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Abstrak :
[ABSTRAK
Latar belakang: Ventilasi mekanik (VM) adalah prosedur yang dipilih untuk menyelamatkan bayi dalam kondisi kritis, tetapi merupakan tindakan invasif dan perlu pemantauan ketat untuk menghindari barotrauma dan volutrauma. Ekstubasi merupakan upaya untuk penyapihan VM. Tujuan: Mengetahui berapa prevalens keberhasilan ekstubasi dan prediktor apa yang berperan dalam keberhasilan ekstubasi pada bayi di NICU RSCM. Metode: Rancangan penelitian ini merupakan penelitian observasional analitik dengan desain potong lintang. Pengumpulan data dilakukan secara retrospektif dengan menggunakan data RM yang lengkap untuk melihat prediktor keberhasilan ekstubasi. Hasil: Dari 60 RM yang dikumpukan, diperoleh data bayi yang berhasil diekstubasi dan data dicatat tanda vital 72 jam kemudian didapatkan 55 (91,7%) bayi yang berhasil diekstubasi dan 5 (8,3%) bayi tidak berhasil. Karakteristik subyek penelitian adalah semua bayi yang dirawat di NICU, dengan UG antara 22 - 41 minggu dan BL berkisar antara 820 g sd 4100 g. Pada bayi yang diekstubasi dengan merujuk pada hasil AGD, tidak berbeda bermakna antara keberhasilan ekstubasi dengan normal tidaknya nilai AGD. Lama pemakaian VM berkisar antara 1- 30 hari. Prediktor ekstubasi yang diteliti adalah setting VM meliputi FiO2, PIP, flow trigger, IT, napas spontan, dan hasil AGD. Pengolahan data dengan regresi logistik terbukti diantara semua prediktor ekstubasi, hanya FiO2 saja yang bermakna dengan p value 0.057 dan OR 0.76. Simpulan: Prevalens keberhasilan ekstubasi adalah 91.7%. Hasil penelitian menunjukkaan bahwa hanya rendahnya setting FiO2 yang terbukti secara statistik sebagai prediktor keberhasilan ekstubasi.

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ABSTRACT
Background: Mechanical ventilation (VM) is a procedure which is chosen to save the baby in critical condition, bu it is an invasive procedure and need close monitoring to avoid barotrauma and volutrauma. Extubation was an attempt to weaning VM. Objective: To determine prevalence and predictors of successful extubation in infants in the NICU RSCM. Methods: The study was design observational analytic research with cross sectional design. Data collected by retrospectively using complete medical record (MR) data to decided prevalence and predictors of successful extubation. Results: Of the 60 MR was collected, the data obtained were successfully extubated infants and data recorded vital signs 72 hours later obtained 55 (91.7%) infants were successfully extubated and 5 (8.3%) infants did not succees. Characteristics of the study subjects were all babies admitted to the NICU, with GA between 22-41 weeks and BW ranged from 820 g up to 4100 g. Refer to the results of blood gas analysis (BGA) normal or not was not significantly different between succesful extubated. Long of used MV ranging between 1 to 30 days. Predictors of extubation were studied were MV settings include FiO2, PIP, flow trigger, IT, spontaneous breath, and the results of BGA. Processing of data by logistic regresion among all predictors extubation, only setting FiO2 are significant with p value 0.057 and OR 0.76. Conclusion: Prevalence successful extubation is 91.7%. Research results that only the low setting FiO2 statistically proven as a predictor of extubation, Background: Mechanical ventilation (VM) is a procedure which is chosen to save the baby in critical condition, bu it is an invasive procedure and need close monitoring to avoid barotrauma and volutrauma. Extubation was an attempt to weaning VM. Objective: To determine prevalence and predictors of successful extubation in infants in the NICU RSCM. Methods: The study was design observational analytic research with cross sectional design. Data collected by retrospectively using complete medical record (MR) data to decided prevalence and predictors of successful extubation. Results: Of the 60 MR was collected, the data obtained were successfully extubated infants and data recorded vital signs 72 hours later obtained 55 (91.7%) infants were successfully extubated and 5 (8.3%) infants did not succees. Characteristics of the study subjects were all babies admitted to the NICU, with GA between 22-41 weeks and BW ranged from 820 g up to 4100 g. Refer to the results of blood gas analysis (BGA) normal or not was not significantly different between succesful extubated. Long of used MV ranging between 1 to 30 days. Predictors of extubation were studied were MV settings include FiO2, PIP, flow trigger, IT, spontaneous breath, and the results of BGA. Processing of data by logistic regresion among all predictors extubation, only setting FiO2 are significant with p value 0.057 and OR 0.76. Conclusion: Prevalence successful extubation is 91.7%. Research results that only the low setting FiO2 statistically proven as a predictor of extubation]

Abstrak :
Latar belakang : Ventilator mekanik masih diperlukan pada neonatus untuk menyelamatkan bayi dalam kondisi distress napas yang berat. Ekstubasi dini sangat diperlukan untuk menghindari komplikasi karena pemakaian ventilator yang lama. Oleh karena itu diperlukan prediktor untuk mengetahui faktor risiko yang mengakibatkan kegagalan ekstubasi dini. Metode : Penelitian kohort retrospektif yang dilakukan di Unit NICU RSCM. Data diperoleh dari RM selama periode waktu 2017 – 2022. Penelitian dilakukan terhadap subyek yang memerlukan ventilator mekanik dan dapat diekstubasi dalam waktu 5 hari (ekstubasi dini). Subyek yang memerlukan reintubasi dalam waktu 72 jam dikategorikan sebagai kelompok yang gagal ekstubasi. Hasil : Kegagalan ekstubasi dini di NICU RSCM sebesar 70/180 (38,9%). Hasil analisis regresi logistik (AUC 0,824): usia gestasi < 28 minggu (p = 0,006, RR 3,39; IK 95%: 1,64-19,02), Usia gestasi (28–32) minggu (p = 0,228, RR 0,29; IK 95%: 0,67-5,52), pH < 7,35 (p = 0,541, RR 1,23: IK 95%; 0,58-2,85), pH > 7,45 (p = 0,022, RR 0,15; IK 95%: 0,02-0,79), dan kadar Hb < 11,5 g/dl (p = 0,001, RR 5,01; IK 95%: 5,58-38,52). Simpulan : Makin rendah Usia gestasi dan Hb makin besar risiko kegagalan ekstubasi dini pada bayi prematur. ......Background : Mechanical ventilators still needed to rescue severe respiratory distress neonates. Early extubation is necessary to avoid complications due to prolonged use of the ventilator. Therefore, predictors are needed to determine the risk factors that result in early extubation failure. Methods : The study was conducted at the NICU Unit of Cipto Mangunkusumo National Hospital. Retrospective data were obtained from medical records during 2017 – 2022 on subjects required mechanical ventilator and extubated within 5 days (early extubation). Early extubation failure defined as reintubation within 72 hours. Results : Early extubation failure at NICU Unit of Cipto Mangunkusumo National Hospital were 70/180 (38.9%). The results of logistic regression analysis (AUC 0.824): gestational age < 28 weeks (p = 0.006, RR 3.39; 95% CI: 1.64-19.02), gestational age (28-32) weeks (p = 0.228, RR 0.29; 95% CI: 0.67-5.52), pH < 7.35 (p = 0.541, RR 1.23: 95% CI; 0.58-2.85), pH > 7, 45 (p = 0.022, RR 0.15; 95% CI: 0.02-0.79), and Hb level < 11.5 g/dl (p = 0.001, RR 5.01; 95% CI: 5.58-38.52).