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"Pijat merupakan terapi sentuh tertua dalam metode pengobatan sejak lama. Tesis ini bertujuan mengetahui pengaruh terapi pijat terhadap bilirubin pada bayi hiperbilirubinemia yang menjalani fototerapi. Desain penelitian adalah quasi experiment nonequivalent control group, before-after design. Jumlah sampel 30 orang diambil secara non probability jenis consecutive samplin. Hasil penelitian menunjukan perberdaan bermaksan rata-rata penurunan level total serum bilirubin (TSB) pada kelompok kontrol dan intervensi sebesar 1,5mg/dL (p<0,05). Terapi pijat berpengaruh pada bayi yang mendapat fototerapi single. Dari hasil multivariat didapatkan bahwa jenis fototerapi paling berpengaruh terhadap penurunan level bilirubin. Hasil penelitian merekomendasikan penelitian lanjut tentang pengaruh terapi pijat terhadap perilaku bayi hiperbilirubinemia yang di fototerapi.

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Massage is the oldest touch therapy that used on the treatment since long ago. This thesis aims to determine the influence of massage therapy with bilirubin level on hyperbilirubinemia infant who undergoing phototherapy. The research design is quasi-experimental nonequivalent control group, before-after design. The samples were 30 infants that taken by non-probability method of consecutive sampling. Results showed that there were significant differences an average decrease of Total Serum Bilirubin (TSB) on control and intervention group 1,5mg/dL (p=0,05). Massage therapy were influence to infant who undergoing single phototherapy. The multivariate analyze showed that kind of phototherapy is the most influences to total serum bilirubin decrease. The results recommend further studies about the influence of massage therapy to infant behaviour as long as phototherapy."

"Ibu hamil merupakan salah satu kelompok yang sangat berisiko jika terpapar virus Covid-19 karena mengalami perubahan sistem imun dan fisiologis selama masa kehamilan. Akibat infeksi virus Covid-19 yang menyerang paru-paru dan kondisi ibu yang sedang hamil maka menambah keluhan sesak napas. Hal tersebut menyebabkan bayi yang berada dalam rahim ibu harus segera dilahirkan karena berpotensi tidak mendapatkan oksigen yang cukup. Oleh karena itu, berisiko bayi lahir prematur. Kondisi bayi yang prematur menyebabkan organ bayi belum berfungsi dengan baik sehingga terdapat beberapa kondisi akibat dari bayi lahir prematur, salah satunya yaitu bayi berisiko mengalami hiperbilirubinemia. By. Ny. E merupakan bayi perempuan yang lahir dari ibu terkonfirmasi positif Covid-19 derajat berat ARDS dengan usia gestasi 32 minggu (prematur). Saat bayi berusia 3 hari, bayi mengalami ikterik dengan kadar bilirubin yang tinggi. Salah satu intervensi utama untuk menurunkan kadar bilirubin yaitu dengan fototerapi. Pada kasus ini, bayi diberikan fototerapi selama 1x24 jam. Peran perawat sangat penting dalam pemberian fototerapi neonatus. Pada kasus ini, asuhan keperawatan yang dilakukan selama pemberian fototerapi diantaranya yaitu setiap 3 jam sekali bayi dilakukan pemeriksaan tanda vital dan mengganti popok bayi, tanda vital bayi dalam batas normal, bayi tidak mengalami hipertermia, diare maupun ruam kulit akibat dari pemberian fototerapi, kulit bayi terpapar sinar fototerapi dan hanya memakai popok dan penutup mata selama pemberian fototerapi, selain itu kadar bilirubin bayi menurun setelah diberikan fototerapi selama 1x24 jam.

