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"Latar belakang. Indonesia merupakan salah satu dari 11 negara di dunia yang memiliki angka kelahiran prematur terbanyak. Salah satu morbiditas bayi prematur yang umum dijumpai adalah anemia. Hal ini menyebabkan mereka sering mendapatkan transfusi darah di minggu-minggu pertama kehidupannya. Mencegah beratnya anemia akan mengurangi kemungkinan tranfusi dan risiko komplikasinya. Tujuan. Mengetahui karakteristik bayi prematur yang mengalami anemia sebelum usia kronologis 4 minggu di unit Perinatologi Departemen Ilmu Kesehatan Anak RSCM Jakarta. Metode. Studi deskriptif retrospektif terhadap rekam medis semua bayi baru lahir prematur yang menjalani perawatan di unit perinatologi RSCM periode 1 Januari 2012 sampai dengan 31 Desember 2013. Pemilihan subyek penelitian secara simple random sampling. Penilaian karakteristik bayi prematur meliputi kadar Hb, berat lahir, usia gestasi, riwayat tranfusi PRC, status sepsis, lama rawat dan status keluar. Hasil. Sebanyak 393 subjek memenuhi kriteria penelitian, terdapat 94 (23,9%) subjek yang mengalami anemia dan 123 (31,3%) subjek yang mendapatkan transfusi PRC minimal satu kali. Frekuensi tersering anemia adalah 4 kali sedangkan frekuensi tersering pemberian PRC adalah 7 kali. Usia pertama kali anemia paling banyak ditemukan pada usia ≤7 hari (66%) serupa halnya dengan usia pertama kali mendapatkan transfusi PRC (51,2%). Perbedaan proporsi karakteristik antara bayi prematur yang mengalami anemia dengan yang tidak mengalami anemia menunjukkan hasil yang bermakna secara statistik pada variabel jenis kelamin, usia gestasi, berat lahir, transfusi PRC, status sepsis, lama rawat, dan status keluar. Hampir sama dengan hal tersebut, perbedaan proporsi karakteristik bayi prematur yang mendapatkan transfusi PRC dengan yang tidak mendapatkan transfusi PRC menunjukkan hasil yang bermakna secara statistik pada variabel usia gestasi, berat lahir, status sepsis, lama rawat, dan status keluar. Simpulan. Insidens bayi prematur yang mengalami anemia adalah 23,9% sedangkan insidens transfusi PRC adalah 31,3%. Kejadian anemia dan transfusi PRC paling banyak dialami pada satu minggu pertama kehidupan. Perbedaan proporsi antar variabel untuk kejadian anemia dan kejadian transfusi PRC secara statistik bermakna ditemukan pada variabel yang sama yaitu usia gestasi, berat lahir, status sepsis, lama rawat, dan status keluar.

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Background. Indonesia is one of 11 countries with high number of premature birth rate. One of the morbidity commonly seen ini premature infants is anemia This cause frequent blood transfusion on their first weeks of life. Anemia prevention will reduce transfusion and its complication.

Objectives. To study characteristics of premature infants with anemia before 4 weeks chronological age in Perinatology Unit Cipto Mangunkusumo Hospital, Jakarta.

Methods. A retrospective descriptive study from medical records of premature infants who had hospitalized from January 1st 2012 until Desember 31st 2013 in Perinatology Unit Cipto Mangunkusumo Hospital, Jakarta. Subjects was selected by simple random sampling. Characteristics evaluation include Hb concentration, birth body weight, gestational age, length of stay, history of PRC transfusion, septic status, and discharge status.

Results. There were 393 subjects fulfilled research criteria. Incidence of anemia was 23,9%, while PRC transfusion was done in 31,3% subjects. The most frequent anemia episode is 4 times and PRC transfusion is 7 times. First episode anemia is mostly found at age ≤7 days (66%) as well as PRC transfusion (51,2%). Proportion difference of characteristic between premature infants with anemia and not anemia revealed statistically significant in gestational age, birth weight, PRC transfusion, septic status, length of stay, and discharge status. Proportion difference of premature infants with PRC transfusioan also statistically significant in gestational age, birth weight, PRC transfusion, septic status, length of stay, and discharge status.

