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Latar Belakang: Hipoglikemia merupakan masalah metabolik yang sering terjadi pada neonatus terutama bayi kurang bulan dan bayi kecil masa kehamilan. Sebagaian besar neonatus kompensasi hipoglikemia fisiologis dengan memproduksi benda keton. Tujuan: Membantu menambahkan data dalam membuat pedoman pemeriksaan glukosa darah pada bayi late preterm dan bayi cukup bulan kecil masa kehamilan. Metode Penelitian: Penelitian cross sectional untuk melihat gambaran kadar gula darah diawal kelahiran pada bayi late preterm dan cukup bulan kecil masa kehamilan dan hubungannya dengan keton darah sebagai respons adaptasi metabolik. Penilaian respons kadar keton darah terhadap perubahan kadar gula darah dengan melakukan uji korelasi pada masing-masing tahap penilaian. Hasil: Sebanyak 53 subyek memenuhi kriteria penelitian. Rerata kadar gula darah pada usia 0-4 jam 69,83±22,19 mg/dL, >4-24 jam 63,02±16,80 mg/dL, >24-48 jam 62,94±14,80 mg/dL ) keseluruhan secara statistik tidak berbeda bermakna (p= 0,117). Median kadar keton darah pada usia 0-4 jam 0,60 (0,10-1,40) mmol/L, >4-24 jam 0,60 (0,30-1,3) mmol/L, >24-48 jam 0,60 (0,10-1,40) mmol/L keseluruhan secara statistik tidak berbeda bermakna (p = 0,326). Hubungan antara perubahan kadar gula darah dengan perubahan kadar keton darah menunjukkan bahwa setiap perubahan satu unit kadar gula darah mengakibatkan perubahan kadar keton darah sebesar 0,0012 secara statistik tidak bermakna (p = 0,192). Simpulan: Pola perubahan glukosa darah bayi late preterm dan bayi cukup bulan kecil masa kehamilan tidak selalu mengalami hipoglikemia, produksi badan keton pada bayi late preterm dan bayi cukup bulan kecil masa kehamilan memadai.

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Introduction: Hypoglycaemia is the most common manifestation of failure of metabolic adaptation in the newborn period, especially in premature infants and small for gestational age. Most of the physiological neonatal hypoglycaemia compensate physiologist hypoglycaemia by producing ketone body. Objective: Provide data to establish guidelines blood glucose tests in late preterm infants and term infants small for gestational age. Methods: A cross sectional research to see pattern of blood glucose concentration at the newborn and its relationship with blood ketones as a response to metabolic adaptation. Evaluation of blood ketone concentration to the change of blood glucose is done by correlation test at each evaluation stage. Results: A total of 53 subjects fulfil the study criteria. The mean blood glucose level at the age of 0-4 hours was 69,83 ± 22,19 mg/dL, > 4-24 hours was 63,02 ± 16,80 mg/dL, > 24-48 hours was 62,94 ± 14,80 mg/dL overall was not statistically significant (p = 0.117). Median levels of blood ketones at the age of 0-4 hours was 0.60 (0.10 to 1.40) mmol/L, > 4-24 hours was 0.60 (0.30 to 1.30) mmol/L , > 24-48 hours was 0.60 (0.10 to 1.40) mmol/L overall was not statistically significant (p = 0.833). The relationship between changes in blood glucose levels by changing levels of blood ketones indicate that any change in one unit of blood glucose levels lead to changes in levels of blood ketones at 0.0012 was not statistically significant (p = 0.192) . Conclusion: The change of blood glucose in late preterm infants and term infants small for gestational age not always having hypoglycemia. Production of ketone body at late preterm infants and term infants small for gestational age is not sufficient., Introduction: Hypoglycaemia is the most common manifestation of failure of metabolic adaptation in the newborn period, especially in premature infants and small for gestational age. Most of the physiological neonatal hypoglycaemia compensate physiologist hypoglycaemia by producing ketone body. Objective: Provide data to establish guidelines blood glucose tests in late preterm infants and term infants small for gestational age. Methods: A cross sectional research to see pattern of blood glucose concentration at the newborn and its relationship with blood ketones as a response to metabolic adaptation. Evaluation of blood ketone concentration to the change of blood glucose is done by correlation test at each evaluation stage. Results: A total of 53 subjects fulfil the study criteria. The mean blood glucose level at the age of 0-4 hours was 69,83 ± 22,19 mg/dL, > 4-24 hours was 63,02 ± 16,80 mg/dL, > 24-48 hours was 62,94 ± 14,80 mg/dL overall was not statistically significant (p = 0.117). Median levels of blood ketones at the age of 0-4 hours was 0.60 (0.10 to 1.40) mmol/L, > 4-24 hours was 0.60 (0.30 to 1.30) mmol/L , > 24-48 hours was 0.60 (0.10 to 1.40) mmol/L overall was not statistically significant (p = 0.833). The relationship between changes in blood glucose levels by changing levels of blood ketones indicate that any change in one unit of blood glucose levels lead to changes in levels of blood ketones at 0.0012 was not statistically significant (p = 0.192) . Conclusion: The change of blood glucose in late preterm infants and term infants small for gestational age not always having hypoglycemia. Production of ketone body at late preterm infants and term infants small for gestational age is not sufficient.]

