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Oktaviati
Diameter draining vena pasca operasi minggu pertama sebagai prediktor maturasi arteriovenous fistula avf = First week postoperative draining vein diameter as a predictor of arteriovenous fistula maturation avf
"[ABSTRAK
Pendahuluan Masalah utama pada ArterioVenous Fistula AVF adalah kegagalan maturasi Deteksi dini bahwa AVF akan mengalami gagal maturasi dibutuhkan sehingga memungkinkan untuk melakukan revisi atau membuat akses vaskular yang baru sesegera mungkin Diameter vena pra operasi adalah faktor prediktor independen dalam maturasi Tujuan penelitian ini adalah untuk mengetahui prediksi dini maturasi AVF berdasarkan peningkatan ukuran diameter draining vein pasca operasi minggu pertama Metode Penelitian dilakukan secara kohort retrospektif dengan mengambil data rekam medis pasien yang menjalani operasi pembuatan AVF di RSCM tahun 2013 2014 Diameter vena pra operasi dan diameter draining vein pasca operasi minggu pertama diukur dengan USG Doppler Peningkatan diameter draining vein pasca operasi minggu pertama dihubungkan dengan maturasi AVF Hasil Didapatkan 38 pasien dengan angka maturasi 81 6 Tidak didapatkan perbedaan maturasi yang bermakna pada usia jenis kelamin diabetes melitus hipertensi CHF CAD stroke hepatitis hiperlipidemia riwayat dilakukan AVF operator dan diameter arteri pra operasi Terdapat perbedaan yang bermakna pada AVF jenis radiosefalika dan brakiosefalika p 0 022 Didapatkan perbedaan maturasi yang bermakna pada diameter draining vein pasca operasi minggu pertama dan peningkatannya pada AVF tipe brakiosefalika p 0 034 dan p 0 041 dan radiosefalika p 0 012 dan p 0 011 Nilai cut off peningkatan diameter draining vein pasca operasi minggu pertama untuk batasan prediksi maturasi adalah 0 65 mm dengan sensitifitas sebesar 90 3 spesifisitas sebesar 85 7 Pada AVF tipe brakiosefalika nilai cut off adalah 0 45 mm dengan sensitifitas sebesar 95 8 spesifisitas sebesar 100 Pada AVF tipe radiosefalika nilai cut off adalah 1 00 mm dengan sensitifitas sebesar 85 7 spesifisitas sebesar 100 Simpulan Peningkatan diameter draining vein pasca operasi minggu pertama dapat dijadikan sebagai prediktor maturasi AVF ABSTRACT Introduction The main problem in ArterioVenous Fistula AVF is the failure of maturation Early detection for non mature AVF is needed making it possible to revise or create a new vascular access as soon as possible Preoperative vein diameter is considered to be an independent predictor factor in the maturation The purpose of this study was determining the early prediction of AVF maturation using the enlargement of draining vein diameter in the first week postoperative Methods Design of this study was cohort retrospective by taking patients medical records who underwent AVF surgery Vein diameter were measured preoperative and first week postoperative with Doppler ultrasound The enlargement of the first week draining vein diameter was associated with AVF maturation Results There was 38 patients with maturation rate was 81 6 There were no significant maturation differences on age sex diabetes mellitus hypertension CHF CAD stroke hepatitis hyperlipidemia AVF history operator and preoperative arterial diameter There was significant maturation difference in the radiocephalica and brachiocephalica AVF type p 0 022 There were significant maturation difference in first week postoperative draining vein diameter and it s increasement in brachiocephalica type p 0 034 and p 0 041 and radiocephalica type p 0 012 and p 0 011 Cut off value for first week postoperative draining vein diameter increasement in maturation prediction limitation is 0 65 mm with a sensitivity of 90 3 specificity of 85 7 For brachiocephalica type cut off value is 0 45 mm with a sensitivity of 95 8 specificity of 100 For radiocephalica type cut off value is 1 00 mm with a sensitivity of 85 7 specificity of 100 Conclusion First week postoperative draining vein diameter increasement can be used as predictors of AVF maturation ;Introduction The main problem in ArterioVenous Fistula AVF is the failure of maturation Early detection for non mature AVF is needed