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Journal : Paediatrica Indonesiana

Using pRIFLE criteria for acute kidney injury in critically ill children Rina Amalia C. Saragih; Jose M. Mandei; Irene Yuniar; Rismala Dewi; Sudung O. Pardede; Antonius Pudjiadi; Abdul Latief
Paediatrica Indonesiana Vol 53 No 1 (2013): January 2013
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (104.685 KB) | DOI: 10.14238/pi53.1.2013.32-6

Abstract

Backgi-ound Incidence of acute kidney injury (AKI) in critically illchildren and its mortality rate is high. The lack of a uniform definitionfor AKI leads to failure in determining kidney injury, delayedtreatment, and the inability to generalize research results.Objectives To evaluate the pediatric RIFLE (pRIFLE) criteria (riskfor renal dysfunction, injury to the kidney, failure of kidney function,loss of kidney function, and end-stage renal disease) for diagnosingand following the clinical course of AKI in critically ill children. Wealso aimed to compare AKI severity on days 1 and 3 of pediatricintensive care unit (PICU) stay in critically ill pediatric patients.Methods This prospective cohort study was performed in PICUpatients. Urine output (UOP), serum creatinine (SCr) , andglomerular filtration rate on days 1 and 3 of PICU stay wererecorded. Classification of AKI was determined according topRIFLE criteria. We also recorded subjects' immune status,pediatric logistic organ dysfunction (PELOD) score, admissiondiagnosis, the use of vasoactive medications, diuretics, andventilators, as well as PICU length of stay and mortality.Results Forty patients were enrolled in this study. AKI wasfound in 13 patients (33%). A comparison of AKI severity onday 1 and day 3 revealed no statistically significant differences forattainment of pRIFLE criteria by urine output only (pRIFLfu0 p;P=0.087) and by both UOP and SCr (pRIFLEcr+uo p; P= 0.577).However, attainment of pRIFLE criteria by SCr only (pRIFLEcrlwas significantly improved between days 1 and 3 (P =0.026). Therewas no statistically significant difference in mortality or length ofstay between subjects with AKI and those without AKI.Conclusion The pRIFLE criteria is feasible for use in diagnosingand following the clinical course of AKI in critically ill children.
Clinical features of dengue hemorrhagic fever and risk factors of shock event Rismala Dewi; Alan Roland Tumbelaka; Damayanti Rusli Sjarif
Paediatrica Indonesiana Vol 46 No 3 (2006): May 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.3.2006.144-8

Abstract

Background Dengue hemorrhagic fever (DHF) can lead to highmorbidity and mortality. Its clinical features vary from time to time.Many studies were performed to determine the risk factors of se-vere dengue infection.Objective To find out clinical features and risk factors for predict-ing the likelihood of shock in DHF.Methods A retrospective cohort study was conducted in all con-firmed DHF children who were hospitalized at the Department ofChild Health, Cipto Mangunkusumo Hospital within the period ofJanuary 1, 2003 until June 30, 2004. Risk factors for developmentof shock were analyzed using chi-square test and multiple logisticregressions with a level of significance of <0.05.Results A total of 101 patients, consisted of 47 males and 54females were enrolled in this study. Mean age was 6.5 (SD 3.6)years, ranged from 5 months to 15 years. About 31.7% patientshad grade III DHF, 30.7% grade II, and 26.7% grade IV (including1 patient with encephalopathy). Shock was more frequent amongpatients aged between 6-10 years, female, under-nourished, bodytemperature <38°C, hematocrit level 46-50 vol%, and platelet count<20 000/ml. During year 2003-2004, there was increased numberof patients who developed shock. Based on univariate analysis,hepatomegaly, high hematocrit value, and thrombocytopenia wereconsidered significantly different. Among those variables analyzedwith multiple logistic regression method, only hepatomegaly andthrombocytopenia were identified as predictors of shock.Conclusion There was an alteration on clinical features of DHFin our hospital in 2003-2004 period compared to the previous years.Hepatomegaly and platelet count <50 000/ml are independent riskfactors of shock among DHF patients
Impact of albumin levels on clinical outcomes in children underwent abdominal surgery Rismala Dewi; Freddy Guntur Mangapul Silitonga; Irawan Mangunatmadja
Paediatrica Indonesiana Vol 60 No 3 (2020): May 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (211.056 KB) | DOI: 10.14238/pi60.3.2020.149-53

