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Desiana Nurhayati
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 = Early metabolic adaptation in late preterm and small for gestational age infants pattern of blood glucose and ketone / Desiana Nurhayati
"[ABSTRAK
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.
ABSTRACT
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.]"
2015
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UI - Tesis Membership  Universitas Indonesia Library
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Arum Gunarsih
Peranan biakan usap telinga dalam diagnosis sepsis awitan dini pada bayi baru lahir = The role of ear swabs culture in the diagnosis early onset sepsis of the newborn
"[ABSTRAK
Latar belakang. Sepsis neonatorum awitan dini (SNAD) adalah sindrom klinis
akibat respon sistemik terhadap infeksi pada awal kehidupan. Diagnosis SNAD
seringkali sulit karena gejala klinisnya tidak spesifik.
Tujuan. Mengetahui sensitivitas dan spesifisitas biakan usap telinga dalam
diagnosis SNAD.
Metode. Subjek penelitian adalah neonatus yang lahir di RSCM Jakarta dan RSU
Tangerang Selatan dengan diagnosis SNAD. Dilakukan pengambilan biakan dari
usapan telinga dan darah bayi.
Hasil. Diantara 50 subjek, terdapat 2 neonatus dengan biakan darah positif, dan 32
neonatus dengan biakan usap telinga positif. Hanya 1 subjek yang memiliki
kesesuaian jenis kuman yang tumbuh dari biakan darah dan biakan usap telinga.
Bakteri yang tumbuh pada biakan usap telinga sebagian besar adalah Gram postif
(62%). Biakan usap telinga mempunyai sensitivitas 64,7%, spesifisitas 36,4%,
nilai duga positif 34,3%, nilai duga negatif 66,6%, rasio kemungkinan positif
1,02, rasio kemungkinan negatif 0,97, dan, akurasi 46% untuk mendeteksi SNAD.
Simpulan. Ditemukan hasil biakan darah positif pada 2 subjek. Biakan usap
telinga memiliki sensitivitas 64,7%, spesifisitas 36,4%, nilai duga positif 34,3%,
nilai duga negatif 66,6%, rasio kemungkinan positif 1,02, rasio kemungkinan
negatif 0,97, dan akurasi 46% untuk mendeteksi SNAD.
ABSTRACT
Background. Early-onset neonatal sepsis (EOS) is a clinical syndrome due to
systemic response to infection in early life. EOS is often difficult to diagnosed
because the clinical symptoms are not specific.
Objective. The study aim to determine sensitivity and specificity of ear swabs
culture in the diagnosis of EOS.
Methods. Neonates born in the CMH Jakarta and Tangerang Selatan Hospital
who developed sepsis were studied. Swabs were collected for culture from baby’s
ear. Bacterias isolated from ear swabs cultured were correlated with those from
blood culture.
Results. Among 50 neonates studied, 2 neonates had positive blood cultured and
32 neonates had positive ear swabs cultured. Only one subject had suitability
types of bacterias that grew from blood and ear swabs. Bacteria grew from ear
swab cultured were predominantly Gram-positive (62%). Ear swabs cultured had
sensitivity 64.7%, specificity 36.4%, positive predictive value (PPV) 34.3%,
negative predictive value (NPV) 66.6%, positive likelihood ratio (PLR) 1.02,
negative likelihood ratio (NLR) 0.97, and accuracy 46% to detect EOS.
Conclusions. This study showed positive blood culture results were found in two
subjects. Ear swabs cultured had a sensitivity 64.7%, specificity 36.4%, PPV
34.3%, NPV 66.6%, PLR 1.02, NLR 0.97, and accuracy 46% to detect EOS, Background. Early-onset neonatal sepsis (EOS) is a clinical syndrome due to
systemic response to infection in early life. EOS is often difficult to diagnosed
because the clinical symptoms are not specific.
Objective. The study aim to determine sensitivity and specificity of ear swabs
culture in the diagnosis of EOS.
