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"ABSTRAKBerbagai studi terkini menunjukkan hubungan antara vitamin D dan sepsis. Vitamin D berperan sebagai stimulator produksi peptida antimikroba dan mencegah inflamasi yang berlebihan. Insufisiensi dan defisiensi vitamin D berhubungan dengan risiko terjadinya sepsis. Saat ini belum terdapat data mengenai hubungan status vitamin D dengan pasien infeksi tanpa sepsis, sepsis, dan sepsis berat. Tujuan penelitian ini dilakukan untuk mendapatkan hubungan antara proporsi status vitamin D dengan pasien infeksi tanpa sepsis, sepsis, dan sepsis berat.Desain penelitian potong lintang, terdiri dari 60 pasien infeksi terbagi menjadi kelompok infeksi tanpa sepsis, sepsis, dan sepsis berat masing-masing 20 pasien. Diagnosis sepsis berdasarkan modifikasi SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference 2001. Status vitamin D ditetapkan menurut rekomendasi Holick. Pada ketiga kelompok tersebut dicatat data karakteristik subjek dan dilakukan pemeriksaan 25(OH)D.Status vitamin D pada subjek penelitian ini didapatkan sebanyak 5 (8,33%) orang insufisiensi dan 55 (91,67%) orang defisiensi vitamin D Proporsi insufisiensi pada kelompok infeksi tanpa sepsis adalah 5%, sepsis 10%, dan sepsis berat 10%. Proporsi defisiensi pada kelompok infeksi tanpa sepsis adalah 95%, sepsis 90%, dan sepsis berat 90%. Didapatkan perbedaan tidak bermakna proporsi insufisiensi dan defisiensi vitamin D pada kelompok infeksi tanpa sepsis, sepsis, dan sepsis berat.Kami menyimpulkan status vitamin D tidak berhubungan dengan beratnya sepsis. Proporsi insufisiensi dan defisiensi pada pasien infeksi tanpa sepsis, sepsis, dan sepsis berat masing-masing didapatkan 5% dan 95%; 10% dan 90%; 10% dan 90%.

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ABSTRACTRecent studies have shown that there is a relationship between vitamin D and sepsis. Vitamin D has a a role as a potent stimulator of antimicrobial peptides and prevent an over reaction of the inflammatory response. Insufficiency and deficiency of vitamin D have been associated with sepsis event. Nevertheless, there is no data about the relationship between vitamin D status with infection without sepsis, sepsis, and severe sepsis patient. The aim of this study was to obtain the relationship between proportions of vitamin D with infection without sepsis, sepsis, and severe sepsis patient.This was a cross-sectional study, 60 patients with infection were divided into groups of infection without sepsis, sepsis, and severe sepsis, each consisted of 20 patients. Diagnosis of sepsis was based on modified SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference 2001. Vitamin D status was defined according to Holick recommendations. Baseline characteristics of subjects were recorded and 25(OH)D concentrations were measured in subjects of each groups.According to status of Vitamin D, 5 (8,33%) subjects were insufficiency and 55 (91,67%) were deficiency. The proportions of vitamin D insufficiency at infection without sepsis group were 5%, sepsis 10%, and severe sepsis 10%. The proportions of vitamin D deficiency at infection without sepsis group were 95%, sepsis 90%, and severe sepsis 90%. The proportions of insufficiency and deficiency at infection without sepsis, sepsis, and severe sepsis patient were not significantly different (p > 0.05).It is concluded that vitamin D status were not related to infection severity. The proportions of vitamin D insufficiency and deficiency at infection without sepsis, sepsis, and severe sepsis, i.e. 5% and 95%; 10% and 90%; 10% and 90%, respectively."