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Latar Belakang. Kemajuan dalam penanganan bayi prematur menyebabkan angka kesintasan meningkat. Akibatnya, angka kesakitan bayi prematur juga meningkat, salah satunya adalah osteopenia of prematurity (OOP). Pemeriksaan kadar kalsium, fosfat, dan fosfatase alkali serum saat usia kronologis 4 minggu digunakan sebagai indikator awal sebelum osteopenia tampak secara klinis. Diagnosis sedini mungkin dan pengendalian faktor risiko perlu dilakukan sehingga komplikasi dapat dicegah. Tujuan. Mengetahui prevalens dan faktor risiko terjadinya OOP. Desain Penelitian. Penelitian dengan desain potong lintang ini dilaksanakan pada bayi prematur dengan usia gestasi ≤32 minggu di Divisi Perinatalogi RS Dr. Cipto Mangunkusumo. Subyek diperiksa kadar kalsium serum, fosfat inorganik serum, dan fosfatase alkali serum. Pada subyek dilakukan pencatatan faktor risiko OOP untuk menilai hubungan antar variabel dan dilakukan analisis bivariat dengan uji chi square. Hasil Penelitian. Terdapat 80 subyek yang memenuhi kriteria penelitian. Delapan dari 80 subyek (10%) ditemukan menderita OOP. Faktor risiko yang dianalisis dalam penelitian ini ditemukan tidak memiliki hubungan bermakna dengan kejadian OOP, yakni lama penggunaan nutrisi parenteral total (p=0,457), lama penggunaan metilsantin (p=1,000), berat lahir (p=0,459), preeklampsia berat pada ibu (p=0,344), korioamnionitis pada ibu (p=0,261), dan pemberian nutrisi enteral (p=0,797). Simpulan. Prevalens OOP di RS Dr. Cipto Mangunkusumo adalah 10%. Faktor lama penggunaan nutrisi parenteral total, penggunaan metilsantin, berat lahir, preeklampsia berat pada ibu, korioamnionitis, dan pemberian nutrisi enteral tidak memiliki hubungan bermakna dengan kejadian OOP. ABSTRACT
Background. Advances in management of premature infants had increased the survival rate of these infants. However there is also increase of morbidity such as osteopenia of prematurity (OOP). Laboratory examination of serum calcium, phosphate, and alkaline phosphatase at the chronological age of 4 weeks is used as early indicator before osteopenia become clinically appearant. Early diagnosis and risk control are needed to prevent complication. Objective. To evaluate the prevalence and risk factors of OOP. Methods. A cross sectional study was done in premature infants <32 weeks of gestational age in Perinatalogy Division of Cipto Mangunkusumo Hospital. Laboratory examination of serum calcium, phosphate, and alkaline phosphatasewere conducted toward these subjects. Risk factors of OOP were also evaluated. Bivariat analysis was analysed by chi square test. Results. There are 80 subjects who meet the study criteria. Eight of 80 subjects (10%) was diagnosed as OOP. No risk factors have significant relationship with OOP incidence, which include duration of total parenteral nutrition (p=0,457), duration of methylxanthine usage (p=1,000), birth weight (p=0,459), severe preecalampsia in the mother (p=0,344), chorioamnionitis in the mother (p=0,261), and enteral nutrition (p=0,797). Conclusion. Prevalence of OOP in Cipto Mangunkusumo Hospital is 10%. There are no significant relationship between OOP incidence and duration of total parenteral nutrition, methylxanthine usage, birth weight, severe preeclampsia in the mother, chorioamnionitis, and enteral nutrition. ;Background. Advances