REPRESENTATION OF ERYTHROCYTES IN PIGLET (Sus scrofa) POST HYPOVOLEMIC SHOCK WITH NORMO AND HYPERVOLEMIA RESUSCITATION OF CRYSTALLOID FLUID

The aim of this study is to evaluate the representation of erythrocytes, which is the count of erythrocytes; hemoglobin concentration, hematocrit value, and platelet count in piglet (Sus scrofa) after hypovolemic shock with normal and hypervolemia resuscitation of crystalloid fluid. This study uses nine male castrated piglets 6-8 weeks of age. The piglets are given treatments such catheter installation, shock induction, normovolemia resuscitation, and hypervolemia resuscitation. The fluid for resuscitation is crystalloid fluid, NaCl 0.9%. Blood sample is taken in baseline, normovolemia condition, and hypervolemia condition. The sample is analyzed using hematology blood analyzer and is tested using T-Paired. Total erythrocytes count after normovolemia resuscitation is 3.07x106/µL, while after hypervolemia resuscitation the erythrocytes count decrease until 2.86x106/µL. Hemoglobin concentration after normovolemia resuscitation is 9.4 g/dL, while after hypervolemia resuscitation hemoglobin concentration decreases to 8.64 g/dL. Hematocrit count from piglets after normovolemia resuscitation is 28 %, while it decreases after hypervolemia resuscitation to 25.89%. Platelet count after normovolemia resuscitation is 297.22x103/mm3 and decreases to 263.89x103/mm3 after hypervolemia resuscitation. Evaluation of the erythrocytes index shows that the piglets suffer anemia. Hypovolemic shock and normal, and hypervolemia resuscitation cause the significant decreases in all erythrocytes indexes except the platelet count

Diabetic Ketoacidosis in Adolescents and Children: A Prospective Study of Blood versus Urine Ketones in Monitoring Therapeutic Response

Background: diabetic ketoacidosis (DKA) is a potentially lethal complication of diabetes mellitus (DM). There is no study in Indonesia that compares the much-preferred capillary beta hydroxybutirate (β-OHB) measurement to urine acetoacetate in monitoring therapeutic response of DKA in adolescents. Methods: a prospective study of 37 adolescents and children with DKA in Cipto Mangunkusumo Hospital was done between June 2006 and March 2011. The patients were followed until the time of DKA resolution. Hourly measurement of random blood glucose, capillary β-OHB concentration, and urine ketones were done, while blood gas analysis and electrolyte were measured every four hours. Results: median time to resolution was 21 (9-52) hours. Compared to urine ketones, capillary β-OHB concentration showed stronger correlation with pH (r= -0,52, p= 0,003 vs r= -0,49, p= 0,005) and bicarbonate level (r=-0,60, p=0.000 vs r= -0.48, p=0.007) during the median time of DKA resolution. All capillary β-OHB measurement yielded negative results at median time of DKA resolution, while urine ketones were still detected up to 9 hours after resolution. Conclusion: blood ketone concentration showed better correlation with pH and bicarbonate level, as a tool to monitor therapeutic response in DKA in adolescent, compared to traditional urine ketones test in adolescents

Buku Ajar Pediatri Gawat Darurat

298 hal. : il. ; 17,5 x 25 c

Buku Ajar Pediatri Gawat Darurat

298 hal.; 25 c

Resusitasi Cairan: dari Dasar Fisiologis hingga Aplikasi Klinis

Resusitasi cairan merupakan langkah penting tatalaksana renjatan pada anak. Kebutuhan resusitasi cairan sangat individual. Pemberian cairan yang tidak tepat dapat membahayakan  pasien. Tinjauan pustaka ini akan membahas fisiologi dasar sistem hemodinamik, khususnya dalam kaitannya dengan resusitasi cairan. Berbagai protokol pemberian resusitasi cairan akan dibahas secara teknik, serta masalahnya pada penggunaannya dalam klinis

Buku Ajar Pediatri Gawat Darurat

xvi, 264 hlm.; 14 x 21 c

Evaluation of substrate metabolism in critically ill pediatric patients

Background: Critically ill pediatric patients are characterized by a hypermetabolic state, a catabolic response, and a decreased capacity to utilize substrate. Metabolic state of critically ill pediatric patients can be detected by analyzing substrate utilization.Objective: To determine the metabolic state of critically ill pediatric patients using PRISM III Score, blood glucose level, and urinary nitrogen excretion.Methods: A cross sectional study was conducted in Pediatric Intensive Care Unit (PICU) of Cipto Mangunkusumo Hospital Jakarta between May and September 2006. All admitted PICU patients, except those with renal or hepatic failure, burns, diabetic ketoacidosis and died in the first 24 hours, were included. PRISM III Scores were measured in the first 24-hours of admission. Blood glucose level was observed at random within the first hour of hospitalization, while urinary nitrogen excretion was measured using urine collected in the second 24-hours of admission.Results: Fifteen cases were eligible for this study. Their age ranged between 1 to 96 months. The median (01 ;03) for PRISM III Scores, random blood glucose, and urinary nitrogen excretion were 6.0 (3.0;11.0), 123.0 (100.0;227.0), and 279.4 (124.3;408.4) mg/dL, respectively. There were no significant correlations between PRISM III Scores and random blood glucose (r=0.40;p=0.14), and between PRISM III Scores and urinary nitrogen excretion (r = -0.27;p = 0.33). There was significant correlation between random blood glucose and urinary nitrogen excretion (r=0.56;p=0.03).Conclusion: Critically ill pediatric patients had a catabolic state that had no association with PRISM III Scores. Random blood glucose level within the first hour of admission predicted the increasing protein catabolism.Key words: critically ill pediatric patients - blood glucose level - urinary nitrogen excretion - PRISM III Score

Evaluation of substrate metabolism in critically ill pediatric patients

Background: Critically ill pediatric patients are characterized by a hypermetabolic state, a catabolic response, and a decreased capacity to utilize substrate. Metabolic state of critically ill pediatric patients can be detected by analyzing substrate utilization. Objective: To determine the metabolic state of critically ill pediatric patients using PRISM III Score, blood glucose level, and urinary nitrogen excretion. Methods: A cross sectional study was conducted in Pediatric Intensive Care Unit (PICU) of Cipto Mangunkusumo Hospital Jakarta between May and September 2006. All admitted PICU patients, except those with renal or hepatic failure, burns, diabetic ketoacidosis and died in the first 24 hours, were included. PRISM III Scores were measured in the first 24-hours of admission. Blood glucose level was observed at random within the first hour of hospitalization, while urinary nitrogen excretion was measured using urine collected in the second 24-hours of admission. Results: Fifteen cases were eligible for this study. Their age ranged between 1 to 96 months. The median (0103) for PRISM III Scores, random blood glucose, and urinary nitrogen excretion were 6.0 (3.011.0), 123.0 (100.0227.0), and 279.4 (124.3408.4) mg/dL, respectively. There were no significant correlations between PRISM III Scores and random blood glucose (r=0.40p=0.14), and between PRISM III Scores and urinary nitrogen excretion (r = -0.27p = 0.33). There was significant correlation between random blood glucose and urinary nitrogen excretion (r=0.56p=0.03). Conclusion: Critically ill pediatric patients had a catabolic state that had no association with PRISM III Scores. Random blood glucose level within the first hour of admission predicted the increasing protein catabolism. Key words: critically ill pediatric patients - blood glucose level - urinary nitrogen excretion - PRISM III Score