making it possible to revise or create a new vascular access as soon as possible Preoperative vein diameter is considered to be an independent predictor factor in the maturation The purpose of this study was determining the early prediction of AVF maturation using the enlargement of draining vein diameter in the first week postoperative Methods Design of this study was cohort retrospective by taking patients medical records who underwent AVF surgery Vein diameter were measured preoperative and first week postoperative with Doppler ultrasound The enlargement of the first week draining vein diameter was associated with AVF maturation Results There was 38 patients with maturation rate was 81 6 There were no significant maturation differences on age sex diabetes mellitus hypertension CHF CAD stroke hepatitis hyperlipidemia AVF history operator and preoperative arterial diameter There was significant maturation difference in the radiocephalica and brachiocephalica AVF type p 0 022 There were significant maturation difference in first week postoperative draining vein diameter and it s increasement in brachiocephalica type p 0 034 and p 0 041 and radiocephalica type p 0 012 and p 0 011 Cut off value for first week postoperative draining vein diameter increasement in maturation prediction limitation is 0 65 mm with a sensitivity of 90 3 specificity of 85 7 For brachiocephalica type cut off value is 0 45 mm with a sensitivity of 95 8 specificity of 100 For radiocephalica type cut off value is 1 00 mm with a sensitivity of 85 7 specificity of 100 Conclusion First week postoperative draining vein diameter increasement can be used as predictors of AVF maturation , Introduction The main problem in ArterioVenous Fistula AVF is the failure of maturation Early detection for non mature AVF is needed making it possible to revise or create a new vascular access as soon as possible Preoperative vein diameter is considered to be an independent predictor factor in the maturation The purpose of this study was determining the early prediction of AVF maturation using the enlargement of draining vein diameter in the first week postoperative Methods Design of this study was cohort retrospective by taking patients medical records who underwent AVF surgery Vein diameter were measured preoperative and first week postoperative with Doppler ultrasound The enlargement of the first week draining vein diameter was associated with AVF maturation Results There was 38 patients with maturation rate was 81 6 There were no significant maturation differences on age sex diabetes mellitus hypertension CHF CAD stroke hepatitis hyperlipidemia AVF history operator and preoperative arterial diameter There was significant maturation difference in the radiocephalica and brachiocephalica AVF type p 0 022 There were significant maturation difference in first week postoperative draining vein diameter and it s increasement in brachiocephalica type p 0 034 and p 0 041 and radiocephalica type p 0 012 and p 0 011 Cut off value for first week postoperative draining vein diameter increasement in maturation prediction limitation is 0 65 mm with a sensitivity of 90 3 specificity of 85 7 For brachiocephalica type cut off value is 0 45 mm with a sensitivity of 95 8 specificity of 100 For radiocephalica type cut off value is 1 00 mm with a sensitivity of 85 7 specificity of 100 Conclusion First week postoperative draining vein diameter increasement can be used as predictors of AVF maturation ]"
Fakultas Kedokteran Universitas Indonesia, 2015
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UI - Tugas Akhir  Universitas Indonesia Library
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Hendra Wibowo
Pengaruh Latihan Isometrik Terhadap Perubahan Diameter, Peak Systolic Velocity, Intima Media Thickness dan Volume flow Arteri Radialis dan Vena Cephalica Pada Pasien Gagal Ginjal Kronis Sebelum Tindakan Pembuatan Fistula Radiocephalica = Effect of Isometric Exercise on Changes in Vascular Diameter, Peak Systolic Velocity, Intima Media Thickness and Volume flow of Radial Artery and Cephalic Vein in Patients with Chronic Renal Failure Before Radiocephalic AV Fistula Making Procedure