"Latar Belakang. Sepsis neonatal awitan dini SNAD masih merupakan masalah di Indonesia. Vitamin D memiliki efek pada fungsi imunitas. Neonatus kurang bulan NKB berisiko mengalami defisiensi kadar vitamin D. Hubungan kadar vitamin D dengan kejadian SNAD pada NKB belum jelas.Tujuan. Menganalisis hubungan kadar vitamin D dengan kejadian SNAD pada NKB.Metode. Duapuluh NKB dengan klinis dan pemeriksaan laboratorium menyokong SNAD kelompok kasus dan 20 NKB tanpa hasil laboratorium SNAD kelompok kontrol ikut dalam penelitian ini. Subjek penelitian adalah NKB usia gestasi ge; 28 sampai dengan < 37 minggu dirawat di RSUPN Cipto Mangunkusumo selama bulan Juli - September 2017. Pemeriksaaan kadar vitamin D 25 OH D dengan metode competitive chemiluminescense immunoassay CLIA direk dengan alat Diasorin Liaison.Hasil. Median kadar vitamin D pada NKB dengan SNAD 8,95 4,10 - 16,30 ng/mL dengan rerata usia gestasi 33,25 1,71 minggu dan rerata berat lahir 1863,75 415,06 gram. Median kadar vitamin D tanpa SNAD 11,75 5,80 - 42,80 ng/mL dengan rerata usia gestasi 34,67 1,53 minggu dan rerata berat lahir 2125,0 340,55 gram. Median kadar vitamin D NKB SNAD lebih rendah secara bermakna dibandingkan NKB tanpa SNAD.

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Background. Early onset neonatal sepsis EONS is still a problem in Indonesia. Vitamin D has effect on immune function. Preterm infants have a risk of deficiency of vitamin D levels. The association between vitamin D levels with EONS were unclear.Objective. To determine the association between vitamin D levels with EONS in preterm infants.Methods. Twenty preterm infants with clinical and laboratory finding of EONS study group and 20 preterm infants with no signs of laboratory infection control group were enrolled this study. The subjects were preterm infants of gestational age ge 28 37 weeks in Cipto Mangunkusumo Hospital during July September 2017. Vitamin D 25 OH D levels were measured using Diasorin Liason with competitive chemilunescence immunoassay CLIA technique.Results. Median vitamin D levels with EONS was 8,95 4,10 16,30 ng mL, mean of gestational age and birth weight were 33,25 1,71 weeks and 1863,75 415,06 g, respectively. Median vitamin D levels without EONS was 11,75 5,80 42,80 ng mL, mean of gestational age and birth weight were 34,67 1,53 weeks and 2125,0 340,55 g, respectively. Median vitamin D levels of preterm infants with EONS was significantly lower than without EONS.Conclusion. Vitamin D levels are associated with EONS in preterm infants."

"Latar belakang: luka bakar berat dapat disertai dengan trauma inhalasi, yang akan memicu respons lokal dan sistemik, sehingga menyebabkan berbagai komplikasi, termasuk systemic inflammatory response syndrome (SIRS) dan sepsis. Berbagai kondisi ini menyebabkan hipermetabolime dan hiperkatabolisme, yang membutuhkan tatalaksana nutrisi adekuat untuk membantu proses penyembuhan pasien. Berbagai kelompok ahli telah memberikan rekomendasi tatalaksana nutrisi pada luka bakar berat dan sakit kritis. Namun, akibat keterbatasan sarana dan prasarana, tidak semua rekomendasi dapat dilaksanakan, sehingga tatalaksana nutrisi diberikan secara optimal. Metode: serial kasus ini terdiri atas empat pasien luka bakar berat, yang disebabkan oleh api, dan disertai trauma inhalasi, yang menyebabkan berbagai komplikasi, sepsis, multiple organ dysfunction syndrome (MODS) dan multiple organ failure (MOF). Tatalaksana nutrisi diberikan secara bertahap sesuai dengan keadaan pasien. Pemberian nutrisi diawali dengan nutrisi enteral dini (NED) dalam waktu 2448 jam setelah luka bakar, sebesar 10 kkal/kg BB, menggunakan drip intermiten. Selanjutnya, nutrisi diberikan sebesar 2025 kkal/kg BB pada fase akut dan 2530 kkal/kg BB/hari pada fase anabolik. Setelah pasien keluar dari intensive care unit (ICU), target kebutuhan energi menggunakan persamaan Xie, dengan protein 1,52,0 g/kg BB/hari, lemak 2530%, dan karbohidrat (KH) 5565%. Mikronutrien diberikan berupa multivitamin antioksidan, vitamin B, asam folat, dan vitamin D. Pasien dalam serial kasus ini juga mendapatkan nutrisi spesifik glutamin sebesar 0,3 g/kg BB/hari, selama 510 hari. Hasil: tiga pasien mengalami perbaikan klinis, kapasitas fungsional, dan laboratorium. Pasien selamat dan dipulangkan untuk rawat jalan. Masa rawat pasien yang selamat berturut-turut 33 hari, 70 hari, dan 43 hari. Seorang pasien mengalami perburukan dan MOF, hingga meninggal dunia setelah dirawat selama 23 hari di ICU. Kesimpulan: tatalaksana nutrisi optimal dapat menunjang penyembuhan luka serta menurunkan angka morbiditas dan mortalitas pasien luka bakar berat dengan trauma inhalasi dan sepsis.

