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ANALISIS FAKTOR RISIKO DAN LUARAN DARI PENGGUNAAN TERAPI ANTIBIOTIK EMPIRIK JANGKA PANJANG PADA BAYI DENGAN BERAT LAHIR SANGAT RENDAH DALAM KONDISI SEPSIS Reza, Muhammad; Sampurna, Mahendra Tri Arif; Handayani, Kartika Darma; Angelika, Dina; Utomo, Martono Tri; Etika, Risa; Harianto, Agus
Majalah Kesehatan FKUB Vol 6, No 4 (2019): Majalah Kesehatan
Publisher : Faculty of Medicine Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (682.154 KB) | DOI: 10.21776/ub.majalahkesehatan.2019.006.04.4

Abstract

Terapi antibiotik berkepanjangan pada neonatus menyebabkan beberapa konsekuensi negatif meliputi resistensi antibiotik, sepsis awitan lambat, enterocolitis nekrotikan (EKN), lama rawat lebih panjang, dan peningkatan mortalitas. Semua faktor tersebut mempengaruhi efisiensi biaya pelayanan rumah sakit di era Jaminan Kesehatan Nasional. Penelitian ini bertujuan untuk menganalisis faktor risiko dan luaran dari terapi antibiotik berkepanjangan pada bayi berat lahir sangat rendah (BBLSR) dengan sepsis. Desain penelitian adalah studi retrospektif pada BBLSR dengan sepsis di Neonatal Intensive Care Unit (NICU), RSUD Dr. Soetomo, Surabaya sejak Januari-Desember 2017 dilakukan dengan membandingkan luaran antara kelompok I yang mendapat terapi antibiotik empirik kurang dari sama dengan 2 minggu dengan kelompok II yang mendapat terapi antibiotik empirik lebih dari 2 minggu empirik. Dari 87 bayi yang termasuk ke dalam studi, 37 bayi termasuk dalam kelompok I dan 50 bayi dalam kelompok II. Rerata durasi terapi antibiotik pada kelompok I dan kelompok II adalah 9,2±2,5 dan 17,9±3,2 hari, dengan lama rawat inap 19,7±8,5 dan 27,2±13,1 hari. Analisis faktor risiko menunjukkan bahwa BBLSR terutama 1000 gram (p < 0,001), ventilasi mekanik invasif (p < 0,001), ventilasi mekanik non-invasif (p < 0,001), korioamnionitis (p = 0,003), penyakit maternal (p = 0,004), kehamilan multipel (p = 0,03) merupakan faktor risiko mendapatkan terapi antibiotik empirik berkepanjangan. Luaran dari terapi antibiotik empirik berkepanjangan adalah 41 (47%) bayi mengalami sepsis awitan lambat,  15 (17%) bayi dengan EKN, dan 11 (12%) bayi meninggal. Mortalitas bayi dengan sepsis awitan lambat (p < 0,001) dan EKN (p = 0,02) lebih tinggi pada kelompok II dibandingkan kelompok I. Kesimpulannya, terapi antibiotik empirik berkepanjangan meningkatkan angka kejadian sepsis awitan lambat, enterocolitis nekrotikan, lama rawat, dan mortalitas BBLSR di NICU yang berdampak meningkatkan biaya pelayanan rumah sakit.  
Oral Care Colostrum Effect on Preterm Infants Fecal Immunoglobulin A Secretory Level Eko Wahyudi1 , Martono Tri Utomo2 , Risa Etika2
Indian Journal of Forensic Medicine & Toxicology Vol. 14 No. 4 (2020): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v14i4.11615