Methods. Neonates born in the CMH Jakarta and Tangerang Selatan Hospital
who developed sepsis were studied. Swabs were collected for culture from baby’s
ear. Bacterias isolated from ear swabs cultured were correlated with those from
blood culture.
Results. Among 50 neonates studied, 2 neonates had positive blood cultured and
32 neonates had positive ear swabs cultured. Only one subject had suitability
types of bacterias that grew from blood and ear swabs. Bacteria grew from ear
swab cultured were predominantly Gram-positive (62%). Ear swabs cultured had
sensitivity 64.7%, specificity 36.4%, positive predictive value (PPV) 34.3%,
negative predictive value (NPV) 66.6%, positive likelihood ratio (PLR) 1.02,
negative likelihood ratio (NLR) 0.97, and accuracy 46% to detect EOS.
Conclusions. This study showed positive blood culture results were found in two
subjects. Ear swabs cultured had a sensitivity 64.7%, specificity 36.4%, PPV
34.3%, NPV 66.6%, PLR 1.02, NLR 0.97, and accuracy 46% to detect EOS]"
2015
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Suraiyah
Prevalens dan prediktor keberhasilan ekstubasi pada bayi di Nicu RSCM = Prevalence and predictors of successful extubation in infants at Nicu Cipto Mangunkusumo Hospital
"[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.
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]"
2015
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Thomas Harry Adoe
Perbandingan efektivitas continuous positive airway pressure dan nasal intermittent positive pressure ventilation pada neonatus dengan gawat napas = Effectiveness of continuous positive airway pressure versus nasal intermittent positive pressure ventilation to newborn with respiratory distress
"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.
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"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2015
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Dwi Hidayah
Hubungan antara hipotermia saat masuk instalasi gawat darurat dengan mortalitas bayi baru lahir rujukan di RSUD DR Moewardi = Risk of mortality associated with hypothermia on admission in newborns reffered to Moewardi Hospital
"[ABSTRAK
Latar belakang: Hipotermia pada bayi baru lahir (BBL) masih merupakan masalah utama dan menjadi penyebab morbiditas dan mortalitas. Angka kejadian hipotermia pada BBL rujukan saat datang di rumah sakit masih tinggi.
Tujuan: Mengetahui hubungan antara hipotermia saat masuk Instalasi Gawat Darurat (IGD) dengan mortalitas pada BBL rujukan di RSUD Dr. Moewardi.
Metode: Penelitian ini merupakan penelitian kohort prospektif yang dilakukan di RSUD Dr. Moewardi. Pengumpulan data dilakukan pada 1 Januari sampai 31 Maret 2015 terhadap pasien BBL rujukan.Variabel tergantung adalah mortalitas dan variabel bebas meliputi umur kehamilan, berat lahir, sepsis, gangguan napas berat, dan suhu saat masuk IGD. Data dianalisis dengan menggunakan metode chi-square dan regresi logistik dengan nilai p<0,05 dan 95 % Confidence Interval (CI).
Hasil: Didapatkan 56 BBL rujukan dengan angka kejadian hipotermia 60,7% dan mortalitas 19,6%. Dari analisis chi-square didapatkan variabel umur kehamilan dan berat lahir tidak memenuhi syarat analisis multivariat (p>0,25). Dari analisis multivariat regresi logistik didapatkan gangguan napas berat berhubungan dengan mortalitas pada BBL rujukan yang secara statistik tidak bermakna (OR=5,250; IK 95%=0,894-30,820). Setelah dilakukan analisis multivariat regresi logistik untuk mendapatkan OR terkontrol didapatkan hubungan yang bermakna antara suhu saat masuk IGD (OR=11,04; IK 95%=1,180-103,274) dan sepsis (OR=8,028; IK95%= 1,650-39,053) dengan mortalitas BBL rujukan.
Simpulan: Angka kejadian pada BBL rujukan hipotermia masih tinggi. Hipotermia saat masuk IGD dan sepsis merupakan faktor risiko mortalitas pada BBL rujukan.
ABSTRACT
Background.Hypothermia still as a mayor cause of neonatal morbidity and mortality. The incidence of hypothermia on admission is high.
