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All Journal Nurse Media Journal of Nursing Sari Pediatri Paediatrica Indonesiana Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Pediatric Sciences Journal Jurnal Kesehatan
Yogi Prawira
Departemen Ilmu Kesehatan Anak, Fakultas Kedokteran Universitas Indonesia
Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Nursing Public Health

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Penggunaan Protokol Penyapihan Sedasi dalam Mencegah Sindrom Putus Obat pada Anak yang Sakit Kritis Kadaristiana, Agustina; Djer, Muljadi M; Prawira, Yogi
Sari Pediatri Vol 26, No 1 (2024)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp26.1.2024.54-62

Abstract

Latar belakang. Sedasi merupakan obat esensial pada perawatan anak sakit kritis, tetapi penggunaan jangka panjang dapat menimbulkan sindrom putus obat. Sampai saat ini belum ada pedoman penyapihan sedasi di unit intensif anak. Tujuan. Mengetahui peran protokol penyapihan sedasi dalam menurunkan kejadian sindrom putus obat. Metode. Penelusuran literatur dilakukan melalui PubMed, Cochrane Library, dan Embase untuk mencari artikel yang relevan. Hasil. Tiga studi memenuhi kriteria eligibilitas, yaitu dua uji klinis terandomisasi dan satu kohort prospektif. Masing-masing memiliki protokol penyapihan sedasi yang berbeda. Meskipun tingkat keabsahannya lemah, penggunaan protokol penyapihan sedasi menggunakan titrasi dan konversi obat bermanfaat dalam menurunkan sindrom putus obat, mempersingkat durasi penyapihan sedasi, dan lama rawat.Kesimpulan. Protokol penyapihan sedasi yang mudah digunakan dengan obat-obatan yang ada di Indonesia perlu dikembangkan.
Comparative diagnostic accuracy of ultrasound and chest radiography in ETT tip localization Widyaningtiar, Hapsari; Prawira, Yogi
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/pi65.5.2025.431-7

Abstract

Background Endotracheal intubation is a life-saving intervention, and accurate placement of the endotracheal tube (ETT) is crucial in pediatric patients due to anatomical variability. Ultrasound offers a practical and safe alternative to chest X-ray (CXR) for verifying ETT placement. Objective To compare the diagnostic accuracy of ultrasound compared to CXR in localizing the ETT tip in pediatric patients. Methods A cross-sectional study was conducted from January to April 2025 in the Pediatric Intensive Care Unit and Cardiac Intensive Care Unit at Dr. Cipto Mangunkusumo Hospital. The study included children aged 1 month to 18 years intubated with either cuffed or uncuffed ETTs. A CXR was performed immediately after intubation, followed by ultrasound within 24 hours. ETT position was assessed based on CXR findings and tracheal ring alignment on ultrasound. Results A total of 89 patients were enrolled. Ultrasound demonstrated sensitivity of 88.6%, specificity of 73.7%, overall accuracy of 85.4%, positive predictive value (PPV) of 92.5%, and negative predictive value (NPV) of 63.6%. The area under the receiver operating characteristic curve (AUC) was 0.811. The positive likelihood ratio (LR+) was 3.37, and the negative likelihood ratio (LR–) was 0.16. Multivariate analysis identified ultrasound as a significant predictor of accurate ETT placement [odds ratio (OR) 7.75; 95%CI 1.29 to 4.74; P<0.001]. Conclusion Ultrasound is a feasible, reliable and accurate alternative to CXR for verifying ETT tip positioning in pediatric intensive care settings.
Perfusion index and lactate clearance as microcirculation parameters in pediatric post-cardiac correction surgery Prawira, Yogi; Silawati, Trisna; Kaswandani2, Nastiti
Paediatrica Indonesiana Vol. 65 No. 6 (2025): November 2025
Publisher : Indonesian Pediatric Society