in management of premature infants had increased the survival rate of these infants. However there is also increase of morbidity such as osteopenia of prematurity (OOP). Laboratory examination of serum calcium, phosphate, and alkaline phosphatase at the chronological age of 4 weeks is used as early indicator before osteopenia become clinically appearant. Early diagnosis and risk control are needed to prevent complication. Objective. To evaluate the prevalence and risk factors of OOP. Methods. A cross sectional study was done in premature infants <32 weeks of gestational age in Perinatalogy Division of Cipto Mangunkusumo Hospital. Laboratory examination of serum calcium, phosphate, and alkaline phosphatasewere conducted toward these subjects. Risk factors of OOP were also evaluated. Bivariat analysis was analysed by chi square test. Results. There are 80 subjects who meet the study criteria. Eight of 80 subjects (10%) was diagnosed as OOP. No risk factors have significant relationship with OOP incidence, which include duration of total parenteral nutrition (p=0,457), duration of methylxanthine usage (p=1,000), birth weight (p=0,459), severe preecalampsia in the mother (p=0,344), chorioamnionitis in the mother (p=0,261), and enteral nutrition (p=0,797). Conclusion. Prevalence of OOP in Cipto Mangunkusumo Hospital is 10%. There are no significant relationship between OOP incidence and duration of total parenteral nutrition, methylxanthine usage, birth weight, severe preeclampsia in the mother, chorioamnionitis, and enteral nutrition.

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Perkembangan anak merupakan sesuatu yang bersifat multi dimensi dan terdiri atas area kognitif, bahasa, fungsi gerak, sosial emosional dan perilaku adaptif, masing-masing memiliki nilai tersendiri namun saling berintegrasi. Dua metode stimulasi (Glenn Doman (GD) dan Kemenkes (K)) dinilai kualitasnya dalam penelitian ini. Tujuan.Mengetahui pengaruh perbedaan stimulasi metode GD dan K terhadap skor perkembangan bayi usia 6-12 bulan. Metode.Penelitian kohort prospektif pada bayi normal.Skrining perkembangan awal dilakukan menggunakan alat ukur Denver.Pasca 3 bulan intervensi, perkembangan bayi dinilai menggunakan BSID edisi-III yang terlebih dahulu dilakukan uji validitas dan reliabilitas.Kualitas stimulasi rumah di nilai menggunakan alat ukur HOME. Hasil.Skor validitas dari BSID edisi-III adalah 0,964 (kognitif), 0,934 (bahasa), 0,822 (gerak) dengan Cronbach Alpha sebesar 0,918 serta reliabilitas test-retest 0,846. Subjek yang memenuhi kriteria sebanyak 88 orang, dengan jenis kelamin laki-laki (61,4%), usia 9-12 bulan (68,2%), status gizi baik (75%). Perbedaan bermakna terdapat pada skor HOME dan semua aspek penilaian perkembangan BSID di kedua grup setelah masa intervensi 3 bulan (p<0,001). Skor grup GD lebih unggul 1 angka dibandingkan K pada skor HOME (p=0,024) and 32 angka lebih unggul pada skor BSID (p=0,002). Faktor jumlah anak bermakna secara statistik memengaruhi perkembangan dengan risiko relative 3.13 (IK 95% 1.18- 8.33, p=0,022). Simpulan.Instrumen BSID edisi-III versi Bahasa Indonesia merupakan alat ukur yang sahih dan andal untuk digunakan pada penelitian ini. Secara umum tidak terdapat perbedaan skor perkembangan bayi usia 6-12 bulan yang mendapat stimulasi metode GD dan K kecuali perkembangan perilaku adaptif.