Conclusions. Incidence of anemia in premature infants 23,9% while incidence of PRC transfusion is 31,3%. Anemia and PRC transfusion most frequently happened at first week of life. Characteristic proportion difference with significant result between premature infants who had anemia and got PRC transfusion was similar in gestational age, birth weight, PRC transfusion, septic status, length of stay, and discharge status."

"Latar belakang. Continuous positive airway pressure (CPAP) dan nasal intermittent positive ventilation (NIPPV) mengurangi intubasi dan ventilasi mekanik pada neonatus dengan gawat napas. Masih sedikit penelitian yang membandingkannya pada neonatus cukup bulan maupun kurang bulan. Tujuan. Mengetahui kejadian intubasi, lama dukungan ventilasi non invasif dan pemakaian oksigen, bronchopulmonary dysplasia (BPD), dan kematian antara CPAP dan NIPPV pada neonatus dengan gawat napas. Metode. Studi kohort retrospektif dilakukan terhadap neonatus dengan gawat napas, usia gestasi 28-40 minggu, lahir di Rumah Sakit Umum Daerah Kota Bekasi pada periode Januari 2013 - Juni 2015. Pengambilan subyek penelitian secara konsekutif, memenuhi kriteria inklusi, dan menggunakan bantuan napas dengan CPAP atau NIPPV, masing-masing 50 subjek. Hasil. Neonatus dengan gawat napas menggunakan CPAP maupun NIPPV disebabkan karena respiratory distress syndrome , transient tachypnea of the newborn, pneumonia neonatal. Rerata usia gestasi dan berat lahir pada kelompok CPAP (34±3,11 minggu, 2018±659 gr) dan NIPPV [34 (28-40) minggu, 2050 (900-3900) gr]. Kejadian intubasi dan kematian berkurang, rerata hari dukungan ventilasi non infasif maupun pemakaian oksigen lebih lama pada NIPPV dibandingkan CPAP. Simpulan. NIPPV mengurangi kejadian intubasi dan kematian pada neonatus dengan gawat napas dibandingkan CPAP.

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Background. Continuous positive airway pressure (CPAP) and nasal intermittent positive ventilation (NIPPV) reduce intubation and mechanical ventilation. Still limited studies compare to CPAP and NIPPV in term and preterm infant with respiratory distress.

Purpose. To determine CPAP and NIPPV to the event of intubation, duration non-invasive ventilation and oxygen support, bronchopulmonary dysplasia, and death in neonate.

Methods. Retrospective cohort study was conducted to newborn with gestational age 28-40 weeks were born at General Hospital of Bekasi City, January 2013 - June 2015. Consecutive subjects and met inclusion criteria for CPAP and NIPPV group, each one 50 subjects.

Results. CPAP and NIPPV were support to neonate with respiratory distress due to respiratory distress syndrome, transient tachypnea of the newborn, and pneumonia. Mean gestational age and birth weight in CPAP group (34 ± 3.11 weeks, 2018 ± 659 gr) and NIPPV [34 (28-40) weeks, 2050 (900-3900) g]. Raduce rate of intubation and death, duration of non-invasive ventilation and oxygen support longer to NIPPV than CPAP in neonate.

Conclusion. NIPPV reduce intubation and mortality rate comparison to CPAP in neonate"

"[ABSTRAKTujuan : Untuk menentukan apakah PICC dan PIVC pada bayi berat lahir sangat rendah berbeda, yang merujuk pada: kejadian sepsis, Jumlah pemakaian kateter yang dibutuhkan untuk keseluruhan terapi intravena dan efisiensi biaya pemasangan akses vena. Metoda: desain potong lintang retrospektif terhadap rekam medis semua bayi dengan berat lahir sangat rendah yang mendapatkan akses vena di divisi neonatologi RSCM periode tahun 2012 - 2014. Hasil: terdapat 161 kelompok PICC dan 154 kelompok PIVC. Karakteristik kedua kelompok tidak didapatkan perbedaan yang signifikan (p > 0,05). Terdapat perbedaan yang signifikan antara 2 kelompok untuk jumlah pemakaian (p=0,000). Biaya yang dibutuhkan untuk pemasangan kateter berbeda bermakna pada kedua kelompok (p<0,28). Kejadian infeksi aliran darah lebih tinggi pada kelompok PIVC. Beberapa bayi memiliki lebih dari satu episode sepsis, terdapat perbedaan yang signifikan (p = .032). Simpulan: PICC lebih efektif dan efisien dibandingkan PIVC.