Objective. To analyzed the risk of mortality associated with hypothermia on admission in newborns reffered to Moewardi hospital
Methods.A cohort prospectif study of neonate referred at Moewardihospital from January 1st to March 31st, 2015. Analyzed variables were gestational age, birth weight, septicaemia, severe respiratory distress and temperature on admission. Data were analyzed by chi-square and logistic regretion with 95% confidence interval (CI)
Results. Out of 56 neonates referred, the incidence of hypothermia was 60,7% and mortality was 19,6%. Gestational age and birth weightwere not significant associated with neonates referred mortality (p>0,25). Multivariat logistic regression analysis revealed that severe respiratory distress was not statistically significant associated with neonates referred mortality (OR=5,250; 95% CI =0,894-30,820). Multivariat logistic regression analysis revealed that hypothermia on admission (OR=11,04; 95% CI= 1,180-103,274) and septicaemia [OR=8,028; 95% CI=1,650-39,053) were statistically significant associated with neonates referred mortality.
Conclusion. The incidence of hypothermia on admission is high. Hypothermia on admission to be a risk factor for neonatal mortality., Background.Hypothermia still as a mayor cause of neonatal morbidity and mortality. The incidence of hypothermia on admission is high.
Objective. To analyzed the risk of mortality associated with hypothermia on admission in newborns reffered to Moewardi hospital
Methods.A cohort prospectif study of neonate referred at Moewardihospital from January 1st to March 31st, 2015. Analyzed variables were gestational age, birth weight, septicaemia, severe respiratory distress and temperature on admission. Data were analyzed by chi-square and logistic regretion with 95% confidence interval (CI)
Results. Out of 56 neonates referred, the incidence of hypothermia was 60,7% and mortality was 19,6%. Gestational age and birth weightwere not significant associated with neonates referred mortality (p>0,25). Multivariat logistic regression analysis revealed that severe respiratory distress was not statistically significant associated with neonates referred mortality (OR=5,250; 95% CI =0,894-30,820). Multivariat logistic regression analysis revealed that hypothermia on admission (OR=11,04; 95% CI= 1,180-103,274) and septicaemia [OR=8,028; 95% CI=1,650-39,053) were statistically significant associated with neonates referred mortality.
Conclusion. The incidence of hypothermia on admission is high. Hypothermia on admission to be a risk factor for neonatal mortality.]"
2015
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Hutapea, Andhika Tiurmaida
Perbandingan efektifitasi dan efisiensi pemasangan Peripherally Inserted Central Catheter dibandingkan dengan pemasangan Peripheral Intravneous Catheter pada bayi berat lahir sangat rendah = Cost effectiveness analysis comparison of Peripherally Inserted Central Catheter and Peripherally Intravenous Catheter in very low birthweight infant
"[ABSTRAK
Tujuan : 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.
ABSTRACT
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. , 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. ]"
Fakultas Kedokteran Universitas Indonesia, 2015
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Afifa Ramadanti
Ketuban pecah dini sebagai faktor risiko Neonatal Pneumonia di Rumah Sakit Mohammad Hoesin Palembang = Premature rupture of membrane as risk factor of Neonatal Pneumonia at mohammad hoesin hospital palembang
"Latar belakang: Neonatal pneumonia merupakan penyakit yang menyebabkan morbiditas dan mortalitas yang cukup tinggi. Faktor risiko terjadinya neonatal pneumonia perlu diidentifikasi untuk memberikan tatalaksana yang optimal.
Tujuan: Mengetahui ketuban pecah dini sebagai faktor risiko neonatal pneumonia di Rumah Sakit Mohammad Hoesin Palembang.
