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Abstrak :
Latar belakang: Pneumotoraks merupakan kondisi terjadinya akumulasi udara di pleura yang dapat menyebabkan kolaps pada paru, dan paling lebih sering terjadi pada periode neonatus dibandingkan dengan periode kehidupan lainnya. Angka insidens pneumotoraks meningkat menjadi 6-7% pada kelahiran bayi berat lahir rendah (BBLR). Saat ini sudah banyak kemajuan dalam perawatan intensif neonatus, tetapi pneumotoraks tetap menjadi komplikasi pernapasan utama yang menyebabkan kematian. Identifikasi faktor risiko yang berhubungan dengan pneumotoraks pada neonatus penting agar dapat dilakukan tatalaksana yang tepat dan sebagai evaluasi pencegahan dan tata laksana yang saat ini sudah diterapkan. Metode: Penelitian kasus kontrol ini melibatkan neonatus usia <28 hari yang lahir cukup bulan di RSCM yang diambil retrospektif secara consecutive sampling mulai perawatan 1 Januari 2021 hingga 31 Desember 2022. Subjek dibagi menjadi kelompok kasus (dengan pneumotoraks) dan kontrol (tanpa pneumotoraks) berdasarkan klinis dan radiologis selama perawatan. Faktor risiko yang ada pada masing-masing kelompok diidentifikasi dari rekam medis. Data kemudian dianalisis menggunakan program SPSS. Hasil: Total 116 subjek yang diteliti terdiri atas 58 subjek pada kelompok kasus dan 58 subjek pada kelompok kontrol. Angka kejadian pneumotoraks pada bayi di RSCM yaitu 2%. Faktor yang terbukti menjadi risiko terhadap insidens pneumotoraks adalah ventilasi mekanik invasif (OR 3,19; IK 1,01-10,11; p=0,048). Faktor yang tidak terbukti berhubungan dengan pneumotoraks adalah ventilasi tekanan positif saat resusitasi, sindrom distres napas, dan sepsis neonatorum. Angka kematian bayi dengan pneumotoraks adalah 72,4%. Kesimpulan: Faktor risiko yang mempunyai hubungan bermakna dengan pneumotoraks pada bayi usia <28 hari yang lahir cukup bulan adalah penggunaan ventilasi mekanik invasif. ......Background: Pneumothorax is a condition where air accumulation in the pleura can lead to lung collapse, and is more common in the neonatal period compared to other periods of life. The incidence of pneumothorax increases to 6-7% in low birth weight (LBW) neonates. There have been many advances in the intensive care of neonates, but pneumothorax remains a major respiratory complication leading to death. Identification of risk factors associated with pneumothorax in neonates is important for appropriate management and to evaluate current prevention and management. Method: This case-control study involved neonates aged <28 days who were born at full term at RSCM who were taken retrospectively by consecutive sampling from January 1st 2021 to December 31st 2022. Subjects were divided into case groups (with pneumothorax) and controls (without pneumothorax) based on the clinical and radiology during treatment. The risk factors in each group were identified from medical records. The data were then analysed using the SPSS program. Result: A total of 116 subjects were studied, consisting of 58 subjects in the case group and 58 subjects in the control group. The incidence rate of pneumothorax in neonates at RSCM was 2%. The factor that proved to be a risk factor for the incidence of pneumothorax in neonates was invasive mechanical ventilation (OR 3.19; IK 1.01-10.11; p=0.048). Factors not associated with pneumothorax were positive pressure ventilation during resuscitation, respiratory distress syndrome, and neonatal sepsis. The mortality rate of neonates with pneumothorax was 72.4%. Conclusion: Risk factor that significantly associated with pneumothorax in neonates aged <28 days who were born at full term is invasive mechanical ventilation.