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ABSTRACTBackground: To determine whether the PICC and PIVC in low birth weight infants differ on: the incidence of sepsis, the amount of catheter needed for the overall intravenous therapy, IV and the efficiency of cost on installation venous access. Methods: A cross-sectional retrospective design of the medical records of all infants with very low birth weight who gain venous access in neonatology division RSCM period 2012 to 2014. The comparison of proportions between groups were analyzed with SPSS of which P value <0.05 was considered statistically significant. Results: Characteristics of the two groups was not found significantly differences (p> 0.05). There are significant differences between the 2 groups for the number and the duration of the use (p = 0.000), the cost required for catheter (p <0.28) and the incidence of bloodstream infections was higher in the group PIVC. Some babies have more than one episode of sepsis, which are significantly different (p = .032). Conclusion: PICC is more effective and efficient then PIVC. , Background: To determine whether the PICC and PIVC in low birth weight infants differ on: the incidence of sepsis, the amount of catheter needed for the overall intravenous therapy, IV and the efficiency of cost on installation venous access. Methods: A cross-sectional retrospective design of the medical records of all infants with very low birth weight who gain venous access in neonatology division RSCM period 2012 to 2014. The comparison of proportions between groups were analyzed with SPSS of which P value <0.05 was considered statistically significant. Results: Characteristics of the two groups was not found significantly differences (p> 0.05). There are significant differences between the 2 groups for the number and the duration of the use (p = 0.000), the cost required for catheter (p <0.28) and the incidence of bloodstream infections was higher in the group PIVC. Some babies have more than one episode of sepsis, which are significantly different (p = .032). Conclusion: PICC is more effective and efficient then PIVC. ]"

