya kondisi gagal nafas, ada tidaknya gagal ginjal, waktu pemberian terapi antijamur, Charlson Index, dan tempat perawatan ICU atau Non ICU . Uji analisa bivariat dengan uji chi square dilakukan terhadap masing masing faktor yang diduga dengan mortalitas, yang dilanjutkan dengan uji multivariat regresi logistik untuk menilai faktor yang paling berhubungan terhadap mortalitas 30 hari. Hasil Dari 102 sampel penelitian didapatkan laki laki 52,9 dan perempuan 47,1 , Median usia 53 th. angka mortalitas 68,6 , Spesies candida penyebab terbanyak adalah Candida Tropicalis 34,3 dan Candida Parapsilosis 29,4 . Faktor risiko kandidiasis invasif terkait dengan penyakit dasar adalah sepsis 78,9 , keganasan 42,15 , diabetes melitus 29,4 , sedangkan terkait terapi atau tata laksana yang diberikan adalah penggunaan antibiotik spektrum luas 99 , kateter vena sentral 77,5 , serta pemberian nutrisi parenteral 70,6 . Dari uji multivariat regresi logistik diperoleh data faktor yang paling berpengaruh terhadap mortalitas 30 hari adalah sepsis berat p 0,001, OR 7,7, IK95 2,4 ndash; 24,6 , Charlson Index ge; 3 p 0,022, OR 3,5, IK95 1,2 ndash; 10,2 , dan gagal nafas p 0,066, OR 2,7, IK95 0,9 ndash; 8,0 Simpulan Pada pasien sakit kritis dengan kandidiasis invasif yang dirawat di RSCM laki laki lebih banyak dari perempuan, dengan median usia 53 tahun, dengan angka mortalitas 68,6 . Spesies candida terbanyak penyebab infeksi adalah Candida Tropicalis dan Candida Parapsilosis. Faktor risiko kandidiasis invasif terkait penyakit dasar adalah sepsis, sedangkan terkait tata laksana perawatan yang terbanyak adalah penggunaan antibiotik spektrum luas. Sedangkan faktor faktor yang berhubungan dengan mortalitas 30 hari adalah kondisi sepsis berat, dan Charlson index ge;3. Kata Kunci Kandidiasis invasif, sakit kritis, faktor mortalitas. < hr> b>ABSTRACT
ABSTRACTName Ardi ArdianMajor Internal Medicine Faculty of MedicineTitle Factors related to a 30 day mortality in Critically Ill Patients with Candidiasis Invasive in Cipto Mangunkusumo hospital Background. Mortality rate candidiasis invasive is still high, approximately 30 70 . Every study has a variety mortality rate depend on study design and sample. There is no data in Indonesia about profile and mortality factors analysis in critically ill patients with candidiasis invasive . Objectives To give information about candidiasis invasive profile and to evaluate some factors relate to 30 days mortality in critically ill patients with candidiasis invasive in Cipto Mangunkusumo Hospital, Jakarta.Method. The Study design was Cross Sectional. We studied 102 hospitalized critically ill patients with candidiasis invasive. The demographic, clinical and laboratory data, the risk factors for candidiasis invasive and the outcome of each patient in 30 days were recorded. An analysis bivariate with chi square or Fisher rsquo s test was carried out to analyse some factors such as age 60 years old, severe sepsis, APACHE score 20, respiratory failure, renal failure, delayed antifungal treatment 72 hours after positive culture, Charlson index score, and ICU or Non ICU patients. The logistic regression of multivariate analysis was carried out to identify the most influence of all mortality factors. Result. Among 102 identified sample, the majority was male 52.9 , the median age was 53 years old and the mortality rate was 68,6 . Laboratory candida findings came from blood sample candidemia 98,03 , liquor cerebrospinal 1,5 and retina exudat 1,5 . The most common candida species was Candida Non Albicans especially Candida Tropicalis 34,3 and Candida Parapsilosis 34,3 . The risk factors for Candidiasis invasive from this study, relate to underlying disease were sepsis 78,9 , malignancy 42,15 , diabetes mellitus 29,4 and relate to therapy or treatment were the usage of broad spectrum antibiotic 99 , catheter vena central 77,5 , and parenteral nutrition 70,6 . The result from multivariate analysis, severe sepsis p 0,001, OR 7,7, IK95 2,4 ndash 24,7 , Charlson Index ge 3 p 0,022, OR 3,5, IK95 1,2 ndash 10,2 , and respiratory failure p 0,066, OR 2,7 IK95 0,9 ndash 8,0 were independently asscociated with mortality.Conclusion. Critically ill patients with candidiasis invasive in Cipto Mangunkusumo hospital, male was predominan than female, median age was 53 years old, and mortality rate was 68,6 . The two most species candida caused infection were Candida Tropicalis and Candida Parapsilosis. The most risk factors of candidiasis invasive from underlying disease was sepsis and the one from the treatment was the usage of broad spectrum antibiotic. Severe sepsis, and Charlson index ge 3 were associated with a 30 day mortality in critically ill patients with candidiasis invasive.. Key words Candidiasis invasive, Critically ill, Mortality factors