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;Background: severe burn trauma combined with inhalation injury initiates local and systemic response, resulting in various complications such as systemic inflammatory response syndrome (SIRS) and sepsis. These conditions stimulate hypercatabolic process, leading to the increase of nutrition requirement. Adequate nutritional support is necessary in order to control both inflammatory and metabolic response, and also to improve healing process. To date, nutritional recommendations specific for severe burn trauma and critical illness have been established. However, many problems including patient?s condition and lack of resources exist, so optimal nutritional support that fits our settings was delivered. Method: this serial case focused on four severely burned patients caused by flame. Subjects with inhalation trauma and complications such as sepsis, multiple organ dysfunction syndrome (MODS), and multiple organ failure (MOF) were included in this study. Nutritional support was delivered according to clinical conditions, patient?s tolerance, and laboratory findings. Early enteral nutrition was initiated within 2448 hours post burns, starting from 10 kcal/kg BW/day with intermittent gravity drip method. Nutrition was gradually increased in order to reach the target of energy for critically ill patients, which is 2025 kcal/kg BW/day in acute phase or 2530 kcal/kg BW/day in anabolic recovery phase. Xie Equation was used to calculate target of total energy for burned patient. Protein requirement was 1.52.0 g/kg BW/day. Lipid and carbohydrate given were 2530% and 5565% from calorie intake, respectively. Micronutrient supplementation including antioxidants, vitamin B, folic acid, and vitamin D was also provided. Glutamin as specific nutrient was delivered by 0.3 g/kg BW/day in 510 days. Results: improvement of clinical condition, functional capacity, and laboratory parameters was observed in three patients, who could be discharged from hospital and asked to come back for outpatient care. Their lengths of stay were 33 days, 70 days, and 43 days, respectively. However, one patient experienced worsening of condition and died after 22 days of care in Intensive Care Unit (ICU). Conclusions: optimal nutritional support for severely burned patients with inhalation trauma and sepsis is necessary in order to improve healing process, as well as decrease morbidity and mortality."

"Latar belakang: Sepsis merupakan salah satu penyebab morbiditas dan mortalitas pada anak. Untuk optimalisasi tatalaksana sepsis diperlukan penanda yang dapat memprediksi kejadian sepsis, derajat keparahan dan luaran sepsis klinis. Tujuan penelitian: Mengetahui kadar plasma Cit H3 sepsis klinis pada anak dan menganalisa hubungannya terhadap derajat keparahan penyakit dan prognostik survivalnya. Metode penelitian: Penelitian observasional pendekatan kohort prospektif dilakukan pada anak usia satu bulan sampai 18 tahun dengan diagnosis sepsis klinis sejak Pebruari - Mei 2018 di RSUPN Cipto Mangunkusumo, Jakarta. Penilaian skor PELOD-2, pSOFA dan Cit H3 dilakukan saat diagnosis ditegakkan dan 48 jam kemudian. Mortalitas dipantau selama tujuh hari. Hasil: Diperoleh 67 anak memenuhi kriteria dengan median kadar plasma Cit H3 1.210 800-32.160 ng/mL. Berdasarkan sepsis-3, kadar plasma Cit H3 pasien sepsis lebih tinggi dibandingkan curiga sepsis. Sensitivitas dan spesifisitas kadar plasma Cit H3 ge; 1.200 ng/mL sebagai penanda kejadian sepsis adalah 83,3 dan 75,7. Perubahan kadar plasma Cit H3 dalam 48 jam berhubungan dengan progresifitas sepsis klinis. Citrullinated histone H3 berkorelasi dengan skor PELOD-2 r=0,338;P