Abstract

Background Patients underwent abdominal surgery and had hypoalbuminemia were at risk of post-operative complications. The prognostic role of albumin levels in children with abdominal surgery remains unclear. Objective To investigate the impact of albumin levels on clinical outcomes related to the complications in children with abdominal surgery. Methods This was a retrospective cohort study on children aged 29 days to 18 years, who underwent abdominal surgery, had serum albumin levels measured at pre-operative and within 48 hours post-operatively, and hospitalized in Paediatric Intensive Care Unit of Dr. Cipto Mangunkusumo Hospital, Indonesia. The primary outcomes were post-operative complications (sepsis, surgical site infection, shock), length of stay in PICU, dehiscence, relaparotomy, and postoperative mortality. Results This study recruited a total of 201 children. Pre- and post-operative serum albumin levels of ≤ 3.00 g/dL were found in 15.4% and 51.2%, respectively. Pre- and post-operative serum albumin levels of ≤ 3.00 g/dL were associated with higher risk of post-operative sepsis (RR 3.4; 95%CI 1.54 to 7.51) and relaparotomy (RR 3.84; 95%CI 1.28 to 1.49). The median of length of PICU stay was 4 days longer in children with pre-operative serum albumin levels ≤ 3.00 g/dL (P<0.001). Conclusions Hypoalbuminemia condition in children undergo abdominal surgery is associated with increased risk of post-operative sepsis, longer length of stay in PICU, and risk of relaparotomy.
Blood pressure to height ratio for screening hypertension among Indonesian adolescents Partini Pudjiastuti Trihono; Jeanne Laurensie Sihombing; Rismala Dewi
Paediatrica Indonesiana Vol 63 No 1 (2023): January 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.1.2023.7-12

Abstract

Background Pediatric hypertension is an emerging health issue due to its increasing prevalence. Age-, gender-, and height-specific blood pressure percentiles have been widely used as a primary tool for detection of hypertension in the pediatric population. However, this method is too complicated to be used in general pediatric practice. The blood pressure to height ratio has been proposed as a practical tool to detect hypertension in children. Objective To evaluate the accuracy of blood pressure to height ratio to be used as a tool for screening high blood pressure in Indonesian adolescents. Methods This diagnostic test study using data from the 2013 Indonesia Basic Health Research (Riset Kesehatan Dasar/RISKESDAS) report included 39,057 adolescents aged 15-18 years with complete data on age, gender, weight, height, and blood pressure. Blood pressure values were classified using the 2017 American Academy of Pediatrics (AAP) hypertension clinical guidelines. Blood pressure to height ratio was calculated as mmHg/cm body height. A receiver-operator characteristics (ROC) curve analysis was performed to assess the accuracy of systolic blood pressure to height ratio (SBPHR) and diastolic blood pressure to height ratio (DBPHR) for screening high blood pressure in adolescents. The optimal cut-off points, sensitivity, and specificity of SBPHR and DBPHR were calculated. Results The optimal cut-off points for defining elevated blood pressure in male adolescents aged 13-18 years were SBPHR 0.69 for male adolescents (sensitivity 96%, specificity 80%) and DBPHR 0.46 (sensitivity 97%, specificity 84%). In female adolescents, the optimal cut-offs were SBPHR 0.72 (sensitivity 97%, specificity 82%) and DBPHR 0.48 (sensitivity 98% and specificity 79%). Conclusion Blood pressure to height ratio is a practical method with high sensitivity and specificity for detecting elevated blood pressure in Indonesian adolescents aged 15 to 18 years.
Precision and accuracy of transcutaneous CO2 monitoring in infants born at 32-36 weeks of pregnancy on respiratory support Lubis, Syamsidah; Kaban, Risma Kerina; Dewi, Rismala; Putri, Ruth Angelia
Paediatrica Indonesiana Vol. 64 No. 2 (2024): March 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.2.2024.160-7

Abstract

Background Respiratory disorders in premature neonates often require respiratory support. Continous transcutaneous monitoring is an available non-invasive option to monitor CO2 pressure, substituting the need for blood gas analysis as the gold standard evaluation in practice. Most studies have been conducted on very and extremely preterm neonates, but rarely in late and moderately preterm neonates. Objective To determine the precision and accuracy of transcutaneous CO2 pressure measuring devices compared to arterial blood gas analysis in neonates of 32-36 weeks gestational age who received respiratory support. Methods This diagnostic, cross-sectional study was conducted on 35 late and moderately preterm neonates of 32–36 weeks gestation who received cardiopulmonary resuscitation (CPR) in the Neonatology Unit at Rumah Sakit Cipto Mangunkusumo, Jakarta. Subjects were monitored with a transcutaneous CO2 monitor and blood gas analysis (BGA). CO2 pressure measurements were made three times from the two devices. Data were analyzed using Spearman’s correlation and Bland-Altman tests to determine the precision and accuracy of transcutaneous monitoring by comparing its mean difference (MD) to BGA as the gold standard measurement. Results Spearman’s analysis revealed a significant positive correlation between BGA and transcutaneous CO2 monitoring (P<0.001). However, the Bland - Altman test revealed a level of agreement between measuring devices was -14.46 to 6.9, with mean difference of -3.78; indicating poor precision of the transcutaneous evaluation regardless its high accuracy compared to its gold standard. Conclusion The transcutaneous CO2 monitoring device has low precision, but a strong positive correlation to BGA; underlining its high accuracy in practice. Transcutaneous CO2 monitoring cannot replace BGA, the gold standard examination.
Quality of life in episodic hypoxic children after emergency department or PICU hospitalization Yuniar, Irene; Julianti, Julianti; Gunardi, Hartono; Dewi, Rismala; Wiguna, Tjhin; Lubis, Munar
Paediatrica Indonesiana Vol. 65 No. 5 (2025): September 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.5.2025.357-63