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Child development is multi-dimensional and encompasses cognitive, language, sensory-motor, social-emotional, adaptive behavior domains, all of which are interdependent. Two stimulation interventions (Glenn Doman (GD) and Kemenkes (K) methods) were conducted in this study. Aims.To investigate the difference in developmental aspects after intervention with GD and K methods in infants age 6-12 months. Methods. This was a prospective cohort study in normal developmental infants. Developmental screening at enrollment used Denver instrument. Three months post intervention, the development was assessed with BSID III, in which validation and reliability test were undertaken as first step. A modified version of HOME inventory was used as edition to assess home environment. Results.The validity score of BSID-III was 0.964 (cognitive), 0.934 (language), 0.822 (motor) with Cronbach alpha of 0.918 and a reliability test-retest of 0.846. There were 88 subjects fulfilled the criteria. Subject mostly were male (61.4%) 9- 12 months old (68.2%), normal anthropometric status (75%). The results revealed significant differences in HOME score and all aspects of Bayley score in GD and K group after 3 months intervention period (p<0.001). The GD benefited 1 point compared with K group in HOME score (p=0.024) and 32 points in Bayley score (p=0.002). Number of children was the most influential factor in infants’ development with a relative risk of 3.13 (CI95% 1.18-8.33, p=0.022). Conclusions.The Bahasa Indonesia version of BSID-III was a reliable and valid tool for the assessment of this study. There was no difference in developmental score at age 6-12 months who had GD and K stimulation methods except for adaptive behavior scale.

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Latar belakang: Remaja merupakan kelompok risiko tinggi defisiensi besi. Adanya obesitas pada remaja meningkatkan risiko defisiensi besi disebabkan perbedaan pola asupan dan inflamasi kronis derajat rendah. Tujuan: Mengetahui status besi remaja usia 15 -17 tahun dengan obesitas. Desain penelitian: Penelitian potong lintang pada remaja usia 15 ? 17 tahun di dua SMU Jakarta Pusat pada bulan September ? November 2015. Subjek dibagi 2 kelompok berdasar indeks massa tubuh (IMT). Subjek obes bila IMT≥P95 dan non-obes bila IMT ≥P5 - Background. Adolescent period is high risk group of iron deficiency. Obesity can increase the risk of iron deficiency. It was caused by low iron intake and low grade chronic inflammation. Objective. To assess whether obese adolescents, who often have poor dietary habits, are at increased risk of iron deficiency. Methods: Cross-sectional study on adolescence 15 to 17 years old in Senior High School in Central Jakarta between September to November 2015. Subject was divided into 2 groups based on body mas index (BMI). Obese group if BMI ≥P95 and non-obese group if BMI ≥P5 -

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Latar belakang: Enterokolitis nekrotikans EKN merupakan inflamasi pada saluran cerna yang sering terjadi pada bayi prematur. Lactobacillus reuteri merupakan mikroorganisme hidup yang dilaporkan dapat mencegah kejadian EKN, intoleransi minum dan menurunkan angka mortalitas. Tujuan: Mengidentifikasi kejadian EKN pada bayi prematur yang mendapat Lactobacillus reuteri DSM 17938 dan sekunder kejadian sepsis, intoleransi minum, waktu mencapai full feeding, lama hari perawatan, efek samping dan kematian. Metode: Uji klinis acak tersamar ganda membandingkan pemberian Lactobacillus reuteri dengan plasebo pada neonatus usia gestasi 28-34 minggu dan berat lahir 1000-1800 gram di Rumah Sakit Dr. Cipto Mangunkusumo. Masing-masing kelompok terdiri dari 47 subjek. Hasil: Kejadian EKN stadium 2 dan 3 didapatkan 3 subjek 6,4 pada kelompok plasebo dan tidak ada ada pada kelompok probiotik RR 1,07 IK 95 0,99-1,15, p=0,24 . Intoleransi minum berupa muntah, kembung, atau keduanya lebih rendah pada kelompok probiotik dibandingkan plasebo 8,5 vs. 25,5 , RR 0,33 IK 95 0,12-0,96, p=0,03 . Proven sepsis pada kelompok probiotik dan plasebo tidak berbeda bermakna 2,1 vs. 6,4 , p=0,62 . Waktu mencapai full feeding dan lama perawatan tidak didapatkan perbedaan bermakna antara kedua kelompok. Efek samping yang diobservasi berupa diare tidak berbeda bermakna antara kedua kelompok 2,1 vs. 4,3 , p=1,00 . Kematian tidak berbeda bermakna antara kedua kelompok 2,1 vs. 8,5 , p=0,36. Simpulan: Kejadian EKN terjadi pada kelompok plasebo sebesar 6,4 dan tidak ada pada kelompok probiotik. Intoleransi minum secara bermakna lebih rendah pada kelompok probiotik dibandingkan plasebo. Luaran sekunder proven sepsis, waktu mencapai full feeding, lama perawatan, efek samping diare dan kematian tidak didapatkan perbedaan bermakna antara kedua kelompok.