Abstrak :
Selama proses rawat inap, anak-anak menghadapi berbagai stresor yang dapat memengaruhi kondisi fisik anak-anak. Salah satu dampak fisik yang terjadi pada anak adalah penurunan berat badan, dikenal sebagai malnutrisi di rumah sakit (HaM). Penyebabnya HaM termasuk parah atau kritis penyakit, status gizi pada saat masuk, jenis diet, dan lama tinggal. Itu Tujuan dari penelitian ini adalah untuk melihat hubungan antara karakteristik klien anak dan kejadian HaM. Desain penelitian adalah kohort prospektif. Dalam studi ini, variabel independen adalah karakteristik anak-anak yang dirawat di rumah sakit (usia, jenis kelamin, status gizi pada saat masuk, dan jenis diet yang diberikan), dan tanggungannya variabelnya adalah kejadian HaM. Jumlah sampel dalam penelitian ini adalah 107 anak-anak yang dirawat di rumah sakit di HCU dan PICU. Data dianalisis menggunakan uji Chi-square. Hasil penelitian menunjukkan bahwa hanya jenis diet yang memiliki hubungan signifikan terhadap kejadian dari HaM. Rekomendasi penelitian ini adalah agar tim kesehatan dapat melakukan pemeriksaan HaM dan membuat dokumentasi yang akurat.

---

During the process of hospitalization, children face various stressors that can affect physical condition of children. One physical impact that occurs in children is weight loss, known as hospital malnutrition (HAM). The reasons for human rights include severe or critical illness, nutritional status at entry, type of diet, and length of stay. That The purpose of this study is to look at the relationship between the characteristics of child clients and the human rights incident. The study design was a prospective cohort. In this study, The independent variable is the characteristics of children who are hospitalized (age, sex, nutritional status at entry, and type of diet provided), and dependents the variable is the occurrence of Human Rights. The number of samples in this study was 107 children who are hospitalized in HCU and PICU. Data were analyzed using Chi-square test. The results showed that only the type of diet that has a significant relationship with incidence from HA. The recommendation of this study is for the health team to do inspection of human rights and making accurate documentation.

Abstrak :
Contents Recognition & management of the deteriorating patient -- Assessment of the critically ill patient -- Monitoring respiratory function -- Monitoring cardiovascular function 1 : ECG monitoring -- Monitoring cardiovascular function 2 haemodynamic monitoring -- Monitoring neurological function -- Monitoring renal function -- Monitoring gastrointestinal function -- Monitoring hepatic function -- Monitoring endocrine function -- Monitoring nutritional status -- Monitoring temperature -- Monitoring pain -- Monitoring a patient receiving a blood transfusion -- Monitoring the patient with infection and related systemic inflammatory response -- Monitoring the critically ill, pregnant patient -- Monitoring the critically ill child -- Monitoring during transport -- Record keeping.

