Skrining Retinopathy of Prematuritydi Rumah Sakit dengan Fasilitas Terbatas

Latar belakang. Retinopathy of prematurity(ROP) adalah penyakit vasoproliferatif retina yang dihindari. Sebagian besar ROP derajat rendah dapat sembuh sendiri, namun beberapa kasus dapat berkembang sehingga retina lepas dan diakhiri dengan kebutaan. Oleh sebab itu skrining terhadap ROP telah dianjurkan di banyak negara. Tujuan. Melaporkan insiden ROP di RSIA Eria Bunda Pekanbaru dan melakukan evalusi pelaksanaan skrining ROP selama tiga tahun. Metode. Studi deskriptif terhadap semua bayi dengan risiko ROP. Pemeriksaan dilakukan oleh seorang dokter mata dengan menggunakan binocular indirect opthalmoscopy (BIO). Pemeriksaan dimulai pada usia kronologis 4 sampai 6 minggu dan dilanjutkan tiap 1-2 minggu sekali sampai vaskularisasi retina lengkap. Hasil. Diantara 60 orang bayi yang diperiksa, ROP ditemukan pada 11 (18,3%) bayi, enam (10%) diantaranya ROP berat. Tiga ROP berat dirujuk ke Jakarta, satu meninggal dunia, satu mengalami retinal detachmentdan satu orang sembuh. Tiga lainnya tidak dirujuk, satu mengalami kebutaan, satu meninggal, dan satu tidak diketahui. Kesimpulan. Skrining ROP di rumah sakit daerah dengan fasilitas terbatas dapat dilakukan. Dalam tiga tahun ditemukan insiden ROP sebanyak 18,3%. Tidak semua ROP berat dapat diterapi karena kesulitan transportasi dan keterbatasan biaya. Perlu dipikirkan kemungkinan pengobatan ROP di Pekanbaru, karena transportasi ke tempat rujukan masih menjadi masalah besar

Variations in medical practice of retinopathy of prematurity among 8 Asian countries from an international survey

Abstract Advances in perinatal care have led to the increased survival of preterm infants with subsequent neonatal morbidities, such as retinopathy of prematurity (ROP). This study aims to compare the differences of neonatal healthcare systems, resources, and clinical practice concerning ROP in Asia with review of current literature. An on-line survey at the institutional level was sent to the directors of 336 neonatal intensive care units (NICU) in 8 collaborating national neonatal networks through the Asian Neonatal Network Collaboration (AsianNeo). ROP screening was performed in infants born at < 34 weeks in Indonesia and Japan. In South Korea, Malaysia, and Taiwan, most screened for ROP in infants born at < 32 weeks. In all networks, majority of NICUs conducted ROP screening to infants with birth weight < 1500 g. In most NICU’s in-hospital ophthalmologists performed indirect ophthalmoscopy and some were supplemented with digital imaging. Both laser photocoagulation and anti-vascular endothelial growth factor injection are performed for treatment and, vitreous surgeries are conducted less frequently in all countries. Despite limited information collected by the survey, this first study to compare ROP practices implemented in eight Asian countries through AsianNeo will enable an understanding of the differences and facilitate quality improvement by sharing better practices

Table2_Contemporary fluid management, humidity, and patent ductus arteriosus management strategy for premature infants among 336 hospitals in Asia.docx

ObjectivesThe management of patent ductus arteriosus (PDA) is a critical concern in premature infants, and different hospitals may have varying treatment policies, fluid management strategies, and incubator humidity. The Asian Neonatal Network Collaboration (AsianNeo) collected data on prematurity care details from hospitals across Asian countries. The aim of this study was to provide a survey of the current practices in the management of PDA in premature infants in Asian countries.MethodsAsianNeo performed a cross-sectional international questionnaire survey in 2022 to assess the human and physical resources of hospitals and clinical management of very preterm infants. The survey covered various aspects of hospitals resources and clinical management, and data were collected from 337 hospitals across Asia. The data collected were used to compare hospitals resources and clinical management of preterm infants between areas and economic status.ResultsThe policy of PDA management for preterm infants varied across Asian countries in AsianNeo. Hospitals in Northeast Asia were more likely to perform PDA ligation (p ConclusionsIn advanced economies and Northeast Asia, neonatologists tend to adopt a more conservative approach towards fluid management, maintain higher incubator humidity settings and inclined to perform surgical ligation for PDA.</p

Table1_Contemporary fluid management, humidity, and patent ductus arteriosus management strategy for premature infants among 336 hospitals in Asia.docx

ObjectivesThe management of patent ductus arteriosus (PDA) is a critical concern in premature infants, and different hospitals may have varying treatment policies, fluid management strategies, and incubator humidity. The Asian Neonatal Network Collaboration (AsianNeo) collected data on prematurity care details from hospitals across Asian countries. The aim of this study was to provide a survey of the current practices in the management of PDA in premature infants in Asian countries.MethodsAsianNeo performed a cross-sectional international questionnaire survey in 2022 to assess the human and physical resources of hospitals and clinical management of very preterm infants. The survey covered various aspects of hospitals resources and clinical management, and data were collected from 337 hospitals across Asia. The data collected were used to compare hospitals resources and clinical management of preterm infants between areas and economic status.ResultsThe policy of PDA management for preterm infants varied across Asian countries in AsianNeo. Hospitals in Northeast Asia were more likely to perform PDA ligation (p ConclusionsIn advanced economies and Northeast Asia, neonatologists tend to adopt a more conservative approach towards fluid management, maintain higher incubator humidity settings and inclined to perform surgical ligation for PDA.</p

Contemporary fluid management, humidity, and patent ductus arteriosus management strategy for premature infants among 336 hospitals in Asia

ObjectivesThe management of patent ductus arteriosus (PDA) is a critical concern in premature infants, and different hospitals may have varying treatment policies, fluid management strategies, and incubator humidity. The Asian Neonatal Network Collaboration (AsianNeo) collected data on prematurity care details from hospitals across Asian countries. The aim of this study was to provide a survey of the current practices in the management of PDA in premature infants in Asian countries.MethodsAsianNeo performed a cross-sectional international questionnaire survey in 2022 to assess the human and physical resources of hospitals and clinical management of very preterm infants. The survey covered various aspects of hospitals resources and clinical management, and data were collected from 337 hospitals across Asia. The data collected were used to compare hospitals resources and clinical management of preterm infants between areas and economic status.ResultsThe policy of PDA management for preterm infants varied across Asian countries in AsianNeo. Hospitals in Northeast Asia were more likely to perform PDA ligation (p &lt; 0.001) than hospitals in Southeast Asia. Hospitals in Northeast Asia had stricter fluid restrictions in the first 24 h after birth for infants born at &lt;29 weeks gestation (p &lt; 0.001) and on day 14 after birth for infants born at &lt;29 weeks gestation (p &lt; 0.001) compared to hospitals in Southeast Asia. Hospitals in Northeast Asia also had a more humidified environment for infants born between 24 weeks gestation and 25 weeks gestation in the first 72 h after birth (p &lt; 0.001). A logistic regression model predicted that hospitals were more likely to perform PDA ligation for PDA when the hospitals had a stricter fluid planning on day 14 after birth [Odds ratio (OR) of 1.70, p = 0.048], more incubator humidity settings (&lt;80% vs. 80%–89%, OR of 3.35, p = 0.012 and &lt;80% vs. 90%–100%, OR of 5.31, p &lt; 0.001).ConclusionsIn advanced economies and Northeast Asia, neonatologists tend to adopt a more conservative approach towards fluid management, maintain higher incubator humidity settings and inclined to perform surgical ligation for PDA