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Background: Necrotizing enterocolitis NEC is an inflammatory disorder of the gastrointestinal tract that often occurs in preterm infants. Lactobacillus reuteri is a living microorganism that has been reported to prevent NEC. Objectives: Identify the NEC prevalence in preterm infants receiving Lactobacillus reuteri DSM 17938 with secondary outcomes including sepsis, feeding intolerance, time to reach full feeding, length of stay, adverse effects, and mortality. Methods: Double blind randomized controlled trial of Lactobacillus reuteri DSM 17938 versus placebo in 28 34 weeks of gestational neonates and birth weight 1000 1800 grams at Dr. Cipto Mangunkusumo Hospital. Each group consisted of 47 subjects. Results The prevalence of NEC stages 2 and 3 were found in three subjects 6,4 of the placebo whereas none occurred in the probiotic RR 1.07, 95 CI 0.99 1.15, p 0.24 . Feeding intolerance vomiting, distension, or both were found to be lower in the probiotic compared to the placebo 8.5 vs 25.5 RR 0.33 95 CI 0.12 0.96, p 0.03. No significant differences were found between both groups for the proven sepsis, time to reach full feeding, length of stay, and adverse effects of diarrhea. Mortality rates were 2.1 in the probiotic and 8.5 in the placebo, p 0.36. Conclusion 6,4 of the placebo group experienced NEC whereas none occurred in the probiotic group. Feeding intolerance was found to be significantly lower in the group receiving probiotics compared to the placebo group. Secondary outcomes including proven sepsis, time to reach full feeding, length of stay, adverse effect diarrhea , and mortality were also not found to be significantly different between both trial groups.