Metode: Penelitian ini merupakan penelitian kasus kontrol yang dilakukan di RS Mohammad Hoesin Palembang dari bulan Januari sampai Juni 2015. Kelompok kasus adalah neonatus usia kurang dari 48 jam dengan diagnosis neonatal pneumonia yang dipasangkan dengan kelompok kontrol yaitu neonatus sehat berdasarkan usia, berat lahir, jenis kelamin dan usia gestasi yang sama. Variabel yang dianalisis adalah ketuban pecah dini, lamanya pecah ketuban, oligohidramnion, ketuban berbau busuk, riwayat ibu demam, lekositosis pada ibu dan nilai Apgar rendah. Data dianalisis dengan analisis bivariat (chi square) dan multivariat (regeresi logistik).
Hasil: Didapatkan 96 neonatus (32 kasus dan 64 kontrol). Berdasarkan analisis chi square didapatkan ketuban pecah dini lebih dari 12 jam OR 7,96 (p 0,002), ketuban pecah dini lebih dari 18 jam OR 10,3 (p 0,002), riwayat ibu demam OR 7,1 (p 0,015), ketuban berbau busuk OR 6,78 (p 0,018) dan nilai Apgar rendah OR 4,32 (p 0,038) merupakan faktor risiko terjadinya neonatal pneumonia. Setelah dilakukan analisis regresi logistik didapatkan yang masih memiliki hubungan bermakna adalah ketuban pecah dini lebih dari 18 jam OR 10,1 (p 0,006) dan nilai Apgar rendah OR 4,1 (p 0,045).
Background: Neonatal pneumonia cause high morbidity and mortality of the newborn. Risk factors of neonatal pneumonia is important to identify in order to treat neonatal pneumonia properly.
Objective: To identify premature rupture of membrane as risk factor of neonatal pneumonia at Mohammad Hoesin Hospital Palembang.
Methods: A case control study was done at Mohammad Hoesin Hospital Palembang from January to June 2015. Case group are neonates within 48 hours of age with diagnosis of neonatal pneumonia and control group are well neonates which macthed according to age, birth weight, sex and gestational age. Variables that are analyzed are premature rupture of membrane, duration of rupture, smell liquor, maternal fever, oligohydramnion, maternal leucocytosis and low Apgar score. Analyzing using bivariate analysis (chi squre) and multivariate analysis (regression logistic).
Results: Out of 96 neonates (32 cases and 64 controls). Accordng to chi square analysis premature rupture of membrane more than 12 hours OR 7.96 (p 0.002), PROM more than 18 hours OR 10.3 (p 0.002), maternal fever OR 7.1 (p 0.015), smell liquor OR 6.78 (p 0.018) and low Apgar score OR 4.32 (p 0.038) are risk factors of neonatal pneumonia. After analyzing using regression logistic it is revealed that PROM more than 18 hours OR 10.1 (p 0.006) and low Apgar score OR 4.1 (p 0.045) are still have relation with neonatal pneumonia as risk factors.
Conclusion: Premature rupture of membrane is risk factor of neonatal pneumonia at Mohammad Hoesin Hospital Palembang."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2016
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Agnes Yunie Purwita Sari
Upaya peningkatan cakupan penggunaan air susu ibu pada bayi sakit dengan metode diskusi kelompok terarah petugas kesehatan di Rumah Sakit Cipto Mangunkusumo ; Efforts to increase rates of breastfeeding for sick babies through focus group discussion methods of healthcare workers in Cipto Mangunkusumo Hospital
"ABSTRAK
Latar belakang. Upaya peningkatan pencapaian pemberian ASI pada bayi sakit sangat diperlukan. Penelitian ini bertujuan untuk mengetahui pengaruh Focus
Group Discussion tenaga kesehatan terhadap peningkatan pemberian ASI.
Metode. Penelitian ini merupakan operational research, dengan FGD dan
wawancara mendalam sebagai intervensi. Diagram fishbone digunakan untuk analisis masalah. Tingkat pemberian ASI dibandingkan sebelum FGD dan setelah FGD.