Abstract

Objective To evaluate whether oral care colostrum can increase fecal secretory immunoglobulin A levels inpreterm infants.Methods Thirty-eight infants who met the inclusion criteria were randomized. Twenty colostrum oral careinfants and eighteen control control infants. Colostrum oral care by giving as much as 0.1 ml of colostrumon each buccal mucosa for approximately 2 minutes on one side. The procedure is repeated every 4 hoursfor 3 days. Fecal secretory immunoglobulin A levels are taken from the first faecal after birth and 72 hoursafter colostrum administration. Fecal retrieval must first install a urine device so that the urine does not wetthe sample.Result Fecal secretory immunoglobulin A level before treatment in the treatment group were 0.0633 ±0.0037 mg/g feces higher than the control group 0.0166 ± 0.0139 mg/g feces, statistically there were nosignificant differences (p = 0.595). Fecal secretory immunoglobulin A level after treatment in the treatmentgroup amounted to 1,1007 ± 0.2458 mg/g feces higher than the control group 0.6045 ± 0.2358 mg/g faeces,statistically there were no significant differences (p = 0.09 ). Difference in increase in secretory fecalimmunoglobulin A levels after and before treatment in the treatment group 1.0374 ± 0.2575 mg/g feces ishigher than the control group 0.5879 ± 0.2385 mg/g feces, statistically there were no significant differences(p = 0.09).Conclusion Oral care colostrum has been shown to increase secretory immunoglobulin A levels in preterminfants before colostrum oral care, and colostrum oral care has the potential to increase faecal secretoryimmunoglobulin A level than controls in preterm infants.
Risk Factors of Rebound Hyperbilirubinemia in Post Phototherapy Hyperbilirubinemia Infants Alexander Leonard Caesar Josediputra; Martono Tri Utomo; Risa Etika
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 4 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i4.16774

Abstract

Background: Post phototherapy rebound hyperbilirubinemia is a cause for readmission in some infants.However, this phenomenon data of rebound hyperbilirubinemia is lacking from Indonesia. Our study aimsto describe the risk factor of post phototherapy rebound hyperbilirubinemia in the infant.Method: Cross-sectional study of all infants with indirect hyperbilirubinemia who were treated phototherapyaccording to standard guidelines in neonate intermediate unit Dr. Soetomo hospital for 6 months from June2017 until December 2017. Bilirubin was measured 24 hours after phototherapy. Bilirubin rebound isconsidered as increasing total serum bilirubin that needs reinstitution of phototherapy.Result: A total of 53 (44.9%) infants developed rebound hyperbilirubinemia. We revealed the following riskfactor for rebound hyperbilirubinemia was the onset of jaundice on < 3 days, (10 babies, p <0.05). Otherresults are 30 (56.6%) female infants, 39 (73%) birth weight < 2500 g, 36 (67%) infants with a history ofcesarean section, and 38 (71%) preterm infants but there are not statistically significant.Conclusion: Post phototherapy rebound hyperbilirubinemia should be considered in the onset of jaundice< 3 days.
Hand Hygiene Compliance Behavior and Glove Use in the Pediatric Intensive Care Unit During COVID-19 Pandemic Bangkit Putrawan; Dominicus Husada; Parwati Setiono Basuki; Risa Etika; Ismoedijanto; Dwiyanti Puspitasari; Leny Kartina
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 4 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i4.16811

Abstract

Background: The condition of Covid-19 pandemic potentially influences hand hygiene compliance as aresult of workload changes, increased awareness of healthcare workers (HCWs) and personal protectiveequipment procedures, especially in terms of hand glove use,Objective to know the adherence of healthcare workers at the pediatric intensive care unit (PICU) to complywith hand hygiene and glove use during the pandemic.Methods An observational prospective study was carried out including all HCWs stationed at the PICU DrSoetomo General Hospital during January 2021. All participants were to sign an informed consent beforethe study took place. A target of 500 opportunities was estimated during the observation, and recorded usinginfra-red cameras placed at ten points. Hand hygiene compliances were evaluated according to the videosurveillance records by an independent auditor. Compliance was measured by dividing total number ofobserved appropriate hand hygiene by the sum of opportunities. Data were analysed using Chi Square testat a significance of p<0.05.Results: A total of 28 HCWs were eligible for the study; 9 were excluded. The majority were female(21; 75%), the mean age was 37.9 (SD 5.2) years. During 72 hours’ observation among 526 glove-useopportunities 104 (19.7%) actual glove-use episodes were evident. The hand hygiene compliance was lower(41.3%) when wearing gloves as compared to those with no glove use (68.2%) (p<0.001).
Galactooligosaccharide (GOS) Fortified Formula Feeding in Premature Infants Martono Tri Utomo; Muhammad Reza; Risa Etika; Talitha Y. Aden; Iwan S. Handoko; Ruth A. Alexander
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17587