Abstract

Background Studies on long–term outcomes of hypoxic children after being hospitalized are limited, even though hypoxia is known to affect their quality of life (QoL). Objective To assess the QoL of children with episodic hypoxia following hospitalization in the emergency department (ED) and Pediatric Intensive Care Unit (PICU). Methods A prospective cohort design study targeting pediatric patients aged 2–7 years with critical illness was conducted at Dr. Cipto Mangunkusumo Hospital. Inclusion criteria are hypoxia patients receiving oxygen therapy, defined from the ratio of partial arterial oxygen pressure and inspired oxygen (PaO2/FiO2). The PedsQLTM questionnaire was used to assess QoL at the time of admission and 3 months after hypoxia event. Patients with cerebral palsy, mental retardation, chromosomal abnormalities, liver transplantation, and length of stay ≤24 hours were excluded. Data distribution in numerical form was analyzed using the Kolmogorov–Smirnov test. Results Forty-six children with a median age of 4 (2–7) years had decreased QoL at 3 months after episodic hypoxia, based on PedsQLTM scores. The physical, emotional, and social domains were significantly decreased (P<0.01) compared to QoL at the time of admission. Prior to admission, 78.3% of children had already experienced impaired QoL. Conclusion Children with episodic hypoxia demonstrated a decline in QoL at 3 months after hypoxia event based on PedsQLTM scores. Specifically, the physical, emotional, and social domains were significantly decreased compared to at the time of admission.  
Co-Authors Abdul Latief Abdul Latief Abriyanto, Abriyanto Adam Adam Aditya Wardhana Afif, Ahmad Ainul Alan Roland Tumbelaka Amir S. Madjid, Amir S. Andina Judith Andriani, Adinda Viviana Antonius H. Pudjiadi Antonius Pudjiadi Arie Dian Fatmawati Arvina Novianti Arwin A.P Akib Ashfahani Imanadhia Badriul Hegar Bambang Supriyatno Cahyani Gita Ambarsari Cindy D. Christie Corry Wawolumaya Damayanti Rusli Sjarif Darmawan B Setyanto Darmawan B. Setyanto Dina Nurpita Suprawoto Dwi Utari Rahmiati Ega Iftahul Rizky Eka Laksmi Hidayati, Eka Laksmi Endah Sulistiawati Evita Kariani B. Ifran Fatimatuzzuhroh Fatimatuzzuhroh Freddy Guntur Mangapul Silitonga Gunanti . Hanifah Oswari Hartono Gunardi Hartono Gunardi Helen Dian Fridayani, Helen Dian Hermin Mardiana Hidayat, Nauval Edghina Hotber Pasaribu I Nyoman Budi Hartawan Ifran, Evita Kariani Imam D Imam N Iqbal Zein Assyidiqie Irawan Mangunatmadja Irawan Mangunatmadja Irene Yuniar, Irene Iskandar, Stephen Diah Jayanti, Reny Dwi Jeanne Laurensie Sihombing Jose M. Mandei Julianti Julianti, Julianti Kaltha, Karina Kusumaningrum, Alya Laila Laila Marissa Tania Stephanie Pudjiadi Misbah Muhammad Abhi Purnomosidi Mulya R. Karyanti Munar Lubis Nabilla Novella Riyanti Nathanne Septhiandi Niken Wahyu Puspaningtyas Novie Amelia Nycane Nycane oedjatmiko oedjatmiko Partini Pudjiastuti Trihono Piprim B Yanuarso Piprim B. Yanuarso, Piprim B. Purwasari, Lucy Asri Putri, Ruth Angelia Riki Siswandi Rina Amalia C. Saragih Rinawati Rohsiswatmo Rini Sekartini Risa Imanillah Risma Kerina Kaban, Risma Kerina Ronald Chandra Rosalina Dewi Roeslani, Rosalina Dewi Sita Febriani Sudung O Pardede, Sudung O Sudung O. Pardede Sukasno Sukasno Syafiqurosyid, M. Zufar Syamsidah Lubis, Syamsidah Teny Tjitra Teny Tjitra Sari, Teny Tjitra Tidi Maharani, Tidi Tjhin Wiguna Wahyuni Indawati Wardah, Nabila Amalya Wardhana, Aditya Widjaya, Malik Wisnu