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Abstrak :
Latar Belakang : Tuberkulosis endobronkial (TBEB) adalah salah satu bentuk TB yang terus menjadi masalah kesehatan karena komplikasi berupa bronkostenosis yang tetap terbentuk walaupun sudah mendapatkan obat antituberkulosis (OAT). Gejala dan tanda pernapasan yang tidak khas menyebabkan sering terjadi keterlambatan dan kesalahan diagnosis. Rumah Sakit Rujukan Respirasi Nasional (RSRRN) Persahabatan belum memiliki data mengenai keberhasilan pengobatan TBEB setelah pemberian OAT. Metode : Penelitian ini merupakan penelitian retrospektif pada pasien dengan diagnosis TBEB berdasarkan data bronkoskopi dan rekam medis sejak bulan Januari 2013 sampai Desember 2017. Diagnosis TBEB ditegakkan berdasarkan hasil pemeriksaan mikrobiologi, histopatologi atau berdasarkan kombinasi gejala klinis, radiologis dan tampilan lesi bronkoskopi. Pengobatan TBEB dianggap berhasil bila terdapat perbaikan klinis disertai perbaikan atau jumlah lesi TBEB tidak berkurang dan tampilan radiologi. Hasil :Sampel penelitian terdiri dari 30 subjek. Mayoritas subjek adalah perempuan (86,7%), usia <20-39 tahun (73,3%), berpendidikan tinggi (90%), tidak bekerja (56,6%), status gizi kurang (58,3%), belum pernah mendapat OAT (63,3%), tidak ada riwayat kontak TB (83,4%), tidak merokok (86,7%) dan tidak ada komorbid (76,6%). Sesak napas (83,3%) merupakan gejala respirasi yang paling sering dikeluhkan pasien. Stridor dan ronki merupakan tanda yang paling sering didapat (36,7%).Infiltrat, fibroinfiltrat dan konsolidasi merupakan gambaran radiologis yang paling sering didapat pada foto toraks (26,6%). Sedangkan pada CT scan toraks paling banyak didapatkan gambaran konsolidasi (45%). Lesi TBEB terbanyak didapatkan di trakea (60%) dan berbentuk fibrostenosis 86,7%). Tujuh puluh persen pasien mendapat pengobatan OAT jenis non KDT, mendapat steroid inhalasi (73,3%) dengan median lama pengobatan TBEB adalah 12 bulan. Keluhan membaik setelah pemberian OAT dari klinis pada 76% pasien, bronkoskopi 20% pasien, foto toraks 23% pasien dan CT scan 16,6% pasien. Kesimpulan: Keberhasilan pengobatan TBEB adalah 43%, sebanyak 17% keluhan membaik disertai sekuele dan 40% tidak dapat dinilai. ......Background: Endobronchial tuberculosis (EBTB) is a special form of respiratory tuberculosis that continues to be a health problem because bronchostenosis may develop as a serious complication despite efficacious antituberculosis chemotherapy. The EBTB has nonspesific signs and symptoms, therefor it may cause misdiagnosis and delayed diagnosis. Persahabatan National Respiratory Referral Hospital doesnt have data about successful treatment of EBTB Method: This was a retrospective study of EBTB patients based from the medical record and confirm with bronchoscopy data from January 2013 to December 2017. Endobronchial tuberculosis diagnosed based from microbiology, histopathology examination or based on combination of clinical symptoms, radiology and bronchoscopy lesion appearance. Endobronchial tuberculosis treatment considered successful if there is improvement in clinical symptoms, microbiological conversion, accompanied by improvement or no change in the number of lesions or the radiological appearance. Results: The study sample consisted of 30 subjects. Majority of the subjects were female (86,7%), age <20-39 years (73,3%), highly educated (90%), not working (56,6%), malnutrition (58,3%), never received antituberculosis medication (63,3%), not smoking (86,7%) and has no comorbidities (76,6%). Shortness of breath (83.3%) is the most complained symptom. Stridor and rhonchi are the most frequent signs (36.7%). Infiltrate, fibroinfiltrates and consolidation are the most common radiological images on chest X-ray (26.6%). Whereas most chest CT scans obtained a consolidated picture (45%). Most EBTB lesions were fibrostenosis (86,7%) found in the trachea (60%). Seventy percent of patients received non fix dose combination (FDC) type antituberculosis treatment (ATT), received inhaled steroids (73.3%) with a median duration of TBEB treatment was 12 months. Complaints improved after administration of ATT in clinical symptoms in 76% of patients, bronchoscopy 20% patients, chest X-ray 23% patients and CT scans 16.6% patients. Conclusion: The success of EBTB treatment is 43%, as many as 17% of complaints improve with sequels and 40% cannot be assessed.