"ABSTRAK Soluble CD14-ST presepsin merupakan penanda sepsis baru untuk diagnosis dan prognosis sepsis neonatorum. Kadar presepsin meningkat pada keadaan sepsis disebabkan oleh aktivitas protease di fagolisosom. Penelitian ini bertujuan untuk mengetahui manfaat pemeriksaan serial kadar presepsin sebagai penanda pemantauan respons terapi dan prognosis pada pasien SNAL secara bedside dengan menggunakan sampel darah kapiler. Desain penelitian kohort prospektif. Subjek penelitian terdiri dari 20 neonatus sehat dan 42 pasien SNAL. Pemeriksaan kadar presepsin dengan alat Pathfast pada hari ke-1, ke-3, dan ke-6 setelah diterapi. Kadar presepsin pada pasien SNAL 1104 pg/mL (608 ? 6225 pg/mL) lebih tinggi dibandingkan pada neonatus sehat 448 pg/mL (191 ? 513 pg/mL), nilai p 0,000. Pada pasien SNAL kelompok respons terapi kadar presepsin lebih rendah dibandingkan dengan kelompok non respons pada hari ke-3 dan ke-6 (p<0,05). Pada pasien SNAL kelompok non survivor kadar presepsin lebih tinggi dibandingkan dengan kelompok survivor hari ke-6 (p<0,05). Kadar presepsin berkorelasi positif dengan kadar CRP (r=0,488) dan jumlah leukosit (r=0,321). Nilai cut-off kadar presepsin hari ke-6 untuk penentuan prognosis 1365 pg/mL mempunyai AUC 0,789 (IK 95% 0,652 ? 0.926), sensitivitas 90.9%, dan spesifisitas 67,7%. Pemeriksaan presepsin hari ke-3 atau ke-6 secara bedside dengan darah kapiler bermanfaat untuk pemantauan terapi dan prognostik pasien SNAL.ABSTRACT Soluble CD14-ST presepsin as a new septic marker for diagnostic and prognostic of neonatal sepsis. Concentration of presepsin significantly increases in bacterial sepsis induced by phagolysosome protease activity. The objective of this study is to investigate the prognostic and monitoring value of presepsin in late onset neonatal sepsis (LOS) with serial capillary whole blood assay. This was prosphective cohort, from 20 healthy neonates and 42 LOS patient. The concentration of presepsin was analysed using Pathfast analyzer at 1st, 3rd & 6th day after therapy. Median of presepsin in LOS patient is 1104 pg/mL (608 ? 6225 pg/mL) significantly higher than healty neonates 448 pg/mL (191 ? 513 pg/mL), p value 0.000. Median of presepsin at 3rd & 6th day after therapy in LOS with therapeutic respons is significantly lower than LOS with no respons (p<0.05). Median of presepsin at 6th day after therapy in nonsurvivor is significantly higher than in survivor (p<0.05). There are positive correlation between presepsin and CRP (r=0.488) or leucocyte count (r=0.321). Cut-off presepsin at 6th day after therapy 1365 pg/mL is found with AUC 0.789 (CI 95% 0.652 ? 0.926), sensitivity 90.9%, dan spesificity 67.7%. Presepsin assay at 3rd or 6th day after therapy with capillary whole blood can be used to predict the prognostic and therapeutic respons in LOS patient.;Soluble CD14-ST presepsin as a new septic marker for diagnostic and prognostic of neonatal sepsis. Concentration of presepsin significantly increases in bacterial sepsis induced by phagolysosome protease activity. The objective of this study is to investigate the prognostic and monitoring value of presepsin in late onset neonatal sepsis (LOS) with serial capillary whole blood assay. This was prosphective cohort, from 20 healthy neonates and 42 LOS patient. The concentration of presepsin was analysed using Pathfast analyzer at 1st, 3rd & 6th day after therapy. Median of presepsin in LOS patient is 1104 pg/mL (608 ? 6225 pg/mL) significantly higher than healty neonates 448 pg/mL (191 ? 513 pg/mL), p value 0.000. Median of presepsin at 3rd & 6th day after therapy in LOS with therapeutic respons is significantly lower than LOS with no respons (p<0.05). Median of presepsin at 6th day after therapy in nonsurvivor is significantly higher than in survivor (p<0.05). There are positive correlation between presepsin and CRP (r=0.488) or leucocyte count (r=0.321). Cut-off presepsin at 6th day after therapy 1365 pg/mL is found with AUC 0.789 (CI 95% 0.652 ? 0.926), sensitivity 90.9%, dan spesificity 67.7%. Presepsin assay at 3rd or 6th day after therapy with capillary whole blood can be used to predict the prognostic and therapeutic respons in LOS patient.;Soluble CD14-ST presepsin as a new septic marker for diagnostic and prognostic of neonatal sepsis. Concentration of presepsin significantly increases in bacterial sepsis induced by phagolysosome protease activity. The objective of this study is to investigate the prognostic and monitoring value of presepsin in late onset neonatal sepsis (LOS) with serial capillary whole blood assay. This was prosphective cohort, from 20 healthy neonates and 42 LOS patient. The concentration of presepsin was analysed using Pathfast analyzer at 1st, 3rd & 6th day after therapy. Median of presepsin in LOS patient is 1104 pg/mL (608 ? 6225 pg/mL) significantly higher than healty neonates 448 pg/mL (191 ? 513 pg/mL), p value 0.000. Median of presepsin at 3rd & 6th day after therapy in LOS with therapeutic respons is significantly lower than LOS with no respons (p<0.05). Median of presepsin at 6th day after therapy in nonsurvivor is significantly higher than in survivor (p<0.05). There are positive correlation between presepsin and CRP (r=0.488) or leucocyte count (r=0.321). Cut-off presepsin at 6th day after therapy 1365 pg/mL is found with AUC 0.789 (CI 95% 0.652 ? 0.926), sensitivity 90.9%, dan spesificity 67.7%. Presepsin assay at 3rd or 6th day after therapy with capillary whole blood can be used to predict the prognostic and therapeutic respons in LOS patient.;Soluble CD14-ST presepsin as a new septic marker for diagnostic and prognostic of neonatal sepsis. Concentration of presepsin significantly increases in bacterial sepsis induced by phagolysosome protease activity. The objective of this study is to investigate the prognostic and monitoring value of presepsin in late onset neonatal sepsis (LOS) with serial capillary whole blood assay. This was prosphective cohort, from 20 healthy neonates and 42 LOS patient. The concentration of presepsin was analysed using Pathfast analyzer at 1st, 3rd & 6th day after therapy. Median of presepsin in LOS patient is 1104 pg/mL (608 ? 6225 pg/mL) significantly higher than healty neonates 448 pg/mL (191 ? 513 pg/mL), p value 0.000. Median of presepsin at 3rd & 6th day after therapy in LOS with therapeutic respons is significantly lower than LOS with no respons (p<0.05). Median of presepsin at 6th day after therapy in nonsurvivor is significantly higher than in survivor (p<0.05). There are positive correlation between presepsin and CRP (r=0.488) or leucocyte count (r=0.321). Cut-off presepsin at 6th day after therapy 1365 pg/mL is found with AUC 0.789 (CI 95% 0.652 ? 0.926), sensitivity 90.9%, dan spesificity 67.7%. Presepsin assay at 3rd or 6th day after therapy with capillary whole blood can be used to predict the prognostic and therapeutic respons in LOS patient."