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Latar belakang: Hipotermia merupakan penyebab utama morbiditas dan mortalitas pada bayi, terutama pada bayi prematur dan atau dengan berat lahir kurang. Membungkus bayi menggunakan plastik terbukti mengurangi hipotermia. Saat ini terdapat Neohelp suatu plastik dengan desain baru yang diharapkan lebih efektif mencegah hipotermia. Tujuan: Mengetahui angka kejadian hipotermia bayi baru lahir dan waktu yang dibutuhkan untuk mencapai normotermia pada resusitasi bayi prematur menggunakan plastik polietilen lembaran dibandingkan dengan plastik Neohelp, serta mengetahui faktor risiko dan komplikasi hipotermia. Metode: Dilakukan randomized controlled trial pada 48 bayi baru lahir usia gestasi ≤ 32 minggu, pada 5 rumah sakit. Faktor lingkungan berupa suhu ruangan, kelembaban, waktu transport dari ruang bersalin ke ruang perawatan serta penggunaan 2 macam plastik untuk mencegah hipotermia, dianalisis secara bivariate menggunakan Uji Chi-square, Fisher exact, t-test dan Man-Whitney test. Hasil: Didapatkan nilai angka hampir sama antara kelompok plastik poietilen lembaran dibanding Neohelp untuk mencapai normotermi di ruang bersalin (4,5 menit vs 5 menit), serta rerata suhu tubuh ketika tiba di ruang perawatan (35,6⁰C vs 35,4⁰C). Suhu dan kelembaban ruangan, waktu tempuh dari ruang bersalin ke ruang perawatan, dan 2 jenis plastik tidak terbukti merupakan faktor risiko terjadinya hipotermia. Kesimpulan: Plastik Neohelp tidak terbukti lebih unggul dibanding polietilen lembaran dalam mencegah hipotermia. Peranan petugas kesehatan sangat besar dalam mencegah hipotermia, apapun jenis plastik yang digunakan. ......Background: Hypothermia is one of the primary causes of morbidity and mortality in newborn period, particularly preterm and low birth weight babies. Prevention of hypothermia by wrapping newborns with plastic sheets has been proven helpful. Neohelp is a specially designed plastic wrap for neonates to prevent hypothermia. Aim: We aimed to determine the prevalence of hypothermia of the newborn and time to reach normothermia on preterm newborn resuscitation using polyethylene plastic sheet compared to Neohelp. We also aimed to determine the risk factors and complications of hypothermia following the resuscitation. Method: This is a randomized control trial of 48 newborn ≤ 32 weeks age of gestation in 5 hospitals. The environmental factors assessed were room temperature, humidity, time of travel from delivery room to the care unit and the use of two types of plastic wrap to prevent hypothermia. All of the variables were analyzed using Chi-square, Fischer exact, t-test, and Mann-Whitney. Result: We found only slight difference between polyethylene plastic sheet and Neohelp to reach normothermia in delivery room (4.5 minutes vs 5 minutes). Average temperature on arrival in care unit was not also not significantly different (35.6 centigrade vs 35.4 centigrade). Room temperature, humidity, time of travel from delivery room to care unit, and the type of plastic wrap used were not proven as risk factors of hypothermia. Conclusion: Neohelp was not proven to be superior to polyethylene sheet in preventing hypothermia. Skill of the healthcare personnel has been the biggest role in preventing hypothermia, regardless of the type of plastic used.

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Latar belakang: Nasal CPAP dini sebagai standar bantuan napas untuk mengatasi sindrom gawat napas telah diketahui, namun masih ada 30-80 % kegagalan terapi NCPAP untuk mencegah penggunaan ventilator mekanik. NIPPV dilaporkan lebih mampu menurunkan kegagalan bantuan napas non invasif dibandingkan NCPAP, tetapi beberapa penelitian lain menyatakan bahwa tidak ada perbedaan dalam kegagalan terapi antara NCPAP dan NIPPV. Sampai saat ini belum ada penelitian uji klinik terkendali yang membandingkan NIPPV dengan NCPAP sejak di ruang bersalin. Tujuan: Penelitian ini untuk mengetahui apakah pengunaan NIPPV dini sejak di ruang bersalin sebagai terapi awal sindrom gawat napas pada bayi prematur, mampu menurunkan kegagalan terapi non invasif dibanding dengan NCPAP. Metode: Uji acak terkendali tidak tersamar ganda, pada bayi dengan usia gestasi 28 sampai <35 minggu dengan sindrom gawat napas yang tidak membutuhkan intubasi subyek saat resusitasi, di randomisasi untuk mendapatkan NCPAP