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Pregnant women are one of the groups who are very at risk if exposed to the Covid-19 virus because they experience changes in the immune and physiological systems during pregnancy. Due to the Covid-19 virus infection that attacks the lungs and the condition of the mother who is pregnant, it adds to the complaint of shortness of breath. This causes the baby in the mother's womb to be born immediately because it has the potential to not get enough oxygen. Therefore, the risk of the baby being born prematurely. The condition of premature babies causes the baby's organs to not function properly so that there are several conditions resulting from premature babies, one of which is that babies are at risk for hyperbilirubinemia.Mrs. E’s baby is a baby girl born to a mother who was confirmed positive for COVID-19 with severe ARDS with a gestational age of 32 weeks (premature). When the baby is 3 days old, the baby has jaundice with high levels of bilirubin. One of the main interventions to reduce bilirubin levels is phototherapy. In this case, the baby was given phototherapy for 1x24 hours. The nurse's role is very important in the provision of neonatal phototherapy. In this case, the nursing care carried out during the provision of phototherapy includes every 3 hours the baby is checked for vital signs and changes the baby's diaper, the baby's vital signs is within normal limits, the baby does not experience hyperthermia, diarrhea or skin rash as a result of giving phototherapy, the baby's skin is exposed to sunlight phototherapy and wearing only a diaper and an eye patch during phototherapy, besides that, the baby's bilirubin level decreased after being given phototherapy for 1x24 hours. "

"Ikterus neonatorum merupakan kondisi pada neonatus karena peningkatan bilirubin dalam darah. Ikterus neonatus mempunyai tanda diantaranya kulit dan sklera yang kuning akibat bilirubin tak terkonjugasi. Salah satu terapi hyperbilirubinemia adalah fototerapi. Tujuan penelitian adalah untuk mengetahui hubungan durasi fototerapi dengan nilai bilirubin total akhir pada pasien ikterik neonatorum di RS Polri DKI Jakarta. Penelitian ini menggunakan desain cross sectional dengan total 103 data yang mengalami ikterus neonatorum sebagai responden. Hasil penelitian menunjukkan rata-rata kadar bilirubin awal 14, 81 mg/dL, kadar bilirubin setelah fototerapi selama 24 jam menghasilkan penurunan sebesar 2,60 mg/dL dan fototerapi selama 48 jam menghasilkan rata-rata penurunan bilirubin sebesar 3,69 mg/dL. Terdapat hubungan durasi fototerapi dengan nilai bilirubin total pada 24 jam dan 48 jam pasca fototerapi (p Value <0,005). Rekomendasi penelitian ini adalah perlu dilakukannya eksplorasi factor-faktor yang berhubungan dengan efektivitas fototerapi.

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Neonatal jaundice is a condition in neonates due to increased bilirubin in the blood. Neonatal jaundice has signs including yellow skin and sclera due to unconjugated bilirubin. One of the therapies for hyperbilirubinemia is phototherapy. The purpose of the study was to determine the relationship between the duration of phototherapy and the final total bilirubin value in neonatal jaundice patients at DKI Jakarta Police Hospital. This study used a cross sectional design with a total of 103 data who experienced neonatal jaundice as respondents. The results showed an average initial bilirubin level of 14, 81 mg/dL, bilirubin levels after phototherapy for 24 hours resulted in a decrease of 2.60 mg/dL and phototherapy for 48 hours resulted in an average decrease in bilirubin of 3.69 mg/dL. There is a relationship between the duration of phototherapies with total bilirubin values at 24 hours and 48 hours after phototherapy (p value <0.005). The recommendation of this study is the need to explore the factors associated with the effectiveness of phototherapy."

"Hiperbilirubinelnia merupakan fenomena klinis yang sering ditemukan pada bayibaru lahir. Tujuan penelitian untuk mengidentifikasi pengaruh perubahan posisitidur selama fototerapi terhadap rata-rata kadar bilirubin total. Desain penelitianadalah quasi experimental pre-post test with control group. Sampel yangdigunakan yaitu bayi baru lahir dengan hiperbilirubinemia, terdiri atas 20 bayikelompok intervensi dan 20 bayi kelompok kontrol. Analisis perbedaan kadarbilirubin total menggunakan independent t test. Hasil penelitian menunjukkantidak ada perbedaan yang bermakna pada kadar bilirubin total kelompok kontroldan kelompok intervensi, namun penurunan kadar biliiubin pada kelompokintervensi lebih cepat dari pada kelompok kontrol. Penelitian inimerekomendasikan perubahan posisi tidur dapat mempercepat penurunan kadarbilirubin total.