"Latar Belakang: Pajanan nyeri menimbulkan efek merugikan baik pada neonatus kurang bulan maupun neonatus cukup bulan. Efek analgesik sukrosa pada penyuntikan intramuskular masih kontroversial. Efektivitas sukrosa untuk mengatasi nyeris saat vaksinasi hepatitis B pada neonatus cukup bulan belum pernah diteliti di Indonesia. Tujuan: untuk mengetahui efek analgesik pemberian sukrosa disertai empeng saat vaksinasi hepatitis B pada neonatus cukup bulan. Metode: penelitian ini menggunakan metode uji klinis acak tersamar ganda. Subjek secara random dibagi menjadi kelompok intervensi yang mendapatkan 2 mL sukrosa 24% disertai empeng, serta kelompok kontrol yang mendapatkan 2 mL aquabidestilata disertai empeng. Rasa nyeri yang dirasakan subjek dievaluasi dengan skor nyeri premature infant pain profile (PIPP). Hasil: median skor PIPP pada kelompok yang diberikan sukrosa lebih rendah dibandingkan kelompok kontrol (6 (2-15) vs 11 (2-15), p <0,0001). Lama tangis subjek pada kelompok yang mendapat sukrosa lebih singkat dibandingkan kelompok kontrol (11 (0-33) detik vs 19 (0-100) detik, p <0,0001). Pemberian empeng tidak memberikan efek sinergis dalam menurunkan skor nyeri maupun lama tangis subjek. Pada penelitian ini ditemukan satu subjek yang mengalami desaturasi hingga saturasi oksigen <88% saat pemberian sukrosa, namun efek samping ini tidak memerlukan terapi khusus. Simpulan: sukrosa secara statistik menurunkan skor nyeri PIPP dan lama tangis saat vaksinasi hepatitis B pada neonatus cukup bulan.

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Background: Pain causes adverse effect for preterm and also term newborn. Analgesic effect of sucrose during intramuscular injection is still a controversy. Sucrose effectivity in reducing pain in term newborn during hepatitis B vaccination has not been studied in Indonesia.

Objective: to examine analgesic effect of sucrose with pacifier during hepatitis B vaccination in term newborn.

Method: we used consecutive sampling to reach 70 subjects. Subject was randomised into intervension group receiving 2 mL of 24% sucrose solution with pacifier, and control group receiving 2 mL aquadest with pacifier. Pain was evaluated with the premature infant pain profile (PIPP) scoring system.

Result: median PIPP score in intervension group was significantly lower than control group (6 (2-15) vs 11 (2-15), p <0,0001). Cry duration in intervension group was significantly shorter than control group (11 (0-33) second vs 19 (0-100) second, p <0,0001). Pacifier had no synergistic effect in lowering PIPP score and cry duration. Decreased oxygen saturation below 88% was found in one subject receiving sucrose but additional therapy was not needed.

Conclusion: Sucrose was statistically significant in reducing pain score and cry duration during hepatitis B vaccination in term newborn."