Abstract

Background: Nutritional problems are one of the serious problems in low birth weight or preterm infants. This causes medical and nutrition management of premature infants to be more individual. Objective: To evaluate the outcome of the premature infants with Galactooligosaccharides (GOS) fortified formula feedingMethods: This was prospective, open label cohort study that conducted during March- December 2019 in Neonatology Unit at the one of the main referral hospitals in East Java, Indonesia. The population of the study was very low birth weight infants (1,000 g - ≤1,500g) who needed formula feeding. Weight, body length, head circumference, fecal models and the incidence of diarrhea, colic, regurgitation, and vomiting was observed. Patients were observed for 28 days or adjusted according to length of stay.Results: Totally, 20 infants were included. Mean birth weight was 1236.2±148.5 grams. Mean total volume Galactooligosaccharides fortified formula at the start of recruitment was 209.4±46.1 ml and at the end of observation was 267.9±41.2 ml. There were change in amount and consistency of feces before and after intervention. No patient experienced adverse events (diarrhea, colic, regurgitation or vomiting) while consuming Galactooligosaccharides fortified formula. Conclusion: Galactooligosaccharides fortified formula in premature infant formula did not have a detrimental effect on premature infants and did not cause intolerance
Alteration of Iron, Zinc, Vitamin A Breast Milk Levels During Lactation Period Among Mothers of Low Birth Weight Infant Born at Preterm and Term Rizky Arisanti Maharani; Roedi Irawan; Risa Etika
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17625

Abstract

Background: Duration of lactation and preterm delivery were noticed as dominant factors affecting breast milk composition, including its micronutrient particularly iron, zinc and vitamin A. This study was to analyze the alteration of iron, zinc, vitamin A levels within colostrum and mature breast milk among mothers of low birth weight (LBW) preterm and term infants.Methods: This cross-sectional study was conducted between July 2019 and April 2020 among mothers of LBW infant delivered at preterm and term at Dr. Soetomo hospital. Seventeen samples of breast milk were enrolled on each group. Respectively, colostrum and mature milk were collected between day 2 and 4, between day 15 and 20 after delivery.Results: The iron levels on both groups did not change significantly during lactation period (respectively p=0,266 and p=0,845). Zinc levels were found significantly higher in colostrum of both groups, as well as vitamin A levels within colostrum in LBW preterm group (p<0,05).Conclusions: Higher levels were found in zinc within colostrum of both groups, similar to vitamin A in LBW preterm group. In contrast, iron did not differ significantly during lactation period.
Echocardiographic Study in Preterm Infant with Hemodynamic Significant Patent Ductus Arteriosus Sunny Mariana Samosir; Martono Tri Utomo; Mahrus A. Rahman; Risa Etika; Dina Angelika; Kartika Darma Handayani; Agus Harianto
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17650

