Ramadhanti, Ardhanis
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Case Series: Two Cases of Critical Pulmonary Artery Stenosis Focusing on the Timing of Diagnosis and Management Koentartiwi, Dyahris; Ramadhanti, Ardhanis; Damayani Susilo, Monica
Jurnal Kedokteran Brawijaya Vol. 33 No. 2 (2024)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2024.033.02.17

Abstract

Critical stenosis of the pulmonary valve in neonates is related to ductus-dependent pulmonary circulation. Percutaneous transcatheter balloon valvuloplasty (PTBV) is the treatment of choice for critical pulmonary stenosis. Unfortunately, many children in developing countries are usually diagnosed late and seldom get immediate care, which leads to delayed growth and development and, ultimately, higher morbidity and mortality. We present two cases of critical pulmonary artery stenosis in a 17-year-old boy and a 4-day-old girl who received PTBV procedures, but had different outcomes. We underline the importance of early diagnosis and intervention in critical pulmonary stenosis for the patient’s prognosis.
Comprehensive management for the improved outcome of persistent pulmonary hypertension of the newborn in a one-day-old baby girl: a case report Koentartiwi, Dyahris; Ramadhanti, Ardhanis; Amalia, Najwa
Pediatric Sciences Journal Vol. 4 No. 2 (2023): (Available online: 1 December 2023)
Publisher : Medical Faculty of Brawijaya University, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/pedscij.v4i2.64

Abstract

Introduction: Persistent pulmonary hypertension of the newborn (PPHN) is characterized by an increase in pulmonary vascular resistance (PVR), caused by failure of circulatory adaptation within minutes after delivery. Persistent pulmonary hypertension of the newborn (PPHN) can lead to severe respiratory distress and hypoxemia. Newborns with PPHN are at high risk of severe asphyxia and its complications. This study aims to present a comprehensive assessment and treatment of newborn PPHN that might be applicable in any hospital setting. Case description: A one-day-old baby girl came to the emergency room with the chief complaint of cyanosis since birth. The baby was born with oxygen, with pre-ductal and post-ductal differentiation of 5%. The baby showed weak crying movements and inadequate spontaneous breathing, indicating persistent respiratory distress and a chest x-ray revealed pneumonia. The echocardiogram showed a bidirectional secundum, an atrial septal defect, moderate patent ductus arteriosus, and severe pulmonary hypertension. Sputum culture showed Klebsiella pneumoniae (ESBL). Comprehensive management was given to the patient. After several days of hospitalization, the patient was discharged in good condition. Conclusion: PPHN is associated with high morbidity and mortality in newborns. Comprehensive evaluation and management of PPHN and control of any comorbid conditions must be performed to improve patient outcomes.
Pendekatan Diagnosis dan Tatalaksana Awal Kelainan Hematologi pada Anak dengan Penyakit Jantung Bawaan Sianotik Amalia, Najwa; Koentartiwi, Dyahris; Nugroho, Susanto; Ramadhanti, Ardhanis
Sari Pediatri Vol 26, No 2 (2024)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp26.2.2024.125-30

Abstract

Penyakit Jantung Bawaan sianotik adalah kelainan jantung bawaan akibat pirau darah dari kanan ke kiri yang mengakibatkan penurunan saturasi oksigen dalam sirkulasi sistemik. Pada PJB sianotik yang belum dikoreksi dalam jangka waktu yang lama akan terjadi hiperviskositas dan eritropoesis sekunder. Polisitemia, koagulopati, trombositopenia, dan anemia defisiensi besi relatif merupakan masalah yang sering ditemui. Tatalaksana awal kelainan hematologi ini sangat penting dalam menurunkan morbiditas dan mortalitas anak dengan PJB sianotik. Pemberian suplementasi zat besi untuk anemia defisiensi besi relatif, phlebotomi untuk kondisi polisitemia serta berbagai tatalaksana kelainan hematologi lainnya masih sangat terbatas dan kontroversial.