Abstrak :
Latar Belakang : Pneumotoraks merupakan kasus kegawat daruratan yang harus ditatalaksana segera. Penilaian berbagai penyakit paru dan faktor-faktor penyebab secara tepat sangat penting diketahui sebagai panduan dalam kerjasama antardisiplin ilmu dan untuk meningkatkan penatalaksanaan pneumotoraks secara menyeluruh. Faktor risiko yang mempengaruhi kesintasan pasien pneumotoraks adalah usia dan infeksi HIV, namun data di Indonesia masih belum ada. Tujuan : Untuk mengetahui karakteristik pasien pneumotoraks dan faktor-faktor yang mempengaruhi kesintasannya selama perawatan di RSCM. Metode : Penelitian desain kohort retrospektif, dilakukan terhadap pasien pneumotoraks yang dirawat inap di RSCM pada kurun waktu Januari 2000 sampai Desember 2011. Kesintasan kumulatif selama 8 hari perawatan dan faktor yang mempengaruhi dianalisis secara bivariat dengan metode Kaplan Meier dan uji Log-rank serta analisis multivariat dengan Cox proportional hazard regression model untuk menghitung hazard ratio (HR) dan interval kepercayaan 95%. Hasil : Seratus empat pasien pneumotoraks yang memenuhi kriteria penelitian ditemukan lebih banyak pada laki-laki 78(73,1%) dengan rerata usia 39,7(simpang baku[SB],16,2) tahun. Keluhan respirasi terbanyak berupa sesak napas 103(99%) dan kelainan pada pemeriksaan fisik hipersonor 101(97,1%). Foto polos toraks menunjukkan hiperlusen avaskular 95(91,4%). Faktor penyebab kejadian yang didapatkan adalah merokok 43(41,3%), pneumonia 42(40,3%), tuberkulosis 37(35,5%), trauma dada 13(12,5%), kejadian iatrogenik 6(5,7%), keganasan paru 6(5,7%), PPOK 5(4,8%), asma bronkiale 5(4,8%) dan artritis reumatoid 1(1%). Jenis pneumotoraks terbanyak adalah pneumotoraks spontan sekunder 49(47,1%). Tatalaksana sebagian besar dengan pemasangan WSD 98(94,2%). Keluaran pasien pneumotoraks hidup 69(66,3%), meninggal 35(33,7%). Penyebab kematian terbanyak pada pasien pneumotoraks saat perawatan adalah gagal napas 16(45,8%). Faktor-faktor yang memperburuk kesintasan pasien pneumotoraks adalah trauma dada (HR=3,49 (IK 95% 1,52;8,04)) dan tuberkulosis paru (HR=3,33 (IK 95% 1,39;7,99)). Kesimpulan : Adanya tuberkulosis paru dan trauma dada memperburuk kesintasan pasien pneumotoraks selama perawatan di RSCM. ...... Background : Pneumothorax is an emergency case should be managed immediately. Assessment of lung diseases and the factors that cause pneumothorax is very important to know the proper guidelines in cooperation an interdisciplinary medical science and to improve the overall management of pneumothorax. Risk factors affecting the survival rate of pneumothorax patients are age and HIV infection, but there is no data in Indonesia. Objective : The purpose of this study was to determine the characteristics of pneumothorax patients and factors affecting survival during hospitalization in RSCM. Methods : Retrospective cohort study design conducted on pneumothorax patients who were admitted in RSCM in the period January 2000 to December 2011. Cumulative survival rate for 8 days of hospitalization and the factors affecting analyzed by bivariate with Kaplan Meier method and log-rank test and multivariate analysis by cox proportional hazard regression model to calculate hazard ratio (HR) and 95% confidence intervals. Results : A total of 104 pneumothorax patients were reviewed. Their mean age was 39.7 years (SD ± 16.2 years) with a male to female ratio of 3:1. Commonest symtoms was shortness of breath 103(99%) and abnormalities on physical examination was hypersonor 101(97.1%). Plain chest X-ray showed hyperlucent avascular 95(91.4%). Etiologic factors for the incidence of secondary pneumothorax were smoking 43(41.3%), pneumonia 42(40.3%), tuberculosis 37(35.5%), chest trauma 13(12.5%), iatrogenic 6(5.7%), lung malignancy 6(5.7%), COPD 5(4.8%), asthma 5(4.8%) and rheumatoid arthritis 1(1%). Commonest type of pneumothorax was secondary spontaneous pneumothorax 49(47.1%). Most of pneumothorax patients were successfully managed by chest thoracoscopy 98(94.2%). Outcome of pneumothorax patients were live 69(66.3%), died 35(33.7%). Causes of death in pneumothorax patients was respiratory failure 16(45.8%). Factors that worsen the survival rate of pneumothorax patients were chest trauma (HR = 3.49 (95% CI 1.52 to 8.04)) and pulmonary tuberculosis (HR = 3.33 (95% CI 1.39 to 7.99 )). Conclusions : Factors that worsen the survival rate of pneumothorax patients were pulmonary tuberculosis and chest trauma that hospitalized in RSCM.