"Latar belakang. Dermatitis atopik (DA) merupakan penyakit kulit kronik residif dengan manifestasi utama berupa gatal dan iritasi kulit yang berkepanjangan. Antihistamin oral telah digunakan secara luas untuk mengurangi gatal pada DA namun efektivitasnya masih kontroversial. Setirizin merupakan antihistamin-1 generasi kedua yang digunakan pada penyakit alergi, termasuk gatal yang berhubungan dengan DA. Tujuan. Untuk menilai efektivitas penggunaan setirizin dibandingkan dengan plasebo dalam terapi DA. Metode. Studi klinis acak terkontrol dilakukan selama Agustus 2014 sampai Mei 2015. Subjek yang memenuhi kriteria inklusi usia 6 bulan sampai 15 tahun dengan DA derajat sedang dibagi menjadi kelompok perlakuan dan kelompok kontrol. Kelompok perlakuan diterapi dengan setirizin (0,25mg/kgBB, dua kali sehari untuk pasien < 2 tahun dan sekali sehari untuk pasien > 2 tahun) sedangkan kelompok kontrol mendapat plasebo. Derajat keparahan DA pada kedua kelompok diukur dengan indeks SCORAD dan kekambuhan DA dievaluasi setiap bulan selama 6 bulan. Hasil penelitian. Total 38 subjek penelitian (18 plasebo, 20 setirizin) ikut serta dalam penelitian dan dianalisis dengan per protocol analysis. Karakteristik dasar meliputi usia, jenis kelamin dan riwayat atopi tidak berbeda di kedua kelompok. Derajat keparahan DA berdasarkan indeks SCORAD pada kedua kelompok adalah derajat sedang (kelompok kontrol 31,5 vs kelompok perlakuan 34,75). Selama pengobatan 6 bulan derajat keparahan DA menurun bertahap dengan tidak ada perbedaan bermakna antara kelompok kontrol dan perlakuan (31,5 menjadi 0 vs 34,75 menjadi 0, p=0,200). Kekambuhan DA pada kelompok setirizin tidak lebih rendah daripada kelompok kontrol dengan tidak terdapat perbedaan bermakna (2 dari 17 subjek vs 2 dari 14 subjek, p=1,000). Simpulan. Pengobatan setirizin selama 6 bulan pada anak dengan DA derajat sedang tidak dapat mengurangi kekambuhan maupun derajat keparahan penyakit.

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Background. Atopic dermatitis (AD) is chronic relapsing skin disease, characterized by intense itching and inflammation. Oral antihistamine has been widely used to reduce pruritus of AD but the effectiveness is still controversial. Cetirizine is a second generation H1 selective antagonist that has been used in allergic diseases, including AD-associated pruritus.

Objective. To assess the efficacy of cetirizine compared with placebo for the treatment of AD.

Method. A randomized clinical controlled trial was performed during August 2014 until May 2015. Eligible patients aged 6 months ? 15 years with moderate AD was divided into treatment group and control group. Treatment group were treated for 6 months with cetirizine (0.25 mg/kg twice daily for patients < 2 years old, once daily for patients > 2 years old), while the control group was given placebo. The severity of AD between both groups was measured by SCORAD index and recurrence was evaluated every month for 6 month-period.

Results. A total of 38 subjects (18 with placebo, 20 with cetirizine) participated in this study and a per protocol analysis was performed. The baseline characteristics, including age, gender and atopic history were similar in both groups. The severity of AD according to SCORAD index were moderate (control group 31,5 vs treatment group 34,75). During 6 month-study period, the severity of AD decreased steadily with no statistical differences between placebo and treatment group (31,5 to 0 vs 34,75 to 0, p=0,200). The recurrence of AD in cetirizine group were not lower than control group with no statistical differences (2 from 17 subject vs 2 from 14 subject, p=1,000).

Conclusion. Cetirizine treatment in children with atopic dermatitis for 6 month-period cannot reduce reccurence and disease severity of moderate AD."

