Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
Latar Belakang: Hipotermia pasca bedah merupakan kejadian yang umum terjadi pada pasien pascabedah, khususnya geriatri yaitu sebesar 70%. Hipotermia memiliki dampak serius, antara lain gangguan koagulasi dan perdarahan, gangguan metabolisme obat, infeksi, iskemia miokardial, aritmia, hospitalisasi lama, dan peningkatan morbiditas serta mortalitas pascabedah. Di Indonesia, khususnya di RSUPN dr. Cipto Mangunkusumo memiliki karakteristik distribusi status fisik preoperasi, jumlah pemberian cairan, dan indeks massa tubuh yang berbeda dari negara lain. Tujuan: Studi ini dilakukan untuk menganalisa hubungan status fisik preoperasi, jumlah pemberian cairan kristaloid intraoperasi, dan indeks massa tubuh terhadap hipotermia pascabedah pada pasien geriatri. Metode: Penelitian menggunakan metode potong-lintang dengan uji observasional terhadap 108 subjek penelitian dari rekam medis sejak November 2018-Januari 2019. Subjek penelitian adalah pasien geriatri yang telah menjalani pembedahan dalam anestesi umum dengan/tanpa anestesi regional dan dirawat di RSUPN dr. Cipto Mangunkusumo. Kriteria eksklusi yaitu pasien tidak memiliki catatan rekam medis lengkap, meninggal pada saat operasi atau saat tiba di rumah sakit, dan sudah mengalami hipotermia sebelum pembedahan. Hasil: Pada penelitian ini didapatkan proporsi hipotermia pascabedah pada pasien geriatri adalah 67,6%. Hasil penelitian antara hipotermia pascabedah dengan status fisik preoperasi, jumlah pemberian cairan kristaloid intraoperasi, dan indeks massa tubuh pada pasien geriatri yaitu nilai p = 0,997, p = 0,310, p = 0,413. Kesimpulan: Hipotermia pascabedah pada pasien geriatri tidak memiliki hubungan yang bermakna dengan status fisik preoperasi, jumlah pemberian cairan kristaloid intraoperasi, dan indeks massa tubuh pada pasien geriatri. ......Background: Postoperative hypothermia is commonly found in postoperative patients, especially in geriatrics, which is 70%. Hypothermia also has serious effects, including coagulation and bleeding disorders, drug metabolism disorders, infections, myocardial ischemia, arrhythmias, prolonged hospitalization, and increased postoperative morbidity and mortality. In Indonesia, especially in Centre Cipto Mangunkusumo Hospital subjects characteristics, the distribution of preoperative physical status, amount of fluid administration, and body mass index are different from other countries. Objective: This study was conducted to analyze the association between preoperative physical status, the amount of intraoperative crystalloid fluid administration, and body mass index for postoperative hypothermia in geriatric patients. Methods: This was a cross-sectional observational study which included 108 research subjects and obtained from the medical records since November 2018-January 2019. Subjects were geriatric patients who under going surgery with general anesthesia with/without regional anesthesia in Centre dr. Cipto Mangunkusumo Hospital. Exclusion criteria were patient who did not have a complete medical record, died during surgery or when arrived at the hospital, and had history of hypothermia before surgery. Results: In this study, the incidence of postoperative hypothermia among geriatric patients was 67.6%. The results of the study between postoperative hypothermia with preoperative physical status, the amount of intraoperative crystalloid fluid administration, and body mass index in geriatric patients were p = 0.997, p = 0.310, p = 0.413. Conclusion: Postoperative hypothermia in geriatric patients did not have significant association with preoperative physical status, amount of intraoperative crystalloid fluid administration, and body mass index in geriatric patients.

Abstrak :
[ABSTRAK
Latar belakang: Hipotermia pada bayi baru lahir (BBL) masih merupakan masalah utama dan menjadi penyebab morbiditas dan mortalitas. Angka kejadian hipotermia pada BBL rujukan saat datang di rumah sakit masih tinggi. Tujuan: Mengetahui hubungan antara hipotermia saat masuk Instalasi Gawat Darurat (IGD) dengan mortalitas pada BBL rujukan di RSUD Dr. Moewardi. Metode: Penelitian ini merupakan penelitian kohort prospektif yang dilakukan di RSUD Dr. Moewardi. Pengumpulan data dilakukan pada 1 Januari sampai 31 Maret 2015 terhadap pasien BBL rujukan.Variabel tergantung adalah mortalitas dan variabel bebas meliputi umur kehamilan, berat lahir, sepsis, gangguan napas berat, dan suhu saat masuk IGD. Data dianalisis dengan menggunakan metode chi-square dan regresi logistik dengan nilai p<0,05 dan 95 % Confidence Interval (CI). Hasil: Didapatkan 56 BBL rujukan dengan angka kejadian hipotermia 60,7% dan mortalitas 19,6%. Dari analisis chi-square didapatkan variabel umur kehamilan dan berat lahir tidak memenuhi syarat analisis multivariat (p>0,25). Dari analisis multivariat regresi logistik didapatkan gangguan napas berat berhubungan dengan mortalitas pada BBL rujukan yang secara statistik tidak bermakna (OR=5,250; IK 95%=0,894-30,820). Setelah dilakukan analisis multivariat regresi logistik untuk mendapatkan OR terkontrol didapatkan hubungan yang bermakna antara suhu saat masuk IGD (OR=11,04; IK 95%=1,180-103,274) dan sepsis (OR=8,028; IK95%= 1,650-39,053) dengan mortalitas BBL rujukan. Simpulan: Angka kejadian pada BBL rujukan hipotermia masih tinggi. Hipotermia saat masuk IGD dan sepsis merupakan faktor risiko mortalitas pada BBL rujukan.