"Penyakit Ginjal Kronik (PGK) merupakan kelainan struktur atau fungsi ginjal yang mengalami penurunan selama 3 bulan yang mengalami peningkatan prevalensi kasus. Peningkatan prevalensi kejadian PGK juga akan meningkatkan kebutuhan hemodialisis dan penggunaan arteriovenous fistula (AVF). Maturasi dan keberhasilan AVF dipengaruhi oleh faktor pasien dan struktur vaskular. Latihan isometrik dilaporkan dapat meningkatkan diameter vena, arteri, dan peak systolic velocity (PSV). Tujuan penelitian ini untuk melihat pengaruh latihan isometrik pre operatif terhadap diameter vena cephalica, diameter arteri radialis, PSV, intimal medial thickening (IMT), dan volume flow arteri radialis. Desain penelitian adalah eksperimental pre and post-test study, dilakukan di RSUPN Cipto Mangunkusumo. Penelitian dilaksanakan follow up pasien selama 8 minggu latihan isometri. Total subjek penelitian sebanyak 38 orang. Usia median subjek penelitian yaitu 56 tahun dengan rentang usia 20 sampai 71 tahun. Terdapat perbedaan yang signifikan antara diameter vena (p=0,003), PSV (p=0,032), dan volume flow (p=0,030) subjek penelitian pre dan post latihan isometrik. Terdapat perbedaan signifikan antara perubahan diameter vena terhadap komorbid diabetes melitus. Tidak terdapat perbedaan bermakna antara perubahan diameter vena, PSV, dan volume flow paska latihan ismoetrik terhadap kelompok usia, komorbid, dan jenis kelamin (p>0,005). Penggunaan latihan isometrik dapat meningkatkan perubahan diameter vena, PSV dan volume flow pada pasien sebelum pembuatan AVF radiocephalica. Tidak terdapat perubahan signifikan diameter vena pasca latihan isometrik pada penderita diabetes melitus.
Chronic Kidney Disease (CKD) is a disorder of kidney structure or function that has decreased over 3 months and has an increased prevalence of cases. The increasing prevalence of CKD will also increase the need for hemodialysis and the use of arteriovenous fistula (AVF). AVF maturation and success are influenced by patient factors and vascular structure. Isometric exercise is reported to increase the diameter of veins, arteries, and peak systolic velocity (PSV). Objective: Analyzing the effect of preoperative isometric exercise on the diameter of veins, arteries, PSV, intimal medial thickening (IMT), and volume flow. The research design was an experimental pre and post-test study, conducted at Cipto Mangunkusumo Center National Hospital. The study was conducted to follow up patients for 8 weeks of isometric exercise. The total study subjects were 38 people, with the highest prevalence being men, and comorbid hypertension. The median age of the research subjects was 56 years with an age range of 20 to 71 years. There were significant differences between venous diameter (p=0.003), PSV (p=0.032), and volume flow (p=0.030) in pre and post isometric training subjects. There was significant difference between cephalic vein diameter to diabetes mellitus group. There was no significant difference between changes in radial artery diameter, PSV, IMT, and post-isometric exercise volume flow for the age, comorbid, and sex groups (p>0.005). The use of isometric exercises can increase changes in venous diameter, PSV and volume flow in patients before the making of radiocephalic AVF. There was no significant change in venous diameter after isometric exercise in patient with diabetes mellitus.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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UI - Tugas Akhir  Universitas Indonesia Library
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Achroma Fora
Efek Far Infra-Red Therapy dan Latihan Isometrik Terhadap Diameter Pembuluh Darah, Peak Systolic Velocity, Volume Flow Arteri Radialis Dan Diameter Vena Cephalica Pada Pasien Penyakit Ginjal Tahap Akhir Yang Akan Dibuat Fistula Radiocephalica = Effect of Infrared Therapy and Isometric Exercise on Diameter, Peak Systolic Velocity, Volume Flow of Radial Artery and Cephalic vein diameter in Patients with End Stage Kidney Disease before Radiocephalica Fistula Creation
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Latar Belakang :