"[ABSTRAKLatar Belakang: Angka kejadian trombositopenia pada neonatus dilaporkan antara 22-35%, dan salah satu komplikasinya adalah perdarahan intraventrikular (PIV). Penelitian sebelumnya di Rumah Sakit Cipto Mangunkusumo (RSCM) Jakarta melaporkan angka kejadian PIV masih tinggi pada bayi usia gestasi < 35 minggu sebesar 43,47%. Perdarahan intraventrikular menyebabkan dampak yang berat pada perkembangan neurologis dan mortalitas. Di Indonesia, belum ada penelitian mengenai hubungan trombositopenia dan PIV. Tujuan: Mengetahui hubungan trombositopenia dengan PIV pada bayi usia gestasi < 35 minggu dan korelasi antara derajat berat trombositopenia dan derajat berat PIV. Metode: Penelitian potong lintang dengan penelusuran rekam medis dilakukan di Divisi Neonatologi Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Indonesia RSCM pada subjek yang dirawat pada bulan Januari 2012 sampai Desember 2014 dengan diagnosis PIV. Subjek dibagi menjadi kelompok PIV ringan sedang (derajat ≤ 2) dan berat (derajat > 2). Nilai trombosit dicatat pada hari yang sama dengan diagnosis PIV. Digunakan uji Pearson?s chi-square, Fischer, analisis multivariat, dan korelasi untuk analisis data. Hasil: Angka kejadian PIV berat dengan trombosit < 100.000/uL sebesar 28,2% dibanding 10,4% pada nilai trombosit ≥ 100.000/uL (p=0,014). Berdasarkan analisis multivariat, faktor yang memiliki pengaruh terhadap terjadinya PIV berat adalah usia gestasi < 32 minggu dan penggunaan alat bantu napas berupa ventilator dan high frequency oscillatory ventilation (HFOV). Derajat berat trombositopenia tidak memiliki korelasi dengan derajat berat PIV (koefisien korelasi 0,21). Simpulan: Trombositopenia tidak memiliki peranan pada terjadinya PIV berat. Derajat berat trombositopenia tidak memiliki korelasi dengan derajat berat PIV.

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ABSTRACTBackground: The prevalence of thrombocytopenia in neonates ranges from 22 to 35%, and the complication could be intraventricular hemorrhage (IVH). The previous research in Cipto Mangunkusumo Hospital (RSCM) Jakarta reported high incidence of IVH until gestational age < 35 weeks which is 43,47%. Intraventricular hemorrhage has caused a significant defect to neurologic development and mortality. In Indonesia, there were no research about the relationsghip between thrombocytopenia and IVH. Objective: To study the relation between thrombocytopenia and IVH in a baby with gestational age < 35 weeks and the correlation between the severity of thrombocytopenia and the severity of IVH. Methods: A cross sectional study was performed by medical records review in Neonatology Division of Child Health Department University of Indonesia RSCM. The subject of this study is neonates who were hospitalized from January 2012 until December 2014 with IVH diagnosis. Subjects were divided into mild moderate IVH (grade ≤ 2) and severe IVH (grade > 2). Thrombocyte count was recorded in the same day with the diagnosis of IVH. Pearson?s chi-squared, Fischer's tests, multivariate analysis, and correlation were used to analyzed the data. Results: Risk of severe IVH was 28,2% in neonates with thrombocyte count < 100,000/uL versus 10,4% in neonates without (p=0.014). From multivariate analysis, gestational age < 32 weeks and the use of respiratory support (ventilator and high frequency oscillatory ventilation) played a significant role in severe IVH. The severity of thrombocytopenia has no correlation with the severity of IVH (correlation coefficient = 0,21). Conclusion: Thrombocytopenia doesn?t have a role in severe IVH based on multivariate anlysis. The severity of thrombocytopenia has no correlation with the severity of IVH., Background: The prevalence of thrombocytopenia in neonates ranges from 22 to 35%, and the complication could be intraventricular hemorrhage (IVH). The previous research in Cipto Mangunkusumo Hospital (RSCM) Jakarta reported high incidence of IVH until gestational age < 35 weeks which is 43,47%. Intraventricular hemorrhage has caused a significant defect to neurologic development and mortality. In Indonesia, there were no research about the relationsghip between thrombocytopenia and IVH. Objective: To study the relation between thrombocytopenia and IVH in a baby with gestational age < 35 weeks and the correlation between the severity of thrombocytopenia and the severity of IVH. Methods: A cross sectional study was performed by medical records review in Neonatology Division of Child Health Department University of Indonesia RSCM. The subject of this study is neonates who were hospitalized from January 2012 until December 2014 with IVH diagnosis. Subjects were divided into mild moderate IVH (grade ≤ 2) and severe IVH (grade > 2). Thrombocyte count was recorded in the same day with the diagnosis of IVH. Pearson’s chi-squared, Fischer’s tests, multivariate analysis, and correlation were used to analyzed the data. Results: Risk of severe IVH was 28,2% in neonates with thrombocyte count < 100,000/uL versus 10,4% in neonates without (p=0.014). From multivariate analysis, gestational age < 32 weeks and the use of respiratory support (ventilator and high frequency oscillatory ventilation) played a significant role in severe IVH. The severity of thrombocytopenia has no correlation with the severity of IVH (correlation coefficient = 0,21). Conclusion: Thrombocytopenia doesn’t have a role in severe IVH based on multivariate anlysis. The severity of thrombocytopenia has no correlation with the severity of IVH.]"