Abstract

Background: Potential complications of hemodynamic significant patent ductus arteriosus (hsPDA) after birth include heart failure, need for respiratory support, renal disfunction, intraventricular hemorrhage, as well as long term altered growth and development. Nevertheless, clinical signs of patent ductus arteriosus (PDA) are not sensitive and specific enough. Therefore, echocardiography still remains the preferred method to evaluate the ductal patency in preterm infant. The present study aimed to evaluate the echocardiography characteristic in preterm infant with hsPDA.Methods: A cross-sectional study was conducted on preterm infants aged 3-7 days with 24-336/7 weeks of gestation. Data taken were demographic, clinical and echocardiography. Diagnosis of hsPDA was carried out by echocardiography; defined as >1.5mm diameter of ductus and >1.4 left pulmonal artery and aorta (La/Ao) ratio. The statistical analysis was undertaken using SPSS 21.0.Results: There were 11 out of 52 preterm infants diagnosed hsPDA. Mean birth weight was 1213±293 gram; Mean gestational age was 30.72±2.01 weeks. In hsPDA group, mean ductus diameter was 2.84±0.93 mm, mean La/Ao ratio was 1.56±0.26, and mean ejection fraction (EF) was 71.55±5.72%.Conclusion: Echocardiographic evaluation is important for addressing hsPDA in preterm infants.
Relationship Between Working Mothers towards Exclusive Breastfeeding in Bunda Maternity Clinic Surabaya Devina Callista Ayungga; Risa Etika; Eighty Mardiyan Kurniawati
Health Notions Vol 4, No 1 (2020): January
Publisher : Humanistic Network for Science and Technology (HNST)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (86.924 KB) | DOI: 10.33846/hn40103

Abstract

Background: The percentage of infants who receive exclusive breastfeeding in Indonesia can be much higher. There are many factors including working mothers. Aim: To find out if there is a significant relationship between working mothers towards exclusive breastfeeding. Methods: This study was an analytic observational study done using the data acquired from a questionnaire given to mothers who come to Bunda Maternity Clinic in Surabaya. Data was then analysed statistically using Chi square test. Result: Out of 20 working mothers, 6 (30%) of them exclusively breastfed their infants while the rest did not. Out of 37 non-working mothers, 28 (76%) of them exclusively breastfed their infants. A p-value of p
The Relationship Between Low Birth Weight and Survival Rate in Premature Babies Pamarga Priyambodo; Hermanto Tri Joewono; Risa Etika
Health Notions Vol 5, No 2 (2021): February
Publisher : Humanistic Network for Science and Technology (HNST)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33846/hn50207

Abstract

Preterm birth is a birth that occurs before 37 weeks of gestation where low birth weight is often found at the same time. This combination of low birth weight and preterm has the potential to cause morbidity and mortality. The aim of this study was to study the relationship between low birth weight and survival rate in preterm infants. The research method used is systematic review approach obtained from 7 research studies in various countries and fulfills the inclusion and exclusion criteria. The variables studied were infant birth weight and survival rate using instruments in the form of studies that have been published on Google Scholar, PubMed, and Science Direct. The article search method uses the characteristics of PICO (Population, Intervention, Comparison, Outcome), then the data in the form of articles that have been collected is managed using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) method. From the 7 articles that were reviewed, it was found that the lower limit of the survival rate in the ELBW category studied was 30.8%, 20.5%, 34.8%, 7%, 69.6%, 58.5%, and 59%. Then at the upper limit in the VLBW and LBW categories, numbers such as 91.8%, 95.6%, 84.8%, 92%, 97.9%, 95%, and 98.1% are obtained. There are consistent results, namely an increase in the survival rate with increasing birth weight, which shows a significant relationship between the two. Keywords: preterm; survival rate; low birth weight
Oxygen saturation among newborns in the first 10 hours of life to detect Critical Congenital Heart Disease - Ductus Dependent Fatchul Wahab; Mahrus Abdul Rahman; Teddy Ontoseno; Risa Etika; Alit Utamayasa; Taufiq Hidayat; Sarmanu Sarmanu
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 4, No 2 (2020)
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30651/jqm.v4i2.4258