Abstrak :
Pneumothorax iatrogenic merupakan suatu kondisi dimana terdapat udara pada rongga pleura yang disebabkan oleh tertusuknya paru saat prosedur medis dilakukan. Pneumothorax menyebabkan masalah ketidakefetifan pola napas. Salah satu penatalaksanaan untuk pasien dengan pneumothorax adalah pemasangan WSD. Karya ilmiah ini bertujuan untuk menganalisis intervensi pemberian posisi dan monitoring WSD pada pasien dengan pneumothorax yang dilakukan selama lima hari. Berdasarkan hasil evaluasi didapatkan berkurangnya keluhan sesak dan menurunnya frekuensi pernapasan pasien dari dari 36 x/menit hingga 24 x/menit, serta nyeri dapat terpantau. Positioning dan monitoring WSD dapat direkomendasikan sebagai tindakan untuk pasien pneumothorax dengan WSD.

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Iatrogenic pneumothorax is a condition where there is air in the pleural cavity caused by puncturing the lungs when a medical procedure is being carried out. Pneumothorax causes ineffective breathing patterns problems. One of treatment for pneumothorax is the using of WSD. This paper aimed to analyze positioning and WSD monitoring interventions in pneumothorax patients that was done for five days. Based on the evaluation results showed that shortness of breath decreased subjectively, respiratory rate decreased from 36 bpm till 24 bpm, and pain level monitored. Positioning and WSD monitoring intervention can be recommended as a nursing intervention to pneumothorax patients. 

Abstrak :
ABSTRACT
Purpose Lung transplantation is accepted as an effective modality for patients with end-stage pulmonary lymphangioleiomyomatosis (LAM). Generally, bilateral lung transplantation is preferred to single lung transplantation (SLT) for LAM because of native lung-related complications, such as pneumothorax and chylothorax. It remains controversial whether SLT is a suitable surgical option for LAM. The objective of this study was to evaluate the morbidity, mortality and outcome after SLT for LAM in a lung transplant center in Japan. Methods We reviewed the records of 29 patients who underwent SLT for LAM in our hospital between March, 2000 and November, 2017. The data collected included the pre-transplant demographics of recipients, surgical characteristics, complications, morbidity, mortality and survival after SLT for LAM. Results The most common complication after SLT for LAM was contralateral pneumothorax (n = 7; 24.1%). Six of these recipients were treated successfully with chest-tube placement and none required surgery for the pneumothorax. The second-most common complication was chylous pleural effusion (n = 6; 20.7%) and these recipients were all successfully treated by pleurodesis. The 5-year survival rate after SLT for LAM was 79.5%. Conclusion LAM-related complications after SLT for this disease can be managed. SLT is a treatment option and may improve access to lung transplantation for patients with end-stage LAM.

Abstrak :
Pneumotoraks catamenial merupakan salah satu jenis pneumotoraks spontan yang langka terjadi dan biasanya menyerang wanita usia produktif. Perubahan status kesehatan dapat memicu terjadinya ansietas. Ansietas adalah masalah psikosisal berupa perasaan yang tidak jelas. karena aktivasi sistem saraf otonom terhadap ancaman yang tidak spesifik. Karya ilmiah ini melaporkan analisis masalah dan intervensi keperawatan psikososial ansietas pada klien dengan pneumotoraks catamenial. Tindakan keperawatan yang dilakukan pada klien dengan ansietas yaitu edukasi terkait penyakit dan ansietas, teknik relaksasi napas dalam, teknik distraksi, hipnosis lima jari dan kegiatan spiritual. Metode yang digunakan dalam karya ilmiah ini adalah analisa kasus. Evaluasi akhir dari asuhan keperawatan yang diberikan menunjukkan adanya hubungan antara masalah psikososial ansietas dan masalah fisik pneumotoraks catamenial, sehingga implementasi keperawatan harus selalu dikembangkan secara terintegrasi antara masalah psikososial dan fisik untuk mengatasi ansietas klien.

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Catamenial pneumothorax is one of kind spontaneous pneumothorax that rarely occurs and usually attacked women at their productive age. The changes in health condition could trigger anxiety. Anxiety is a psychosocial problem which unclearly feelings caused by activation of autonomy neuron systems towards an unspecific threat. This research reporting analytical problems and nursing care for anxiety psychosocial with patient suffered from catamenial pneumothorax. Education about anxiety and illness, deep breath relaxation technic, distraction technic, five fingers hypnosis and spiritual activities are the nursing actions for a patient with anxiety. The method used in this work is case analysis. Final evaluation from nursing care shown indicates the relationship between psychosocial problems and physical problems, so that the intervention of nursing should always be developed integrated between psychosocial and physical problems to solve anxiety problems in patient.