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AbstractHyperbilirubinemia is a clinical phenomenon that mostly appears to the newbornbaby. The purpose of the research is to identify the effect of changing sleepingposition during the phototherapy on the rate of total concentrate of bilirubin. Theresearch design was quasi experimental pre-post test with control group. Thesampel, was new born babies with hyperbilirubinemia; which were classified into20 babies in intervention group and 20 babies in controlled group. The analysis ofdifferent total bilirubin rate used independent t test showed that there was no anysignificant differences on the total of bilirubin rate in controlled group andintervention group. However, the total bilirubin rate reduction on the interventiongroup was faster than control group. This research reccomended that sleepingposition changes can decrease the total bilirubin rate fastly."

"Bayi baru lahir di Indonesia memiliki kemungkinan mengalami hyperbilirubinemia sebesar 51,47% dan jika tidak ditangani dapat menyebabkan penyakit yang lebih buruk, yaitu Kernicteruses yang merupakan kerusakan otak ataupun sistem syaraf pusat akibat kadar bilirubin berlebih. Penanganan bayi hyperbilirubinemia yang umum saat ini adalah dengan menyinari bayi menggunakan lampu fototerapi dan mengambil darah bayi untuk mengetahui kadar bilirubin pada tubuhnya. Cara ini memiliki keterbatasan seperti, membatasi ibu bayi dalam memberi ASI sehingga ikatan emosional antara bayi dan ibu menjadi berkurang serta perlu menyuntikkan jarum suntik ke tubu bayi sehingga dapat menyakiti bayi. Selimut fototerapi dan pengecekkan non invasive (tanpa menyuntik bayi) dapat menjadi solusi dalam penanganan bayi hyperbilirubinemia yang lebih baik, namun harga dari kedua alat tersebut masih tinggi. Penelitian ini berisi tentang rancangan awal selimut fototerapi dan alai pengecekkan bilirubin non invasive berbiaya terjangkau agar dapat digunakan oleh banyak masyarakat di Indonesia. Dengan metode reverse engineering, hasil penelitian ini menunjukkan bahwa selimut fototerapi memenuhi standar irradiance dan suhu permukaan sentuh dari BPFK sebesar 6,51 μW/cm2/nm dan 35,55℃ sedangkan untuk alat pengecekkan bilirubin non invasive masih belum mendappatkan hasil yang signifikan karena keterbatasan colour processing.

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Newborns in Indonesia have a possibility of hyperbilirubinemia of 51,47%, which if left untreated can cause a worse disease namely Kernicterus, which is damage to the brain or central nervous system due to excess bilirubin levels. Treatment of hyperbilirubinemia infant that are common today is to irradiate the baby using phototherapy lights and take the baby’s blood to determine bilirubin levels in his body. This method has limitations, such as limiting the baby’s mother breastfeeding so that the emotional bond between the baby and the mother becomes reduced and the need to inject a syringe into the baby’s body so that it can hurt the baby. Phototherapy blankets and non invasive checks (without injecting the baby) can be a solution for better handling hyperbilirubinemia infants, but the price of both devices is sttill high. This study contains the prototype of phototherapy blankets and non invasive bilirubin checking at affordable costs so that they can be used by many people in Indonesia. With the reverse engineering method, the results of this study show that phototherapy blankets meet the irradiance standards and touch surface temperatures of BPFK at 6,51 μW/cm2/nm and 35,55℃, while non invasive bilirubin checking devices still do not get significant results due to color processing limitations."

"Hiperbilirubinemia adalah kondisi klinis umum yang sering terjadi pada bayi baru lahir akibat peningkatan kadar bilirubin serum dalam darah ≥5 mg/dL, ditandai dengan gejala ikterik. Intervensi utama untuk menurunkan kadar bilirubin serum adalah penggunaan fototerapi yang dikombinasikan dengan terapi adjuvan seperti field massage therapy. Studi kasus ini melibatkan tiga bayi dengan usia gestasi masing-masing 35 minggu, 40 minggu, dan 38 minggu yang mengalami ikterik neonatus pada 48-72 jam setelah kelahiran dan memerlukan fototerapi. Dua kelompok bayi diberikan terapi pijat yang dikombinasikan dengan fototerapi, sementara satu kelompok hanya mendapatkan fototerapi tanpa pijat. Hasil penelitian menunjukkan bahwa terapi pijat, yang dilakukan dua kali sehari selama 10-15 menit, dapat mengurangi durasi fototerapi, menurunkan intensitas ikterik pada kulit bayi, meningkatkan frekuensi buang air besar, dan meningkatkan asupan oral. Berdasarkan hasil ini, diharapkan terapi pijat dapat dikembangkan dan dijadikan sebagai terapi komplementer rutin dalam asuhan keperawatan pada ikterik neonatus.

