KARAKTERISTIK INPUT DAN LUARAN NEONATUS DENGAN TERAPI SURFAKTAN METODE INTUBATION-SURFACTANT-EXTUBATION (INSURE) - Nenden Nursyamsi Agustina; Agus Fitrianto (Mandala Of Health, 2020)
ABSTRAKTerapi surfaktan diberikan pada bayi prematur dengan Hyaline Membrane Disease (HMD) yang mengalami Respiratory Distress Syndrome (RDS). Pemberian terapi surfaktan dengan metode Intubation – Surfactant – Extubation (INSURE) merupakan salah satu metode yang lebih minimal invasif dibandingkan ventilasi mekanik konvensional. Penelitian ini bertujuan mengetahui karakteristik input dan luaran neonatus yang mendapat terapi surfaktan metode INSURE di RSUD Prof. Dr. Margono Soekarjo. Desain penelitian yang digunakan adalah deskriptif dari data sekunder berupa rekam medis dan laporan pasien Neonatal Intensive Care Unit (NICU) periode Juli 2017-Juli 2019. Sampel penelitian sebanyak 11 neonatus yang mendapat terapi surfaktan metode INSURE di RSUD Prof. Dr. Margono Soekarjo. Teknik pengambilan sampel menggunakan total sampling. Karakteristik input terdiri atas jenis kelamin, berat badan lahir (BBL), status asfiksia, kehamilan dengan risiko penyulit, dan waktu pemberian surfaktan. Karakteristik luaran terdiri atas klinis selama perawatan, length of survival, dan status pulang. Asfiksia sedang terjadi pada 90,9% pasien. Sebanyak 36,4% pasien dengan berat badan lahir sangat rendah (BBLSR) dan berat badan lahir amat sangat rendah (BBLASR) dan 27,3% pasien berat badan lahir rendah (BBLR). Karakteristik input dari faktor ibu didominasi kehamilan dengan risiko penyulit. Neonatus yang mendapatkan surfaktan > 6 jam pertama setelah lahir sebesar 72,7%. Karakteristik luaran klinis neonatus selama perawatan adalah 54,5% mengalami respiratory distress dan 45,4% HMD grade III, 54,6% hanya mampu bertahan ≤7 hari, dan 45,4% bayi berhasil bertahan sampai tidak memerlukan Continuous Positive Airway Pressure (CPAP) lagi. Tiga bayi hidup sampai pulang dan 2 meninggal karena sepsis. Karakteristik input terbanyak pasien adalah laki-laki, asfiksia sedang, BBLSR atau BBLASR, dan lahir dari ibu dengan risiko penyulit. Karakteristik luaran terbanyak pasien adalah respiratory distress, HMD grade III, dan hanya mampu bertahan ≤7 hari. ABSTRACTThe surfactant replacement therapy was effective for neonates suffering from Respiratory Distress Syndrome (RDS) with Hyaline Membrane Disease (HMD). Surfactant therapy using Intubation – Surfactant – Extubation (INSURE) method is less invasive than conventional mechanical ventilation. This study was conducted to find out the input and output characteristics of neonates who got surfactant therapy with the INSURE method at Margono Soekarjo General State Hospital. It was a descriptive study by utilizing secondary data from the medical record and NICU patient reports for the period July 2017-July 2019. Total sampling technique was were used in this study. Input characteristics consisted of sexes, birth weight, asphyxia status, pregnancy with complicating risk, and time of surfactant administration. Output characteristics consisted of a clinical duration of treatment, length of survival, and discharge status. Eleven neonates got surfactant therapy using INSURE method in Margono Soekarjo General State Hospital for the period July 2017-July 2019. Moderate asphyxia occurred at 90.9%. There were 36.4% of patients with Very-Low-Birth-Weight and Extremely-Low-Birth-Weight and 27.3% patients with Low-Birth-Weight. Input characteristics of maternal factors were dominated by pregnancy with complicating risks. Neonates receiving surfactants > 6 hours first of life were 72.7%. Characteristics of neonatal clinical outcomes during treatment were 54.5% respiratory distress and 45.4% HMD grade III. There were 54,6% of patients died before 7 days of life and 45,4% of patients survived until Continuous Positive Airway Pressure (CPAP) weaning. There were three patients discharged from hospital and two patients died because of sepsis. The input characteristics of most patients were male, moderate asphyxia, BBLSR or BBLASR, and born to mothers with a risk of complications. The outcome characteristics of most patients are respiratory distress, HMD grade III, and length of survival ≤7 days.