Abstrak :
Latar Belakang: Bronkoskopi adalah prosedur yang umum digunakan sebagai tindakan membantu penegakkan diagnosis kasus tumor paru. Hipoksemia disebut sebagai salah satu komplikasi yang sering terjadi pada bronkoskopi diagnostik oleh karena itu diperlukan data untuk mengetahui faktor yang berpengaruh dan dampak klinis yang ditimbulkan. Metode: Penelitian ini menggunakan desain potong lintang pada pasien tumor paru yang menjalani bronkoskopi diagnostik dan dilakukan selamaJanuari-April 2019 di Rumah Sakit Umum Pusat Rujukan Respirasi Nasional (RSUPRRN) Persahabatan Jakarta. Total 195 pasien diikutsertakan dan dilakukan pengamatan terhadap nilai saturasi oksigen pada tahap premedikasi, durante, pascatindakan. Hipoksemia adalah subjek dengan saturasi oksigen<90% dan diamati berbagai faktor yang dianggap berpengaruh dan dampak klinis yang terjadi. Hasil:Jumlah kejadian hipoksemia pada bronkoskopi diagnostik sebanyak 40 kasus (20,5%). Waktu kejadian hipoksemia paling banyak pada tahap durante tindakan (20%) dengan median lama hipoksemia berlangsung 15 detik. Proporsi waktu muncul hipoksemia terjadi paling banyak pada 10 menit pertama tindakan (11,3%). Faktor demografi yang bermakna terhadap kejadian hipoksemia adalah jenis kelamin (p=0,04) dan riwayat merokok (p=0,005). Faktor yang dianggap berpengaruh dan memiliki hubungan bermakna dengan kejadian hipoksemia antara lain lama waktu tindakan dan timbulnya komplikasi (p<0,05). Total 5 pasien dirawat pascatindakan di ruang intensif dan tidak ada kasus kematian yang dilaporkan. Kesimpulan: Penelitian ini mendapatkan jenis kelamin, riwayat merokok, lama waktu tindakan dan timbulnya komplikasi menjadi faktor yang berpengaruh terhadap kejadian hipoksemia pada tindakan bronkoskopi diagnostik kasus tumor paru. Hipoksemia yang muncul pada bronkoskopi diagnostik kasus tumor paru tidak menimbulkan dampak klinis yang fatal seperti kematian pada penelitian ini. ......Background: Bronchoscopy is a commonly medical procedure perfomed for diagnose lung tumor cases. Hypoxemia often appear as complication related diagnostic bronchoscopy. Therefore, there is a need of research data to knowing related factors and clinical consequences may occur ahead. Methods:Design of this study is cross sectional with suspicion lung malignancy population who undergoing diagnostic bronchoscopy from January until april 2019 at National Respiratory Center Persahabatan General Hospital Jakarta. Total 195 consecutive patients participated dan observed for oxygen saturation in premedication, during and post-bronchoscopy. Hypoxemia was defined as an desaturation <90% and reviewed several related factor and clinical consequences may appear Results:Total hypoxemia events on diagnostic bronchoscopy was 40 cases (20,5%). The most frequent occurrence hypoxemia time is during bronchoscopy (20%) with median duration of hypoxemia is 15 seconds. The proportion of time appears hypoxemia is commonly in first 10 minutes bronchoscopy (11,3%). Demographic factors like gender and smoking history are statistically significant with hypoxemia events (p=0,04 & p=0,005). Other factors may have relation dan statiscally significant are duration of procedure and procedure with complication (p<0,05). Total 5 cases observed in intensive care unit after procedure and no death event have reported in this study Conclusion:This study suggested gender, smoking history, duration of procedure and procedure with complication were related factors with hypoxemic events in lung tumor cases undergoing diagnostic bronchoscopy. Hypoxemia related diagnostic bronchoscopy in this study was not rise into fatal event.