"Latar Belakang : Asfiksia neonatorum menyebabkan gangguan multiorgan, salah satunya adalah gangguan ginjal. Belum adanya kesepakatan dalam menentukan gangguan ginjal akut (acute kidney injury, AKI) pada neonatus menyebabkan kesulitan dalam mendiagnosis dan selanjutnya menghambat tata laksana AKI. Acute Kidney Injury Network (AKIN) merekomendasikan kriteria AKI berdasarkan peningkatan kadar kreatinin serum dan penurunan luaran urin.Tujuan : Mengetahui prevalens AKI dengan menggunakan kriteria AKIN pada asfiksia neonatorum, dan mengetahui perbedaan stadium AKI antara asfiksia sedang dan berat.Metode : Studi ini merupakan potong lintang analitik yang berlangsung selama Juli 2012 hingga Januari 2013. Subjek penelitian adalah semua bayi baru lahir usia gestasi >35 minggu dengan asfiksia yang lahir dan dirawat di Divisi Neonatologi RS Cipto Mangunkusumo dan RSUD Koja. Analisis menggunakan uji hipotesis Chi-square dengan SPSS versi 20.Hasil : Penelitian dilakukan pada 94 subjek yang terdiri atas 70 neonatus asfiksia sedang dan 24 neonatus asfiksia berat. Prevalens AKI berdasarkan kriteria AKIN pada asfiksia neonatorum adalah 63%. Prevalens bayi dengan asfiksia berat dan sedang yang mengalami AKI berturut-turut adalah 21 dari 24 subjek (88%) dan 38 subjek (54%). Prevalens bayi dengan asfiksia berat mengalami AKI stadium 3 yang terbanyak yaitu 14 dari 21 subjek (67%). Stadium AKI yang lebih berat lebih banyak dijumpai pada bayi dengan asfiksia berat dibandingkan asfiksia sedang (P<0,001).Simpulan : Prevalens AKI pada asfiksia neonatorum cukup tinggi. Makin berat derajat asfiksia neonatorum, makin berat stadium AKI.

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Background: Asphyxia neonatorum may result in multiorgan disfunction including renal disfunction. There is no consensus on the determination of acute kidney injury (AKI) in neonates making establishment of the diagnosis and its management difficult. The Acute Kidney Injury Network (AKIN) recommends AKI criteria based on increased serum creatinine level and reduced urine output.

Objective: To identify the prevalence of AKI in asphyxiated neonates using the AKIN criteria and to recognize the difference of AKI stadium between moderate and severe asphyxia.

Methods: The study was a cross-sectional analytical study, which was conducted between July 2012 and January 2013. The study subjects were all asphyxiated neonates with gestational age of >35 weeks who were delivered and hospitalized in Cipto Mangunkusumo Hospital and Koja District Hospital. Analysis was performed by hypothesis Chi-square test using SPSS version 20.

Results: Of 94 subjects participated in the study, there were 70 and 24 neonates with moderate and severe asphyxia, respectively. The prevalence of AKI was 63%. The prevalence of neonates with severe and moderate asphyxia who experienced AKI was 21 out of 24 subjects (88%) and 38 subjects (54%), respectively. The prevalence of AKI in neonates with severe asphyxia who had stage 3 AKI was 14 out of 21 subjects (67%). More severe AKI stage was found more common in neonates with severe asphyxia (P<0.001)

Conclusions: The prevalence of AKI in neonatal asphyxia is high. The more severe stage of neonatal asphyxia, the more severe the AKI stage"