atau NIPPV sejak dari ruang bersalin. Terdapat 52 subyek bayi yang terandomisasi 27 pada kelompok NCPAP dan 25 pada kelompok NIPPV, dengan berat badan lahir 1.513+374 gram vs 1522+411 gram, usia gestasi 32+1,5 minggu vs 32+1,7 minggu. Hasil : Proporsi subyek dalam kelompok NCPAP yang gagal terapi terdapat 16 bayi (59,2%) sedangkan di kelompok NIPPV terdapat 2 bayi (8,0%) dengan RR 0,135 (IK 95% 0,040- 0,619) dengan p =0,025. Dari kelompok NCPAP subyek yang memerlukan intubasi sebanyak 7 bayi (26%) sedangkan di NIPPV sebanyak 2 bayi (12%). Terdapat 9 bayi dalam kelompok NCPAP yang membutuhkan bantuan NIPPV dalam 72 jam pertama, dan semuanya terhindar dari pemakaian ventilasi mekanik. Simpulan : penggunaan NIPPV dini sejak dari ruang bersalin dapat menurunkan kegagalan terapi non invasif pada bayi prematur dibandingkan NCPAP. ......Background: Early nasal CPAP has been proven to be an effective therapy for respiratory distress syndrome in neonates. However, 30-80% of this intervention fails to avoid the use of mechanical ventilator. Some studies report that NIPPV is a more preferable approach compared to NCPAP, but the results remain conflicting. There are no randomized clinical trials of using NIPPV compare to NCAP in the delivery room. Objective: The aim of this study was to determine the efficacy of early NIPPV as an initial therapy for respiratory distress compared to early NCPAP in premature neonates. Methods: This is a randomized, controlled, single blind study. Subjects included neonates with a gestational age between 28 until less than 35 weeks with respiratory distress syndrome that did not require intubation at resuscitation. Patients were randomized into NCPAP and NIPPV since in the delivery room, immediately after birth. Twenty-seven infants randomized to NCPAP and 25 comparable infants to NIPPV, with birth weight  1.513+374 gram vs 1.522+411 gram, and gestational age 32+1,5 week vs 32+1,7 week. Results: A higher number of premature neonates eventually failed NCPAP in the  control group compared to the NIPPV group (59.2% vs. 8.0%, RR 0,135 (IK 95% 0,040 - 0,619), p = 0.025. There were 26% subjects in the NCPAP group that required intubation, as opposed to only 12% in the NIPPV group. Additionally, there were 9 subjects in the NCPAP group that required NIPPV in the first 72 hours, all of whom did not require mechanical ventilation. Conclusion: The use of early NIPPV after birth was found to reduce the intervention failure of non-invasive methods compare with NCPAP.

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Latar belakang: Bayi prematur, terutama late dan moderately preterm sering mengalami masalah kesehatan terutama masalah pernapasan, yang merupakan penyebab tertinggi kematian. Gangguan pernapasan sering dialami bayi prematur hingga sering membutuhkan bantuan pernapasan. Bantuan pernapasan berupa oksigenasi dan ventilasi membutuhkan pemantauan terhadap tekanan oksigen dan CO2. Analisis gas darah merupakan baku emas untuk memantau oksigenasi dan ventilasi. Saat ini dapat dilakukan pemantauan tekanan CO2 secara non invasif dengan monitor transkutan yang dilakukan secara kontinyu. Namun, penelitian terkait pemantauan CO2 transkutan pada bayi late dan moderately preterm belum banyak dilakukan, karena umumnya penelitian dilakukan pada bayi very dan extremely preterm. Di Indonesia juga belum didapatkan data penelitian pemantauan CO2 transkutan, khususnya pada bayi late dan moderately preterm. Tujuan: Mengetahui karakteristik bayi usia kehamilan 32-36 minggu yang mendapat bantuan pernapasan serta presisi dan akurasi alat ukur tekanan CO2 transkutan pada bayi usia kehamilan 32-36 minggu yang mendapat bantuan pernapasan. Metode: Penelitian ini merupakan penelitian uji diagnostik yang menggunakan desain penelitian cross sectional. Subjek penelitian adalah 35 bayi late dan moderately preterm dengan usia kehamilan 32 – 36 minggu yang mendapatkan bantuan pernapasan di unit Neonatologi Rumah Sakit Cipto Mangunkusumo (RSCM) di Jakarta pada bulan Juli hingga Desember 2019. Bayi tersebut akan dipasangkan alat ukur tekanan CO2 dan dilakukan pengambilan sampel Analisa Gas Darah (AGD) sebanyak tiga kali dan dilakukan pencatatan nilai tekanan CO2 yang didapat dari kedua alat ukur tersebut. Hasil yang didapat kemudian dibandingkan dan diolah secara statistik untuk menentukan akurasi dan