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ABSTRAK
Latar Belakang: Penyakit infeksi paru menjadi masalah utama kesehatan di Indonesia, termasuk mikosis paru yang disebabkan oleh infeksi, kolonisasi jamur maupun reaksi hipersensitif terhadap jamur. Bronkoskopi sebagai alat diagnostik untuk melihat gambaran lesi endobronkial dan mengambil bahan klinis seperti bronchoalveolar lavage BAL dan bilasan bronkus. Pemeriksaan biakan jamur dari bahan klinis bronkoskopi dapat membantu penegakan diagnosis mikosis paru.Metode: Studi deskriptif potong lintang pada pasien bronkoskopi yang dilakukan pemeriksaan biakan jamur dari BAL dan bilasan bronkus. Jumlah sampel adalah total sampling sejak Januari 2016 sampai dengan Desember 2017. Penelitian dilakukan di SMF Paru RSUP Persahabatan.Hasil: Bahan klinis dari bronkoskopi pada penelitian ini berupa bilasan bronkus sebanyak 67 buah dan BAL sebanyak 21 buah. Dari bahan klinis didapatkan hasil biakan tumbuh jamur sebanyak 35 buah dan tidak tumbuh jamur sebanyak 53 buah.Jenis jamur yang tumbuh adalahCandida sp. dengan spesies terbanyak Candida albicans sebanyak 30 isolat, Candida parapsilosis sebanyak 3 isolat, serta spesies Candida glabratadanCandida tropicalis masing-masing sebanyak 1 isolat.Kesimpulan: Bahan bronkoskopi BAL dan bilasan bronkus dapat digunakan untuk pemeriksaan biakan jamur.Kata Kunci: biakan jamur, bronkoskopi, bronchoalveolar lavage, bilasan bronkus.

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Background: ABSTRACT
Lung infection diseases become health main problem in Indonesia, including lung mycosis caused by infection, fungal colonization or hypersensitivity reaction against the fungal. Bronchoscopy is used as diagnostic tool to see endobronchial lesion and to gain clinical specimens such as bronchoalveolar lavage BAL and bronchial washing. Fungal culture from clinical specimen of bronchoscopy can help diagnosing lung mycosis.Method: Cross sectional descriptive study of bronchoscopy patients with fungal culture assay from BAL and bronchial washing. Total sample is total sampling from January 2016 to December 2017. The study is in Department of Pulmonology and Respiratory Medicine, Persahabatan Hospital, JakartaResult: Clinical specimens from bronchoscopy in this study are 67 samples of bronchial washing and 21 samples of BAL. There are positive fungal growth in 35 samples and no fungal growth in 53 samples.All growing fungal come from Candida sp. with most species come from Candida albicans 30 isolates, followed by Candida parapsilosis 3 isolates, Candida glabrata and Candida tropicalis each one 1 isolate.Conclusion: Bronchoscopy samples of BAL and bronchial washing can be used forfungal culture assay examination.

Abstrak :
ABSTRAK
Background: diagnostic of pulmonary TB in HIV patients is a problem due to non specific clinical features, or radiological appearance. HIV patients with CD4≤200 cells/mL infected with M. tuberculosis have less capacity in containing M. tuberculosis, developing granulomas, casseous necrosis, or cavities. This condition is caused by weakend inflammatory which later reduced sputum production and may cause false negative result. This study aimed to assess differences in the positivity level of acid fast bacilli (AFB) and cultures of M. tuberculosis from non-bronchoscopic sputum (spontaneous and induced sputum) compared to bronchoscopic sputum (bronchoalveolar lavage) in HIV positive patients suspected pulmonary tuberculosis with CD4<200 cells/μL. Methods: this cross sectional study was conducted in adult HIV patients treated in Hasan Sadikin Hospital with CD4≤200 cells/μL suspected with pulmonary tuberculosis by using paired comparative analytic test. All patients expelled sputum spontaneously or with sputum induction on the first day. On the next day, bronchoalveolar lavage (BAL) was performed. The two samples obtained from two methods were examined by AFB examination with staining Ziehl Neelsen (ZN) and cultured of M. tuberculosis on solid media Ogawa on all patients. Positivity, sensitivity and increased sensitivity of AFB and culture of M. tuberculosis in the non bronchoscopic and bronchoscopic groups were compared. Results: there were differences in the positivity level of AFB with ZN staining between non-bronchoscopic and bronchoscopic groups which were 7/40 (17.5%) vs 20/40 (50.0%) (p<0.001). The differences between the cultures of non-bronchoscopic and bronchoscopic groups were 16/40 (40.0%) vs 23/40 (57.5%) (p=0.039). Bronchoscopic sputum increased the positivity level of the ZN AFB examination by 32.5% (from 17.5% to 50.0%) as well as on culture examination by 17.5% (from 40.0% to 57.5%). Conclusion: Bronchoalveolar lavage can improve the positivity level of smears and cultures in patients suspected of pulmonary TB in HIV patients with CD4<200 cells/μL.