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Hyperbilirubinemia is a common clinical condition often observed in newborns due to elevated serum bilirubin levels (≥5 mg/dL), characterized by jaundice. The primary intervention to reduce serum bilirubin levels is phototherapy, often combined with adjuvant therapies such as field massage therapy. This case study involved three infants with gestational ages of 35 weeks, 40 weeks, and 38 weeks, respectively, who developed neonatal jaundice 48–72 hours after birth and required phototherapy. Two groups of infants received massage therapy combined with phototherapy, while one group received only phototherapy without massage intervention. The results indicate that massage therapy, administered twice daily for 10–15 minutes, can reduce phototherapy duration, decrease jaundice intensity on the infant's skin, increase defecation frequency, and improve oral intake. These findings suggest that infant massage therapy could be developed as a complementary routine therapy in nursing care for neonatal jaundice. "

"Penelitian ini bertujuan untuk mengetahui perbedaan status hidrasi, perubahan nilai total serum bilirubin, dan perbedaan durasi fototerapi bayi yang mendapat fototerapi dengan diberi ASI dan susu formula Desain penelitian yang digunakan adalah deskriptif, observasional, dan prospektif terhadap 34 bayi cukup bulan yang sehat di sebuah rumah sakit di Jakarta. Responden dibagi ke dalam tiga kelompok, yaitu; kelompok bayi yang hanya diberi susu formula, kelompok bayi yang hanya diberi ASI, dan kelompok bayi yang diberi ASI dan susu formula. Hasil penelitian, menggunakan analisa data univariat dan bivariat dengan tes statistik Chi-square, ANOVA dan Mann-Whitney, menunjukkan bahwa tidak ada perbedaan status hidrasi dan perbedaan perubahan nilai total serum bilirubin (p= 0,76; α= 0,05), tetapi ada perbedaan durasi fototerapi antara ke tiga kelompok (p= 0,001; α= 0,05). Kelompok yang diberi ASI mempunyai durasi fototerapi tersingkat. Penelitian ini merekomendasikan agar perawat memastikan keefektifan breastfeeding selama fototerapi.

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This study aims to determine differences in hydration status, changes in value of total serum bilirubin, and the difference induration of phototherapy newborns who received phototherapy with breast-fed and formula feeding. The study design used is descriptive, observational, and prospective to 34 healthy newborns at a hospital in Jakarta. Respondents were divided in to three groups, there is group of newborns with formula feeding, group of newborns with breast-fed, and group of newborns with breast -fed and formula feeding. The results, using univariate and bivariate data analysis with statistical chi-square test,ANOVA, and Mann-Whitney, shows that there is no difference in hydration status and differences in changes in value of total serum bilirubin (p= 0.76; α= 0.05) , but there are differences in the duration of phototherapy between to the three groups (p=0.001; α= 0.05). The group who were breastfeed has the shortest duration of phototherapy. This study recommends that nurses ensure the effectiveness of breastfeeding during phototherapy."