Hasil. Terdapat 257 subjek penelitian, yaitu 177 subjek sebelum FGD dan 80
subjek setelah FGD. Proporsi subjek yang mendapat ASI selama perawatan adalah 97,5% setelah FGD dan 82,9% sebelum FGD (X1
2=9,43 p=0,002). Subjek yang mendapat ASI dalam 0-4 jam lebih tinggi setelah FGD (10(12,5%)) dibandingkan sebelum FGD (6,(3,5%)) (X5
2=52,5; p<0. 001). Kendala program pemberian ASI
diselesaikan dengan 1) dukungan Manajemen Rumah Sakit, 2) dukungan petugas
kesehatan kepada ibu menyusui, 3) dukungan suami dan keluarga kepada ibu
menyusui, 4) biaya, 5) faktor lain seperti level perawatan dan FGD secara secara konsisten, dan 6) diperlukan penelitian kohort prospektif.
Simpulan. FGD petugas kesehatan meningkatkan pemberian ASI selama perawatan, serta mempercepat inisiasi pemberian ASI. Perangkat diagram
fishbone dalam FGD dapat menganalisis kendala pelaksanaan program pemberian
ASI pada bayi sakit.ABSTRACT Background. Improving breastfeeding in sick infants is essential. The purpose of this study is to analyse the influence of Focus Group Discussion (FGD) on
healthcare workers on breastfeeding achievement in sick infants.
Methods. This study was an operational research using FGD and in-depth interviews an intervention. Fishbone diagram was used to analyse problems.
Breastfeeding achievement was compared before FGD and after FGD.
Results. There were 257 subjects, 177 infants before FGD and 80 infants after
FGD. The proportion of subjects with breastfeeding during admission was 97.5%
after the FGD, and 82.9% before the FGD (x1
2 = 9.43; p = 0.002). Breastfeeding
initiation in 0-4 hours was higher after the FGD, 10 (12.5%) compared to 6
(3.5%) before the FGD (x5
2 = 52.5; p < 0.001). The solutions for breastfeeding
problems were: 1) Supporting for the hospital management, 2) supporting of healthcare workers for breastfeed mothers, 3) supporting of husband and family
for breastfeed mother, 4) finance, 5) other factors such as admission level and
FGD consistently. 6) and a prospective cohort study was required.
Conclusions. FGD increased breastfeeding acheivement during admission, and
accelerated breastfeeding initiation. Fishbone diagram effectively analyzed the
problems or difficulties on breastfeeding programs for sick babies;Background. Improving breastfeeding in sick infants is essential. The purpose of this study is to analyse the influence of Focus Group Discussion (FGD) on
healthcare workers on breastfeeding achievement in sick infants.
Methods. This study was an operational research using FGD and in-depth interviews an intervention. Fishbone diagram was used to analyse problems.
Breastfeeding achievement was compared before FGD and after FGD.
Results. There were 257 subjects, 177 infants before FGD and 80 infants after
FGD. The proportion of subjects with breastfeeding during admission was 97.5%
after the FGD, and 82.9% before the FGD (x1
2 = 9.43; p = 0.002). Breastfeeding
initiation in 0-4 hours was higher after the FGD, 10 (12.5%) compared to 6
(3.5%) before the FGD (x5
2 = 52.5; p < 0.001). The solutions for breastfeeding
problems were: 1) Supporting for the hospital management, 2) supporting of healthcare workers for breastfeed mothers, 3) supporting of husband and family
for breastfeed mother, 4) finance, 5) other factors such as admission level and
FGD consistently. 6) and a prospective cohort study was required.