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Abstract

Background Congenital heart disease (CHD) is a common congenital anomaly in children, with corrective cardiac surgery using cardiopulmonary bypass (CPB) being the definitive treatment. However, post-operative morbidity and mortality remain high, requiring effective hemodynamic monitoring in the cardiac intensive care unit (CICU). Blood lactate levels are traditionally used to assess microcirculation, while non-invasive methods like the perfusion index (PI) have gained interest for real-time monitoring. Objective To determine the correlation between PI and blood lactate levels in pediatric patients following corrective cardiac surgery. Methods A prospective cohort study was conducted in the cardiac intensive care unit (CICU) at Cipto Mangunkusumo Hospital from September to October 2024. Thirty-four pediatric patients aged 1 month to 18 years who underwent corrective cardiac surgery were included. PI and lactate levels were measured at one, four, and eight hours post-operation. Results The median age of participants was 21.5 (IQR 10.25–79.5) months. Non-cyanotic CHD was the most common diagnosis (58%), and 67.6% of cases involved CPB. Low cardiac output syndrome occurred in 17.6% of subjects. Lactate levels decreased significantly over time (P<0.001), while PI showed an increasing trend. Correlation analysis revealed a significant negative correlation between PI <1.4 and lactate levels at the fourth (r =-0.455; P=0.038) and eighth hours (r=-0.515; P=0.017). Conclusion  PI has a significant negative correlation with lactate levels and may serve as a useful non-invasive parameter for microcirculation monitoring in pediatric patients after corrective cardiac surgery.
Perbandingan Efikasi dan Keamanan Parasetamol serta Ibuprofen dengan Dosis Berdasarkan Berat Badan dalam Penanganan Demam Anak: Uji Klinis Acak Terbuka Prawira, Yogi; Agustina, Agustina; Hamik, Welli; Santi, Theresia; Garniasih, Dina; Tandra, Irene Mutiara; Lukman, Leni; Sugiharto, Jessica; Ardini, Ni Putu
Sari Pediatri Vol 27, No 5 (2026)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp27.5.2026.299-308

Abstract

Latar belakang. Demam adalah keluhan tersering di praktik pediatri Indonesia. Parasetamol dan ibuprofen menjadi antipiretik utama, baik dengan pengawasan medis maupun swamedikasi. Namun, sebagian besar produk di Indonesia masih menggunakan panduan dosis berbasis usia, padahal variasi berat badan anak yang lebar berisiko menyebabkan dosis kurang atau berlebih.Tujuan. Menilai efikasi dan keamanan pemberian tunggal parasetamol dan ibuprofen berbasis berat badan dalam menurunkan demam pada anak usia 2-15 tahun di Indonesia.Metode. Penelitian ini merupakan uji klinis fase III, acak terbuka, dua lengan paralel, non-inferioritas, dan multisenter. Subjek diacak menerima parasetamol sirup 250 mg/5 mL (10-15 mg/kg) atau ibuprofen suspensi 100 mg/5 mL (5-10 mg/kg). Suhu timpani diukur pada menit ke-15, 30, 60, 120, 180, dan 240 setelah pemberian pertama. Keamanan dievaluasi melalui efek samping serta pemeriksaan hematologi, fungsi hati dan ginjal, dan CRP dalam 48-72 jam setelah dosis terakhir.Hasil. Sebanyak 93 anak dibagi menjadi dua kelompok: parasetamol (45 anak) dan ibuprofen (48 anak). Penurunan suhu mulai terlihat pada 15 menit pertama (rata-rata 0,55°C). Pada menit ke-60, penurunan suhu kedua obat sebanding (parasetamol 1,13°C; ibuprofen 1,06°C). Pada menit ke-240, ibuprofen unggul 0,20°C, tetapi masih dalam batas non-inferioritas (0,65°C). Efek samping ringan dan sementara, tanpa kejadian serius. Laboratorium menunjukkan peningkatan ringan enzim hati (?7 U/L) dan penurunan CRP ±17 mg/L, sesuai proses penyembuhan alami.Kesimpulan. Dosis parasetamol dan ibuprofen berbasis berat badan terbukti cepat, aman, dan setara dalam menurunkan demam anak Indonesia. Keduanya dapat menjadi terapi lini pertama yang fleksibel. Temuan ini mendukung penerapan panduan dosis berbasis berat badan (mg/kg) menggantikan panduan berbasis usia.
Tinjauan Sindrom Inflamasi Multisistem pasca COVID-19 pada Anak Yogi Prawira; Nicodemus Nicodemus
Majalah Kedokteran Indonesia Vol 72 No 4 (2022): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.72.4-2022-800

