Dadang Hudaya Somasetia
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Journal : Paediatrica Indonesiana

Agreement of simplified Fencl-Stewart with Figge-Stewart method in diagnosing metabolic acidosis in critically ill children Rotua Sinaga; Abdurachman Sukadi; Dadang Hudaya Somasetia
Paediatrica Indonesiana Vol 47 No 4 (2007): July 2007
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (436.663 KB) | DOI: 10.14238/pi47.4.2007.144-9

Abstract

Background The traditional Henderson-Hasselbalch approach hasproven to be imprecise in critically ill patients. Stewart’s approachcan detect metabolic acidosis missed by traditional approach,including acidosis caused by increased unmeasured agreement(UA). The complexity of Stewart’s method leads to developmentof simpler modifications, simplified Fencl-Stewart and Figge-Stewart method. Agreement between both modifications isunknown.Objective This study aimed to measure the agreement of simplifiedFencl-Stewart with Figge-Stewart method in diagnosing metabolicacidosis in critically ill children.Methods The was performed in Hasan Sadikin General Hospital,Bandung from July to August 2006, involving <14 year-old criticallyill children. Blood samples for gas analysis, sodium, potassium,chloride and albumin measurement were taken simultaneously. Testresult was analyzed with simplified Fencl-Stewart and Figge-Stewartmethod and recorded with Excell spreadsheet. PASS was used forinterim analysis and DAG_Stat for raw agreement indices andKappa calculations.Results Forty-five (31 males, 14 females) children were enrolled.Acid base disturbances based on Stewart’s method were identifiedin 10 subjects with normal base excess and nine with normalbicarbonate. Significant increase of UA was detected in 11 of 45subjects with simplified Fencl-Stewart method, compared to thatof 12 subjects with Figge-Stewart method. Raw agreement indicesshowed 95.65% and 98.51% agreement for positive and negativeresult, Kappa was 0.94 (P=0.0000).Conclusions Excellent agreement is shown between simplifiedFencl-Stewart and Figge-Stewart method in diagnosing metabolicacidosis in critically ill children. Increased UA can be assessedwith both methods.
Neutrophil-lymphocyte count ratio correlation to procalcitonin and PELOD-2 score in pediatric sepsis Desak Gede Arie Yudhantari; Dadang Hudaya Somasetia; Eddy Fadlyana; Djatnika Setiabudi
Paediatrica Indonesiana Vol 61 No 4 (2021): July 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.4.2021.211-6

Abstract

Background Sepsis is a leading cause of children’s mortality worldwide. Procalcitonin (PCT) is a widely used infection marker, but has limitations in terms of cost and availability. The neutrophil-lymphocyte count ratio (NLCR) is easy to perform, low-cost, and widely used as a diagnostic and prognostic marker of various inflammatory processes. Objective To investigate possible correlations of NLCR to PCT and Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score among pediatric sepsis patients. Method A retrospective study was conducted by reviewing the Pediatric Sepsis Registry at Dr. Hasan Sadikin General Hospital, Bandung, West Java, from January 2019–June 2020. We recorded patients’ characteristics, PELOD-2 score, NLCR, and PCT results. Correlation analysis was conducted using Spearman’s Rank test with significance value of P<0.05. Results Ninety patients were included in the study. Most patients were male (56.7%), under 2 years of age (57.8%), and had lower respiratory tract infection (67.8%) as the most common source of infection. The NLCR value had significant, positive correlations to PCT (r=0.642; P<0.001) and PELOD-2 score (r=0.233; P=0.027) in pediatric sepsis patients. Conclusion The NLCR is directly proportional to PCT in pediatric sepsis patients. This result suggents that NLCR may have a potential role as an alternative marker for sepsis in emergency setting.