---

ABSTRACT
Background.Hypothermia still as a mayor cause of neonatal morbidity and mortality. The incidence of hypothermia on admission is high. Objective. To analyzed the risk of mortality associated with hypothermia on admission in newborns reffered to Moewardi hospital Methods.A cohort prospectif study of neonate referred at Moewardihospital from January 1st to March 31st, 2015. Analyzed variables were gestational age, birth weight, septicaemia, severe respiratory distress and temperature on admission. Data were analyzed by chi-square and logistic regretion with 95% confidence interval (CI) Results. Out of 56 neonates referred, the incidence of hypothermia was 60,7% and mortality was 19,6%. Gestational age and birth weightwere not significant associated with neonates referred mortality (p>0,25). Multivariat logistic regression analysis revealed that severe respiratory distress was not statistically significant associated with neonates referred mortality (OR=5,250; 95% CI =0,894-30,820). Multivariat logistic regression analysis revealed that hypothermia on admission (OR=11,04; 95% CI= 1,180-103,274) and septicaemia [OR=8,028; 95% CI=1,650-39,053) were statistically significant associated with neonates referred mortality. Conclusion. The incidence of hypothermia on admission is high. Hypothermia on admission to be a risk factor for neonatal mortality., Background.Hypothermia still as a mayor cause of neonatal morbidity and mortality. The incidence of hypothermia on admission is high. Objective. To analyzed the risk of mortality associated with hypothermia on admission in newborns reffered to Moewardi hospital Methods.A cohort prospectif study of neonate referred at Moewardihospital from January 1st to March 31st, 2015. Analyzed variables were gestational age, birth weight, septicaemia, severe respiratory distress and temperature on admission. Data were analyzed by chi-square and logistic regretion with 95% confidence interval (CI) Results. Out of 56 neonates referred, the incidence of hypothermia was 60,7% and mortality was 19,6%. Gestational age and birth weightwere not significant associated with neonates referred mortality (p>0,25). Multivariat logistic regression analysis revealed that severe respiratory distress was not statistically significant associated with neonates referred mortality (OR=5,250; 95% CI =0,894-30,820). Multivariat logistic regression analysis revealed that hypothermia on admission (OR=11,04; 95% CI= 1,180-103,274) and septicaemia [OR=8,028; 95% CI=1,650-39,053) were statistically significant associated with neonates referred mortality. Conclusion. The incidence of hypothermia on admission is high. Hypothermia on admission to be a risk factor for neonatal mortality.]

Abstrak :
Bayi baru lahir post SC sangat rentan mengalami hipotermia, bagaimana upaya untuk mencegah dan mengatasinya merupakan tanggung jawab perawat dan tim memberikan asuhan keperawatan yang tepat. Tujuan karya ilmiah ini adalah untuk menganalisis optimalisasi asuhan keperawatam pada bayi baru lahir Post SC dengan pendekatan Teori Konservasi Levine. Metode karya ilmiah ini adalah studi kasus. Terdapat tiga kasus Bayi Post SC di ruang Perinatologi yang diberikan asuhan keperawatan dengan pendekatan Teori Konservasi Levine. Aplikasi Teori Konservasi Levine dengan memperhatikan Konservasi energi dan tiga konteks Integritas yaitu Integritas Struktural, Integritas Personal dan Integritas Sosial. Intevensi keperawatan yang dilakukan berdasarkan evidence based nursing yaitu rantai hangat dan manajemen suhu tubuh. Edukasi kepada perawat baru dengan menggunakan video dan lembar checklist persiapan SC, didapati efektif meningkatkan pengetahuan perawat untuk dapat mempersiapkan diri dan alat untuk pelaksanaan SC dengan tepat dan baik sesuai standard pada lembar cheklist yang ada. ...... Post SC newborns are very susceptible to hypothermia. Nurse and other clinicians are responsible to prevent hypothermia particularly in the first period of newborn life. The aim of this study is to analyze how to improve nursing care for Post SC newborns using concept of Levine's Conservation Theory. This study using a case study method. Respondents were three cases of Post SC neonatal in the Perinatology room were given nursing care with Levine's Conservation Theory concept. Application of Levine's Conservation Theory by recognizing to energy conservation and the three contexts of Integrity, that are Structural Integrity, Personal Integrity and Social Integrity. Nursing interventions based on evidence based nursing are warm chains and body thermal management. Education for new nurses using videos and SC preparation checklist sheets are effectived to improve the knowledge of nurses for preparing themselves and tools to appropriate a good SC implementation.