Abstract

Coronavirus disease (COVID-19) caused by infection of severe respiratory syndrome coronavirus 2 (SARS-CoV-2) was first detected in December 2019. Since then, many countries have started reporting a series of cases in children post COVID-19 infection, with various clinical manifestations, i.e: persistent fever, cardiovascular shock, and hyperinflammation similar with Kawasaki disease and/or toxic shock syndrome. The terminology Pediatric Inflammatory Multisystem Syndrome Temporarily Associated with SARS-CoV-2 (PIMS-TS) was given by the Royal College of Paediatrics and Child Health (RCPH), hence commonly known as Multisystem Inflammatory Syndrome in Children (MIS-C) as named by the Centers for Disease Control (CDC) and the World Health Organization (WHO). Multisystem Inflammatory Syndrome in Children has a very wide spectrum of clinical signs and symptoms, with the most common symptoms reported is persistant fever, along with gastrointestinal, cardiovascular and dermatological symptoms. Fever is reported in 97-100% of patients. Gastrointestinal symptoms are the second most common symptom occurring in 70% of patients. Until now, the pathogenesis underlying the occurrence of MIS-C is still unknown. Multisystem Inflammatory Syndrome in Children case management requires multidisciplinary knowledge. Consensus or standard guideline for the management of MIS-C is a work in progress, but in general, the initial management includes intravenous immunoglobulin (IVIG) and corticosteroids.
ANAK DENGAN COVID-19 DALAM TINJAUAN KEPERAWATAN Efendi, Defi; Utami, Ayuni Rizka; Asmarini, Titik Ambar; Prawira, Yogi; Lestari, Pande Lilik; Sari, Dian; Mais, Pricilia; Babakal, Abram; Triana, Komang Yogi
Jurnal Kesehatan - STIKes Prima Nusantara Vol 13 No 1 (2022): Jurnal Kesehatan
Publisher : LPPM Universitas Prima Nusantara Bukittinggi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35730/jk.v13i1.568

Abstract

Tingkat kematian (case fatality rate) COVID-19 pada anak di Indonesia merupakan salah satu yang tertinggi didunia. Berbagai upaya dilakukan untuk menurunkan tingkat  kematian ini, salah satunya meningkatkan kualitas asuhan keperawatan.Telaah literatur ini bertujuan untuk memberikan rekomendasi mengenai perawatan pasien anak dengan COVID-19 di rumah sakit, mulai dari   pencegahan dan pengendalian infeksi, perawatan anak dengan distres napas berat, pemantauan kondisi klinis, perawatan anak dengan hipertermia, masalah nyeri akut, keseimbangan cairan, dukungan psikologis anak dengan COVID 19, aplikasi family-centered care, edukasi keluarga dan persiapan pulang. Meskipun asuhan keperawatan mempunyai cakupan yang sangat luas, hendaknya perawat terus beradaptasi dalam memberikan asuhan yang sesuai dengan usia perkembangan, karakteristik masalah yang muncul, serta ketersediaan sumber daya pendukung.
Co-Authors Abram Babakal Abram Babakal Abram Babakal Agustina Ali Alhadar Ardini, Ni Putu Aryono Hendarto Aslinar Asmarini, Titik Ambar Ayuni Rizka Utami Ayuni Rizka Utami Bernie Endyarni Medise Dave Anderson Defi Efendi Defi Efendi Defi Efendi Dian Sari Dian Sari Dimas Dwi Saputro Dimas Tri Anantyo Dina Garniasih, Dina Djer, Muljadi M Efendi, Defi Erwin Hendrata Fathy Zuandy Pohan Hamik, Welli I Nyoman Arie Purwana Intan Tumbelaka Jaya Ariheryanto Effendy Kadaristiana, Agustina Kaswandani2, Nastiti Komang Yogi Triana Kurniawan Taufiq Kadafi Lestari, Pande Lilik Lina Ninditya Lukman, Leni Mais, Pricilia Marsubrin, Putri Maharani Tristanita Martinus M. Leman Martinus Martin Leman Mega Hasanul Huda Muhammad Reza Nasution, Badai Buana Nia Kurniati Nicodemus Nicodemus Nicodemus Nicodemus Nicodemus Suwandy Niken Wahyu Puspaningtyas Nina Dwi Putri Novie Amelia Chozie Pande Lilik Lestari Pande Lilik Lestari Piprim B. Yanuarso Piprim Basarah Yanuarso Piprim Basarah Yanuarso, Pramita Gayatri Pricilia Mais Pricilia Mais R. Rr Maria Dyah Kurniasari Raudha Ilmi Farid Renno Hidayat Rini Sekartini Santoso, Dara Ninggar Silawati, Trisna Sugiharto, Jessica Tandra, Irene Mutiara Theresia Santi, Theresia Titik Ambar Asmarini Titik Ambar Asmarini Trevino Pakasi Utami, Ayuni Rizka Wahyuni Indawati Widyaningtiar, Hapsari Yohanes Andy Rias Yosilia Nursakina