Abstract

ABSTRACT Delay diagnosis of Critical Congenital Heart Disease (CHD) can be associated with sudden clinical deterioration and dangerous cardiovascular conditions. The oxygen saturation screening among newborns in the first 10 hours of life is essential for early detection of critical CHD. This study aims to prove that measuring oxygen saturation among newborns in the first 10 hours of life can detect critical CHD. This study is a diagnostic experimental with consecutive sampling subjects in the infant care unit of Dr. Soetomo Hospital, including all newborns with birth weight ≥ 1500 grams and oxygen saturation at ≥ 1 hour of age below 90%. The measurement of oxygen saturation uses fingertip pulse oximetry in the right hand and foot at the age of 10 hours. A "positive oxygen saturation" is defined as oxygen saturation ≤ 85% or different oxygen saturation ≥ 3%, while a "negative oxygen saturation" is when the oxygen saturation is 85% to 90% or different oxygen saturation is 3%. Echocardiography is performed for the gold standard. From November 2019 to January 2020, 11 newborns underwent an oxygen saturation examination. Five subjects (45.46%) in the category of positive oxygen saturation, echocardiographic showed all Critical CHD (100%). Six subjects (54.54%) with negative oxygen saturation category, echocardiographic results showed two critical CHD (33.34%) and four non-critical CHD (66.66%). Fisher's exact test p < 0.005 (α). The diagnostic oxygen saturation test among newborns at 10 hours of life shows ≤85%, all subject’s echocardiography (100%) shows detection of critical CHD, while saturation 85% to 90% has of 33.3% for detection of critical CHD. The sensitivity and specificity of oxygen saturation for early diagnosis of critical CHD are 100% and 67%, respectively. Keywords: critical congenital heart disease, oxygen saturation, fingertip pulse oximetry, diagnostic tests*Corresponding Author: wfatchul045@gmail.com
Co-Authors . Suwarno Aditiawarman Aditiawarman, Aditiawarman AGUS HARIANTO Agus Sulistyono Ahmad Suryawan Aldika Akbar, Muhammad Ilham Alexander Leonard Caesar Josediputra Alit Utamayasa Aminuddin Harahap Aprilawati, Dwi Aprilia Indra Kartika Aprilia Laraswati Armawa, Syihab Armedian Oktaviani Puspaningrum Bambang Permono Bambang Purwanto Bangkit Putrawan Basuki, Setio Chiquita Febby Pragitara Denai Wahyuni Desy Jein Rimelda Masombe Devina Callista Ayungga Dina Angelika Dominicus Husada Dwiyanti Puspitasari, Dwiyanti Eighty Mardiyan K, Eighty Elisia, Latiful Erlina Suci Astuti Ernawati Ernawati Esti Yunitasari Fatchul Wahab Fatimah Indarso Fatimah Indarso Fatimah lndarso HERAWATI, LILIK Herlisa Anggraini Hermanto Tri Joewono Ilya Krisnana, Ilya Irwanto Irwanto Irwanto, Irwanto Ismoedijanto Iwan S. Handoko Izzati, Dwi Jenica Hillary Eka Firnanda MCRP Jianti Fina Lestari Kartika Darma Handayani Kartina, Leny Komang Ayu Witarini Mahiroh, Hodimatum Mahrus A Rahman, Mahrus A Martono Martono Martono Tri Utomo Martono TU Melinda Masturina Mellisa Kristanti Hosea, Mellisa Kristanti Mia R A Moersintowarti B. Narendra Moersintowati B. Narendra Muhammad Pradhika Mapindra Muhammad Pradhiki Mahindra Muhammad Reza Muhammad Reza Ni Made Mertaniasih Nimas Anggie Auliasari Ningrum, Astika Gita Nurmeyda Lentina Nursalam, Nursalam Nyilo Purnami Oktavian Prasetya Pamarga Priyambodo Pudji Lestari Puspa Wardhani Rahayu Catur Ria Wati Rize Budi Amalia Rizky Arisanti Maharani Roedi Irawan Rohma, Annisa Nur Ruth A. Alexander Salsabila Hansa Kamal Sampurna, Mahendra Tri Arif Sari, Ernita Sari, Trias Kusuma Sarmanu, Sarmanu Setya Mithra Hartiastuti Shanty Djajakusli Shrimarti Rukmini Devy Sudarmo, Subijanto Marto Sunny Mariana Samosir Syamsul Arifin Sylviati M Damanik Sylviati M. Damanik Talitha Y. Aden Teddy Ontoseno Tuti Herawati Virani Diana Woro Setia Ningtyas Yulida Mufidah