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Anemia Profile in Pediatric Patients at Pediatric Intensive Care Unit (PICU) of Dr. Soetomo General Academic Hospital Larasati, Sarah Ayu; Setyaningtyas, Arina; Hanindito, Elizeus; Andarsini, Mia Ratwita
Indonesian Journal of Anesthesiology and Reanimation Vol. 4 No. 2 (2022): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V4I22022.80-86

Abstract

Introduction: Anemia often occurs in critically ill children and is associated with increased morbidity and mortality in women and children and impaired cognitive and behavioral development in children. Objective: This study aims to understand the profile and characteristics of anemia patients in the critical care population. Methods: This is a retrospective, descriptive study of the patient's medical records. Data were collected by the total sampling technique. Results: Among 203 patients, 52% were anemic at admission to the Pediatric Intensive Care Unit (PICU), while 45% were anemic at discharge. Anemia tends to be more common in older age and male individuals with their chief complaints being respiratory symptoms, higher mean Red Cell Distribution Width (RDW) levels, and poorer nutritional status. There were 84 patients (41%) who received Packed Red-Cells (PRC) transfusions, among them there were 54 patients (51%) who were anemic at PICU admission. Of the 84 patients who received PRC transfusions during their PICU stay and 43 patients (47%) were anemic on PICU discharge. Conclusion: Anemia is quite common in critically ill children and is dominated by male patients aged under 5 years. Anemia also mostly happens in patients with higher organ dysfunction scores and poorer nutritional status than nonanemic patients. Half of the patients with anemia at the PICU also received PRC blood transfusion.
Pediatric Shock Profile in The Pediatric Intensive Care Unit (PICU) of Dr. Soetomo General Academic Hospital Anshori, Rafida; Setyaningtyas, Arina; Utariani, Arie; Kusumastuti, Neurinda Permata
Indonesian Journal of Anesthesiology and Reanimation Vol. 5 No. 1 (2023): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V5I12023.11-17

Abstract

Introduction: Shock is a life-threatening condition caused by circulatory failure which increases morbidity and mortality rate. According to the western literature, about 2% of children are admitted to hospitals worldwide due to shock. Objective: This study aimed to describe the pediatric shock profile of patients in the Pediatric Intensive Care Unit (PICU) of Dr. Soetomo General Academic Hospital between 1 January to 1 December 2019. Methods: A total of 60 patients were selected as the participants using a descriptive method. Data collection was carried out by recording the exact time the participants first entered the PICU. Furthermore, data were collected based on gender, age, physical and laboratory examination, diagnosis of shock, patients' outcomes, as well as PRISM III score. Results: The results of this study that the males and children are 51.7% and 53.3%, respectively. At an infant age, the distribution of the highest average pulse and breathing frequency was 135 and 32.2, respectively. The highest average body temperature at the age of adolescents was 37.19°C. Furthermore, the patients' diagnoses were dominated by distributive shock with the highest PRISM III score ≥8 and deaths recorded of 76.6%, 60%, and 61.7%, respectively. The diagnosis results showed that distributive shock leads to the highest mortality with a PRISM III score of 51.7% and 53.3%. Conclusion: Distributive shock contributes to the patient's diagnoses and mortality rate with the highest score of PRISM III being ≥8. From this conclusion, the PICU needs to be more responsive to detect distributive shock in children.
Positive Blood Culture as a Marker of Sepsis and MODS Risk in Critically Ill Children A Narrative Literature Review Rafly Bayu Surya Wardhana; Arina Setyaningtyas; Rebekah Juniati Setiabudi; Neurinda Permata Kusumastuti
Jurnal Ilmiah Kesehatan Vol 17 No 2 (2025): Jurnal Ilmiah Kesehatan
Publisher : Universitas Mohammad Husni Thamrin

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37012/jik.v17i2.3063

Abstract

Blood culture is an essential examination for establishing the diagnosis of bloodstream infection (BSI) in critically ill children, as it enables the detection of causative pathogens and guides appropriate antimicrobial therapy. This study aims to examine the association between positive blood culture results and disease severity in children admitted to the pediatric intensive care unit (PICU). A literature review was conducted by searching articles in PubMed, Google Scholar, NCBI, and ScienceDirect over the past 15 years, which were then selected based on topic relevance and methodological quality. Analysis of ten studies revealed that positive blood cultures were strongly associated with increased mortality, longer hospital stay, and a higher incidence of multiple organ dysfunction. Frequently reported risk factors included younger age, the use of central venous catheters, immunocompromised conditions, and infections caused by drug-resistant Gram-negative bacteria. Parameters such as time to positivity (TTP), procalcitonin levels, and organ dysfunction scores (PELOD-2) were identified as important prognostic indicators reflecting infection severity. Thus, a positive blood culture serves not only as a diagnostic tool but also as a crucial prognostic marker for risk stratification and clinical decision-making in critically ill children.
Association Between Pediatric Sofa Score and Coagulation Abnormalities in Critically Ill Children at Dr. Soetomo General Hospital: A Retrospective Study Fadillah, Saskia Putri; Setyaningtyas, Arina; Romadhon, Pradana Zaky; Semedi, Bambang Pujo
Indonesian Journal of Anesthesiology and Reanimation Vol. 8 No. 1 (2026): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V8I12026.9-16

Abstract

Introduction: Coagulation disorder is a common complication related to mortality in pediatric patients at the intensive care unit. It is characterized by prolongation of blood clotting time as reflected in activated partial thromboplastin time (APTT) and prothrombin time (PT) values. Organ dysfunction, often found in a patient with critical illness, is one of the causes of coagulation disorder. The degree of organ dysfunction in pediatric patients can be assessed using the pediatric sequential organ failure assessment (pSOFA) score. Objective: To analyze the association of pSOFA score with coagulation disorder and the association of thrombocytopenia with mortality in critically ill children at the PICU. Methods: This study used a retrospective analytical observational design involving 43 critically ill pediatric patients with organ dysfunction treated in the PICU of Dr. Soetomo General Hospital in 2023. The associations between pSOFA score and coagulation parameters, as well as thrombocytopenia and mortality, were statistically analyzed using the chi-square test. The pSOFA cutoff value for predicting coagulation disorder was determined by the ROC curve. Results: The pSOFA score was significantly associated with prolonged APTT (p= <0.001; φ= 0.506) and PT (p= 0.018; φ= 0.362). The cutoff point of a pSOFA score ≥6.5 for APTT prolongation showed 86.7% sensitivity and 71.4% specificity (AUC= 0.804). With a pSOFA score cutoff point of ≥8.5 for PT prolongation, the sensitivity was 56.3% and the specificity was 85.2% (AUC= 0.720). Subanalysis showed a significant association between thrombocytopenia and mortality (p= 0.017; φ= 0.365). Conclusions: The pSOFA score was significantly associated with APTT and PT prolongation, and thrombocytopenia was significantly associated with mortality in critically ill children.