Jumlah kasus Pasien dengan Penyakit Ginjal Tahap Akhir (PGTA) terus meningkat, dan permintaan akan hemodialisis juga semakin melonjak. Arteriovenosa Fistula (AVF) menjadi pilihan utama dalam prosedur hemodialisis dan sering ditempatkan sedistal mungkin, namun tingkat keberhasilan cenderung rendah karena ukuran diameter yang tidak optimal. Latihan isometrik dan terapi Far Infrared (FIR) berpotensi untuk meningkatkan diameter, Peak Sistolyc Velocity (PSV), Volume flow arteri Radialis, serta diameter vena Cephalica pada pasien PGTA yang akan menjalani pembuatan AVF radiocephalica.

Tujuan Penelitian ini bertujuan untuk mengidentifikasi korelasi antara pemberian Terapi Far Infra-Red dan latihan isometrik terhadap diameter, PSV, dan aliran volume arteri radialis serta diameter vena cephalica pada pasien-pasien dengan penyakit ginjal tahap akhir yang akan menjalani pembuatan AVF Radiocephalica.

Metode penelitian dilakukan dengan rancangan penelitian eksperimental RCT (Randomized Controlled Trial) di ruang hemodialisis RSUPN Ciptomangunkusumo. Selama 4 minggu, kelompok eksperimen diberikan latihan isometrik dan terapi FIR, dan hasilnya kemudian dibandingkan dengan kelompok kontrol yang hanya diberikan Latihan isometrik

Hasil: Jumlah total subjek penelitian adalah 46 orang, dengan mayoritas perempuan (65,2%) dan komorbiditas Diabetes Melitus (37%). Median usia subjek adalah 54 tahun dengan rentang usia antara 18 hingga 73 tahun. Tersingkap adanya perbedaan signifikan secara statistik antara diameter arteri radialis (p<0.05), PSV arteri radialis (p<0,05), Volume Flow arteri radialis (p<0,05), dan diameter vena cephalica (p<0,05) pada subjek penelitian sebelum dan setelah menjalani latihan isometrik dan Terapi Far Infrared (FIR). Faktor risiko Diabetes Melitus (p<0,05) dan obesitas (p<0,05) juga terbukti memiliki pengaruh signifikan terhadap diameter vena cephalica.

Kesimpulan: Dapat disimpulkan bahwa aplikasi latihan isometrik dan Terapi Far Infrared (FIR) efektif dalam meningkatkan parameter-parameter seperti diameter arteri radialis, PSV arteri radialis, volume flow arteri radialis, serta diameter vena cephalica pada pasien dengan Penyakit Ginjal Tahap Akhir sebelum prosedur pembuatan AVF radiocephalica.

Background :The number of patients with End Stage Kidney Disease (ESKD) continues to increase, and the need for hemodialysis is also increasing. Arterivenosa Fistula (AVF) is the main access option for hemodialysis and is performed as distally as possible, but the success rate is not very high due to the diameter that is not optimal. The utilization of isometric exercise in conjunction with Far Infrared (FIR) therapy is potentially more effective in enhancing the diameter, Peak Systolic Velocity (PSV), Volume Flow of the Radial Artery, and the cephalic vein diameter in ESKD patients before the creation of radiocephalic AVF compared to using isometric exercise alone.

 

Objective: To determine the difference between isometric exercises combined with Far Infrared therapy and isometric exercise alone on the diameter, Peak Systolic Velocity (PSV), and volume flow of the radial artery, as well as the cephalic vein diameter in End-Stage Kidney Disease patients before radiocephalic AVF creation, compared to utilizing only isometric exercises as the standard procedure..

 

Methods: This study is an RCT (Randomized Controlled Trial) experimental study, conducted in the hemodialysis room of Ciptomangunkusumo Hospital. The study was conducted for 4 weeks of isometric exercise and FIR therapy, the results were compared with the control.

 

Results: The total study subjects were 46 people, mostly female (65.2%), comorbid Diabetes mellitus (37%). Median age was 54 years with a range of 18-73 years. There were statistically significant differences between radial artery diameter (p<0.05), radial artery PSV (p<0.001), radial artery flow volume (p<0.001), cephalic vein diameter (p<0.001) pre and post isometric exercise and FIR. Risk factors of diabetes mellitus (p <0.05) and obesity (p <0.05) have a significant change on the diameter of the cephalic vein.

 

Conclusion: The use of isometric exercise and FIR can increase radial artery diameter, radial artery PSV, radial artery flow volume and cephalica vein diameter in ESKD  patients before radiocephalica AVF creation.

 

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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2024
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UI - Tesis Membership  Universitas Indonesia Library