Conclusions. FGD increased breastfeeding acheivement during admission, and
accelerated breastfeeding initiation. Fishbone diagram effectively analyzed the
problems or difficulties on breastfeeding programs for sick babies"
Fakultas Kedokteran Universitas Indonesia, 2016
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Pudji Andayani
Hubungan antara kadar c reaktif protein saliva dan darah pada bayi baru lahir risiko infeksi = Correlation between c reactive protein saliva level and blood samples in newborn baby with infection risk
"ABSTRAK
Latar belakang Bayi baru lahir BBL sangat rentan terhadap infeksi dari dalam kandungan maupun di lingkungan luar kandungan Infeksi berat yang terjadi di 3 hari pertama kehidupan Early Onset Sepsis pada BBL dapat ditegakkan melalui penampakan klinis maupun beberapa marka infeksi seperti C reak tif protein CRP Sampel darah yang diperlukan utuk pemeriksaan CRP cukup banyak dan cukup menyulitkan untuk BBL Saliva mengandung komponen yang mirip dengan darah dalam hal mendeteksi CRP Tujuan Mengetahui apakah CRP saliva dapat digunakan seakurat darah neonatus mendeteksi infeksi dini neonatus Metode Penelitian dilakukan selama periode Oktober 2015 ndash Desember 2015 pada bayi baru lahir risiko infeksi yang memenuhi kriteria Data dianalisis dengan perangkat elektronik statistik dengan tingkat kemaknaan p0 05 terdapat hubungan yang bermakna antara CRP saliva terhadap CRP darah Nilai p 0 05 dengan r positif atau searah yang menunjukkan semakin tinggi kadar CRP saliva semakin tinggi juga kadar CRP darah Kekuatan hubungan sangat kuat 0 8
ABSTRACT
Backgound Newborns babies are very susseptible to infection from intra and extrauterine environment Severe infection within the first 3 day of life is classified as early onset sepsis EOS in the newborn baby based on clinical manifestation and same serological markers such as C reactive protein CRP Blood samples procedure to CRP examination are more volume liquid and requires highly trainned personnel for newborn Objective To know wether salivatory CRP can be used acurated as CRP from blood sample for detection early infection in neonate and to evaluated sample characteristic association with blood and CRP saliva Methods A prospective study was conducted in newborn baby at Ulin Hospital Banjarmasin period 15 october 2015 to December 15 2015 The participates are newborn babies with risk infection who enrolled inclusion criteria Statistical analyses used the software statistic electronic significant is p 0 05 Saliva CRP and blood samples were detected in each group as 8 babies with concentration ge 10mg L There was a statisticaly significant correlation between salivary CRP level to blood CRP level r 0 806 p"
Fakultas Kedokteran Universitas Indonesia, 2016
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Eny Yantri
Perbandingan peningkatan berat badan bayi prematur yang mendapat ASI di fortifikasi dan yang tidak mendapat ASI di RSUP dr. M. Djamil Padang Sumatera Barat = Comparison of weight gain among premature infants receiving fortified breastmilk and who did not receive breast milk in dr. M. Djamil hospital West Sumatera
"Breastmilk is the best nutrition for infant but giving only breastmilk for preamature infants older than 2 weeks could not comply the needs and has to be fortified Human milk fortifier HMF is very recommended to fortify breastmilk In west Sumatera including DR M Djamil Hospital HMF was unreachable and expensive At certain hospital in Africa and several Hospital in United States they exclusively use fortified breastmilk with Post Discharge Formula PDF Objective To compare the weight gain among premature infants receiving fortified breastmilk with PDF and premature formula milk and also to observe the adverse event Methods A 4 weeks experimental study on premature infants gestational age ge 28 until 37 weeks who receive fortified breastmilk with PDF and some of them received premature formula milk acted as a control from March until December 2015 in DR M Djamil Hospital West Sumatera Results Data was obtained from 30 sample for each group intervention and control Sample baseline characteristic such as sex gestational age GA birth weight and previous illness history was indifferent statistically The mean of birth weight in control group was 1643 grams the mean of weight at the initial study was 1631 grams and the mean of birth weight at the end of study 4 weeks was 2573 grams The mean of birth weight in intervention group was 1682 grams the mean of weight at the initial study was 1722 grams and the mean of birth weight at the end of study 4 weeks was 2775 grams The mean of time to reach full feed condition initial study in control group was 14 days and 18 days in intervention group The mean of weight gain during 4 weeks was 958 grams in control group and 1053 grams in intervention group p 0 22 There was no adverse event found in infants received both breastmilk fortified with PDF and premature formula milk Conclusion It appears that weight gain of premature infants who receive breastmilk fortified with PDF is indifferent statistically compared with premature infants who receive formula milk There is no adverse event found in this study"
Depok: Universitas Indonesia, 2016
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