Abstrak :
Since the very beginning of critical care medicine, much attention has been paid to the risk of bleeding, but only recently the risk of thrombosis has been recognized in critical patients; in fact, current laboratory investigations aimed to monitor blood coagulation are more focused on the assessment of the hemorrhagic than of the thrombotic risk. Since mid-90s, many studies have detected powerful pro-thrombotic actions of endogenous mediators in sepsis and other inflammatory conditions, including trauma and postoperative status. Unfortunately, the related complication are both hard to detect and extremely harmful. The volume provides a full coverage of the hemocoagulative problems in anesthesia and intensive care, taking into consideration the physiology and monitoring of hemostasis, its relation with sepsis, and the specific aspects of the various critical conditions, from trauma to burns, to heart and transplant surgery or acute renal failure.

Abstrak :
Ulkus diabetikum merupakan salah satu komplikasi yang sering terjadi pada pasien diabetes mellitus. Ulkus diabetikum tidak hanya menyebabkan ketidaknyamanan fisik tetapi juga menyebabkan ketidaknyamanan psikologis berupa stres. Penelitian ini bertujuan untuk mengidentifikasi hubungan antara strategi koping dengan tingkat stres pada pasien ulkus diabetikum di Rumah Perawatan Luka RUMAT . Jenis penelitian ini adalah kuantitatif dengan desain cross-sectional, pengambilan sampel menggunakan metode purposive sampling sejumlah 93 responden pasien ulkus diabetikum . Sebanyak 93 pasien ulkus diabetikum diwawancarai dengan menggunakan Brief COPE untuk mengukur strategi koping dan Perceived Stress Scale untuk mengukur stres, kemudian dianalisis menggunakan uji t-independen. Hasil penelitian ini didapatkan bahwa terdapat hubungan yang bermakna antara emotion-focused coping dan stres p: 0,003, ?: 0,05 namun tidak terdapat hubungan bermakna antara problem-focused coping dengan stres p: 0,996; ?: 0,05. Penelitian ini merekomendasikan perlunya penelitian lanjutan terkait aspek psikologis pasien ulkus diabetikum. ......Diabetic ulcer is one of the complications that occurs among diabetic patients. It caused physical discomfort and also psychological discomfort stress. This study aimed to identify correlation between coping strategy and stress on diabetic ulcer patients in RUMAT Wound Care. This research was quantitative with cross sectional design, using purposive sampling with 93 respondents. Total of 93 diabetic ulcer patients were interviewed using Brief COPE to measure coping strategies and Perceived Stress Scale to measure stress, then analyzed by independent t test. Results of this study found that there were significant correlation between emotion focused coping and stress p 0,003, 0,05 while there were no correlation between problem focused coping and stress p 0,996, 0,05 . This study recommended further research on psychological aspects of diabetic ulcer patients.

Abstrak :

---

ABSTRACT
This evidence-based text is the perfect resource for both practicing nurses and nursing students alike. Using the latest, most authoritative research, this book will help you identify priorities to accurately and effectively manage patient care. Content spans the areas of medication, patient safety, patient education, nursing diagnosis, and collaborative management and much more to equip you for success in all aspects of critical care nursing. This new edition also features new case studies, new QSEN-focused call-out boxes throughout the text, a complete digital glossary, and revised chapter summaries.

Abstrak :
This is the first comprehensive study guide covering all aspects of pediatric critical care medicine. It fills a void that exists in learning resources currently available to pediatric critical care practitioners. The major textbooks are excellent references, but do not allow concise reading on specific topics and are not intended to act as both text and study guide. There are also several handbooks available, but these are usually written for general pediatric residents and lack the advanced physiology and pathophysiology required for the higher level pediatric critical care practitioner