Abstrak :
ABSTRAK
Latar belakang. Cedera inhalasi dapat terjadi saluran napas atas hingga bawah. Sebagai prediktor diagnosis cedera inhalasi di instalasi gawat darurat IGD masih terbatas pada temuan klinis adanya edema laring pada saluran napas atas. Bronkoskopi sebagai baku emas diagnostik cedera inhalasi belum dapat dilakukan di IGD. Penelitian ini dilakukan untuk mencari hubungan antara temuan klinis edema laring dengan temuan bronkoskopi pada pasien luka bakar dengan cedera inhalasi.Metode. Studi potong lintang retrospektif pada 18 subjek. Di IGD dilakukan laringoskopi untuk menilai adanya edema laring. Hanya subjek yang dilakukan pemasangan selang endotrakeal dan dilakukan bronkoskopi dimasukkan sebagai kriteria inklusi, sedangkan derajat cedera inhalasi dibagi menurut kriteria Chou yang diamati melalui bronkoskopi.Hasil. Subjek terbanyak pria yaitu 16 subjek. Usia berkisar antara 19-56 tahun. Luas luka bakar berkisar antara 5-95 . Dari 14 subjek didapatkan adanya edema laring. Dari 14 subjek yang didapatkan edema laring, 13 subjek terdapat cedera inhalasi. Hubungan antara temuan klinis edema laring dengan adanya cedera inhalasi yang diamati melalui bronkoskopi memiliki nilai sensitivitas 76,4 , spesifitas 0 .Kesimpulan. Adanya edema laring berhubungan dengan cedera inhalasi pada saluran napas bawah meski secara statistik belum signifikan serta belum mampu menunjukkan akurasi derajat cedera inhalasi.

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ABSTRACT
Background. Inhalation injury may occur from the upper until the lower respiratory tract. In the ER, diagnose of inhalation injury only suspected from the presence of laryngeal edema based on laryngoscopy. Bronchoscopy as a gold standard diagnostic of inhalation injury could not been done in the ER. This study was conducted to determine the association between clinical findings of laryngeal edema and bronchoscopic findings in burns which is suspected inhalation injury.Objectives. This study was conducted to determine the association between clinical findings of laryngeal edema and bronchoscopic findings in burns which is suspected inhalation injury.Materials and Methods. A retrospective cross sectional study was conducted in 18 subjects. In the ER laryngoscopy was performed to assess the presence of laryngeal edema. Only subjects which is intubated and bronchoscopy were included as inclusion. The degree of inhalation injury was divided according to the Chou criteria which is observed through bronchoscopy.Results. Subjects most are men 16 subjects. Age ranges from 19 56 years. Burns range between 5 95 . 14 subjects presences larygeal edema. Of the 14 subjects who had laryngeal edema, 13 subjects had inhalation injury. The association between laryngeal edema in the presence of inhaled injury observed through bronchoscopy has a sensitivity value of 76.4 , a specificity of 0 .Conclusions. In this study The presence of laryngeal edema associated with inhalation injury in the lower airway although not statistically significant and has not been able to show the accuracy of the degree of inhalation injury.

Abstrak :
Tingkat kecemasan akan meningkat pada pasien yang diduga menderita kanker paru, apalagi saat direncanakan tindakan invasif diagnostik bronkoskopi. Salah satu intervensi keperawatan mengurangi sensasi cemas adalah terapi pijat. Tujuan penelitian adalah untuk mengidentifikasi pengaruh terapi pijat terhadap tingkat kecemasan pasien suspect kanker paru yang akan menjalani tindakan bronkoskopi. Penelitian ini merupakan penelitian kuantitatif dengan bentuk quasi experiment dengan nonequivalent control group design. Teknik pengambilan sampel menggunakan teknik consecutive sampling (n = 28). Hasil penelitian menunjukkan ada perbedaan tingkat kecemasan antara kelompok kontrol dan intervensi : a) post-test I, Pvalue = 0,048 pada OR = 1 ,556; b) post-test II, Pvalue = 0,021 pada OR sebesar 1,750. Penelitian ini menyimpulkan ada pengaruh yang signifikan (p < 0,05) terapi pijat terhadap tingkat kecemasan pasien suspect kanker paru yang akan menjalani tindakan bronkoskopi. Penelitian ini merekomendasikan, terapi pijat dijadikan sebagai prosedur tetap tindakan mandiri keperawatan dalam menurunkan respon kecemasan pasien sebelum dilakukan tindakan bronkoskopi.