MECHANICAL VENTILATION VS NASAL CPAP DURATION AND THE RISK OF LATE ONSET SEPSIS IN PREMATURE BABIES WITH RESPIRATORY DISTRESS SYNDROME

ABSTRA

MEKANISME PERBAIKAN SEPSIS SETELAH PEMBERIAN SENG PADA HEWAN COBA YANG DIPAPAR LIPOPOLISAKARIDA E COLI INTRAVENA

Background: Severe sepsis increases pro-inflammatory cytokines and damage to the intestinal mucosa, causing systemic translocation to the commensal bacteria. Low zinc levels were also found in patients with sepsis. Objective To explain the mechanisms of sepsis improvement after zinc administration through cytokine regulation and improvement of intestinal mucosal Material and Method: Samples of 40 rats were randomized into 4 group of Control, LPS, LPS-Zinc, and Zinc . Blood sampling in 2-hour after LPS or placebo administration to measure zinc level. Zinc was administered in LPS-Zinc and Zinc group, placebo was given in other groups. Blood sampling in 8, 24 and 72 hours to measure NFkB monocyte expression, TNF-α, IL-6, IL-10, TGF-, MDA, MMP-8 by sandwich-ELISA method and in 72 hours also measured the zinc content by AAS method and jejunal tissue by SEM analysis. Statistical analyzes used were one-way Anova, Kruskall Wallis, Mann-Whitney, Paired-t tests, Wilcoxon Signed Rank Test and path analysis. Results There were decreased in NFkB monocyte expression, levels of TNF-α, IL-6, MDA, and MMP-8 serum in the LPS-Zinc group compared to the LPS group and elevated levels of IL-10, TGF- in the LPS-Zinc group compared to the LPS group. Improvement of intestinal mucosa occured in LPS-Zinc group. Conclusion Administration of zinc in sepsis improves the condition of sepsis by decreasing proinflammatory cytokine (TNF-α and IL-6), increasing anti-inflammatory cytokine (TGF- and IL-10) and improving intestinal mucosa (villi structure of jejunum)

PENGARUH METODE KANGURU TERHADAP PENINGKATAN BERAT BADAN PADA BBLR.

Abstrak Latar Belakang : Di Indonesia angka kematian neonatal sebesar 15 bayi per 1000 angka kelahiran menurut SDKI tahun 2017, dan di Jawa Timur khususnya Surabaya pada tahun 2018 kematian BBLR sebesar 50 per 1000 kelahiran hidup, sedangkan di RSU Haji kematian BBLR sebesar 12 bayi dalam 1 tahun. Perawatan metode kanguru merupakan cara yang paling efektif untuk memenuhi kebutuhan dasar BBLR. Bayi dengan Berat badan 1500-2500 gram baik karena prematuritas atau kecil masa kehamilan (KMK) akan kehilangan berat badan berkisar antara 10-15% pada 7 hari kehidupannya (ANU,2016) maka dari itu untuk mengatasi masalah agar BBLR tidak kehilangan berat badan dengan pemberian perawatan metode kanguru 4 komponen bertujuan meningkatkan berat badan, menjaga suhu tubuh tetap stabil dan memudahkan pemberian ASI Metode: metode penelitian ini adalah Observasional analitik dengan rancang penelitian Kohort. Jumlah sample sebanyak 40 BBLR dengan tehnik pengambilan sample menggunakan Sequential Sampling dalam kurun waktu Agustus-Oktober 2019.Variabel bebas adalah perawatan metode kanguru yang diberikan sebanyak 1-2 kali dalam sehari dengan durasi lebih dari 120 menit. Variabel terikatnya adalah peningkatan berat badan yang dilakukan 3x pengukuran.Hasil: Hasil penelitian menggunakan uji paired T test menunjukkan adanya peningkatan berat badan yaitu 1) pengukuran pertama sebesar 31,82 gram selama 3 hari dengan p = 0,037, 2) pengukuran ke dua mengalami peningkatan sebesar 227,15 selama 7 hari, dengan p=0,000, 3) pengukuran ke tiga sebesar 258,97 dengan p=0,000. Kesimpulan : pada penelitian terdapat perbedaan yang signifikan antara perawatan metode kanguru terhadap peningkatan berat badan BBLR di Ruang NICU Rumah Sakit Haji Surabaya

Incidence and Risk Factors of Retinopathy of Prematurity (ROP): A Single Center Study in a Tertiary Center in Indonesia.

Abstract Background: Retinopathy of prematurity (ROP) is an abnormal proliferative retinal blood vessel in premature infants. ROP is known as one of the causes of blindness in children in developed countries. Objectives: We conducted this study to report the incidence and identify the potential risk factors associated with ROP. Methods: This study was a hospital-based retrospective cohort study of preterm infants in the tertiary neonatal intensive care unit from May 2009 to April 2011. The ROP was identified by an ophthalmologist with binocular indirect ophthalmoscope (BIO). Potential risk factors such as gestational age, birth weight, oxygen therapy, sepsis, small for gestational age, blood transfusion, asphyxia, and respiratory distress syndrome were analyzed using the bivariate and multivariate analysis. Results: There were 248 preterm infants enrolled in this study. Thirty-two (12.9%) patients were diagnosed with various ROP stages, and 43.7% patients suffer from severe ROP requiring treatment for severe ROP. Gestational age and birth weight were not independent risk factors of ROP. In contrast, oxygen therapy (OR 36.93, CI 4.73-288.02), sepsis (OR 4.86, CI 1.85-12.82), and small for gestational age (OR 3.99, CI 1.47-10.82) include as independent risk factors. Conclusions: Incidence of ROP were 12.9%, while the independent risk factors were oxygen therapy, sepsis, and small for gestational age

Ence Of ESBL Bacteria In Baby Box Handle At Dr. Soetomo Hospital

Health Associated Infection (HAI) in neonates can increase neonatal infection risk, which is a fairly frequent cause of neonatal death. Microorganisms that are quite often found to contaminate include gram-negative bacteria such as Escherichia coli and Klebsiella pneumoniae. Gram-negative bacteria are also quite often found to have resistance to antibiotic therapy that is usually given, especially actlactam, and will increase the degree of disease to mortality, this bacterium is called ESBL. The study was conducted to determine the level of ESBL bacterial contamination in health facilities at Dr. Soetomo general hospital. Swabs are taken and biochemical tests were done to identify pathogen species. These isolates were also tested for ESBL production by the double-disc synergy test (DDST). There were 30 samples that contaminate the handle of the baby box, 2 of which (6.67%) tested positive for ESBL. With good hand hygiene, the use of disinfectants in medical devices, floors, walls, and doors, maintenance and replacement of tap water filters, and regular monitoring can reduce the number of bacterial contamination