presisi dari alat uji tekanan CO2 secara transkutan. Hasil: Berdasarkan data dari tabel korelasi, didapatkan bahwa nilai koefisien korelasi terhadap kadar CO2 pada pemeriksaan melalui AGD dan alat CO2 Transkutan secara total adalah sebesar 0,738 (p <0,001). Berdasarkan hasil ini, didapatkan bahwa alat uji tekanan CO2 secara transkutan memiliki korelasi positif sedang dengan AGD. Hal ini berarti semakin tinggi kadar CO2 pada AGD akan memberikan peningkatan nilai yang terbaca pada alat uji CO2 secara transkutan dengan kekuatan sedang. Berdasarkan grafik Bland – Altman, dapat ditentukan bahwa Level of agreement dari penelitian ini berdasarkan hasil pemeriksaan kedua alat tersebut adalah -14,46 hingga 6,9 dengan nilai mean difference dari hasil penelitian ini adalah -3,78. Simpulan: Alat ini memiliki presisi yang kurang baik. Namun, alat ini juga memiliki korelasi positif yang kuat pada hasil pengujian dengan menggunakan uji korelasi Spearman. Berdasarkan grafik Bland-Altman yang diperoleh dari penelitian, alat ini dapat dikatakan memiliki nilai akurasi yang cukup baik. Alat ini tidak bisa menggantikan pemeriksaan baku emas tetapi hanya bersifat sebagai pelengkap dalam melakukan perawatan bayi di NICU, sehingga dapat mengurangi frekuensi pengambilan sampel darah untuk melakukan pemeriksaan baku emas. ......Background: Neonates who born premature, especially late and moderately preterm, often experience health problems, especially repiratory problems, which are the highest causes of death. Respiratory disorders are often experienced by premature neonates and often need respiratory support device. Respiratory support device in the form of oxygenation and ventilation requires monitoring of oxygen and CO2 pressure. Blood gas analysis is the gold standard for monitoring oxygenation and ventilation. Currently, non-invasive CO2 pressure monitoring can be carried out with continuous transcutaneous monitoring. However, studies related to monitoring of transcutaneous CO2 in late and moderately preterm infants have not been done much, because generally research is conducted on very and extremely preterm infants. In Indonesia there is no research data on transcutaneous CO2 monitoring, especially in late and moderately preterm infants. Objective: To determine the characteristics of 32-36 weeks gestational age neonates who receive respiratory support device and the precision and accuracy of transcutaneous CO2 measuring devices in 32-36 weeks gestational age neonates who receive respiratory support device. Method: This study is a diagnostic test that uses a cross sectional study design. Subjects were 35 late and moderately preterm infants with 32-36 weeks gestational age who received respiratory support device at the Neonatology unit of Cipto Mangunkusumo Hospital (RSCM) in Jakarta on July to December 2019. The neonates would be fitted with a transcutaneous CO2 and taken Blood Gas Analysis (BGA) sample three times and recording the CO2 pressure values obtained from the two measuring devices. The results obtained will be compared and processed statistically to determine the accuracy and precision of the transcutaneous CO2 device. Results: Based on data from the correlation table, it was found that the value of the correlation coefficient on CO2 levels on examination through BGA and the Transcutaneous CO2 device in total was 0.738 (p <0,001). Based on these results, it was found that the transcutaneous CO2 device had a strong positive correlation with BGA. This means that the higher levels of CO2 in the BGA will provide an increase in the value read on the Transcutaneous CO2 device with strong strength of correlation. Based on the Bland-Altman graph, it can be determined that the level of agreement of this study based on the results of the examination of the two measurement is -14.46 to 6.9 with the mean difference from the results of this study is -3.78. Conclusion: Transcutaneous CO2 measurement device has low precision but also has a strong positive correlation on the test results using the Spearman correlation test. Based on Bland – Altman graph from the study, the device can be said to have a good accuracy. This device can’t replace the gold standard examination but can only as a complement in taking care of neonates in the NICU, to reduce the frequency of blood sampling for conducting gold standard examinations.