"Latar Belakang: Neonatus kurang bulan berisiko mengalami hiperbilirubinemia 12,5 kali lipat lebih besar dibandingkan neonatus cukup bulan, 54% membutuhkan fototerapi. Hiperbilirubinemia dapat menyebabkan neurotoksisitas hingga kematian, sedangkan fototerapi dapat menyebabkan beberapa komplikasi. Terapi ajuvan seperti asam ursodeoksikolat diperlukan untuk meningkatkan klirens bilirubin sehingga mengurangi durasi fototerapi. Saat ini belum ada data yang tersedia mengenai pengaruh penambahan asam ursodeoksikolat terhadap durasi fototerapi pada neonatus kurang bulan dengan hiperbilirubinemia.Tujuan: Penelitian ini bertujuan untuk menentukan durasi fototerapi dan penurunan kadar bilirubin pada neonatus kurang bulan yang mendapat fototerapi dan tambahan asam ursodeoksikolat.Metode: Penelitian ini merupakan uji klinis, terandomisasi, tersamar ganda, dengan kontrol plasebo, mencakup neonatus usia gestasi <37 minggu, mengalami hiperbilirubinemia yang terindikasi fototerapi, dirawat di unit perinatologi Rumah Sakit Dr. Cipto Mangunkusumo sejak bulan Februari-Mei 2024, sudah mendapat minum per oral sebanyak ≥10 mL/kgBB/hari. Grafik American Academy of Pediatrics (AAP) tahun 2022 dan The Royal Women’s Hospital (RWH) tahun 2020 digunakan untuk menentukan batas fototerapi. Total 40 subjek yang dibagi menjadi 2 kelompok. Kelompok intervensi (n=20) mendapat asam ursodeoksikolat 10 mg/kgBB/hari (puyer) dibagi 2 dosis sebagai terapi tambahan fototerapi, sedangkan kelompok kontrol (n=20) hanya mendapat fototerapi. Kadar bilirubin total diukur setiap 24 jam dengan serum dan/atau Bilistick. Hasil: Rerata durasi fototerapi adalah 24 jam pada kelompok intervensi, 36 jam pada kelompok kontrol (p=0,289). Di kelompok intervensi, penurunan kadar bilirubin setelah 24 jam fototerapi 4,15 ± 5,50 mg/dL (p=0,758), setelah 48 jam fototerapi 4,99 ± 7,66 mg/dL (p=0,664). Kadar bilirubin setelah 48 jam fototerapi lebih rendah bermakna pada neonatus yang mendapat asam ursodeoksikolat (p=0,020).Kesimpulan: Penambahan asam ursodeoksikolat tidak mengurangi durasi fototerapi maupun mempercepat penurunan kadar bilirubin pada neonatus kurang bulan dengan hiperbilirubinemia yang mendapat fototerapi setelah 24 jam dan 48 jam. Penelitian lanjutan perlu dilakukan sampai jumlah sampel terpenuhi.

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Background: Preterm neonates have a 12.5 times higher risk of developing hyperbilirubinemia compared to full-term neonates, with 54% requiring phototherapy. Hyperbilirubinemia can lead to neurotoxicity and even death, while phototherapy can cause several complications. Adjuvant therapy, such as ursodeoxycholic acid, is needed to increase bilirubin clearance and reduce the duration of phototherapy. Currently, there is no available data on the effect of adding ursodeoxycholic acid on the duration of phototherapy in preterm neonates with hyperbilirubinemia.

Objective: This study aims to determine the duration of phototherapy and the reduction of bilirubin levels in preterm neonates who receive phototherapy and additional ursodeoxycholic acid.

Method: This study is a randomized, double-blind, placebo-controlled clinical trial, involving neonates with a gestational age of less than 37 weeks who have hyperbilirubinemia requiring phototherapy, treated in the perinatology unit of Dr. Cipto Mangunkusumo Hospital from February to May 2024, and who have been fed orally at least 10 mL/kgBW/day. The 2022 American Academy of Pediatrics (AAP) and 2020 The Royal Women’s Hospital (RWH) charts were used to determine the phototherapy threshold. A total of 40 subjects were divided into 2 groups. The intervention group (n=20) received 10 mg/kgBW/day of ursodeoxycholic acid (powder) divided into 2 doses as an additional phototherapy treatment, while the control group (n=20) received only phototherapy. Total bilirubin levels were measured every 24 hours using serum and/or Bilistick.

Results: The average duration of phototherapy was 24 hours in the intervention group and 36 hours in the control group (p=0.289). In the intervention group, the reduction in bilirubin levels after 24 hours of phototherapy was 4.15 ± 5.50 mg/dL (p=0.758), and after 48 hours of phototherapy was 4.99 ± 7.66 mg/dL (p=0.664). Bilirubin levels were significantly lower after 48 hours of phototherapy in neonates who received ursodeoxycholic acid (p=0.020).

Conclusion: The addition of ursodeoxycholic acid did not reduce the duration of phototherapy nor accelerate the decrease of bilirubin levels in preterm neonates with hyperbilirubinemia who received phototherapy after 24 and 48 hours. Further research needs to be conducted until the sample size is sufficient."