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Background: Sepsis is a life threatening organ dysfunction causing high morbidity and mortality in children thus, a highly predictive septic marker to forecast its severity and predict mortality is needed.

Aim: To determine plasma Cit H3 levels in clinically sepsis children and analyze its correlation with disease severity and survival rate.

Method: A prospective observational study was conducted in one month ndash 18 years old children with diagnosed clinically sepsis during February ndash April 2018 in Cipto Mangunkusumo Hospital, Jakarta. Evaluation of PELOD 2, pSOFA score, and Cit H3 were done when diagnosis initially made and 48 hours after. Patient rsquo s survival was observed for 7 days.

Results: Sixty seven children with clinically sepsis had median plasma Cit H3 level 1,210 800 ndash 32,160 ng mL. The plasma Cit H3 level in patients who diagnosed with sepsis sepsis 3 was higher than suspected sepsis. As marker sepsis event, plasma Cit H3 level with cut off point ge 1,200 ng mL has sensitivity 83,3 and specificity 75.5. Changes in plasma Cit H3 level in the first 48 hours was significantly correlated with changes in clinical outcome. Plasma Cit H3 level also correlated with PELOD 2 and pSOFA score. Using survival analysis, plasma Cit H3 level ge 1,200 ng mL significantly increased mortality rate.

Conclusion: Plasma Cit H3 level correlates with severity and survival rate of clinically diagnosed sepsis."

"Pada sepsis terjadi inflamasi sistemik yang menyebabkan ketidakseimbangan mekanisme hemostasis, yaitu, peningkatan aktivasi koagulasi, penurunan antikoagulan alamiah, dan penurunan aktivitas fibrinolisis. Ketidakseimbangan ini bermanifestasi pada pembentukan trombus mikrovaskular yang menyebabkan perfusi jaringan menurun, terjadi disfungsi organ dan kematian. Tujuan penelitian ini mengetahui peranan kadar D-dimer, kadar FDP dan rasio FDP/D-dimer dalam memprediksi mortalitas 14 hari pada pasien sepsis. Penilaian skor Acute physiology and Chronic Health Evaluation II (APACHE II) digunakan untuk memprediksi morbiditas dan mortalitas. Desain penelitian potong lintang, penyajian data secara deskriptif. Subjek penelitian berjumlah 55 orang yang terdiri dari 32 laki-laki dan 23 perempuan dengan rerata usia 51,62 tahun. Pada subjek penelitian, dinilai korelasi kadar FDP, kadar D-dimer, dan rasio FDP/D-dimer dengan skor APACHE II. Pada hasil penelitian, didapatkan 20 pasien hidup dan 35 pasien meninggal. Median kadar FDP (12,9μg/mL) dan kadar D-dimer (7μg/mL) subjek meninggal lebih tinggi dibandingkan median kadar FDP (10,9μg/mL) dan kadar D-dimer (5,2 μg/mL) subjek hidup. Median rasio FDP/D-dimer subjek meninggal (1,9) lebih rendah dibandingkan subjek hidup (2,1). Koefisien korelasi Spearman antara kadar FDP, kadar D-dimer, dan rasio FDP/D-dimer dengan skor APACHE II berturut-turut 0,176, 0,187, dan -0,182. Ketiga korelasi itu secara statistik tidak bermakna (p ≥ 0,05). Pada penelitian ini disimpulkan bahwa kadar FDP, kadar D-dimer, dan rasio FDP/D-dimer tidak dapat digunakan sebagai prognosis keluaran sepsis pada mortalitas 14 hari.

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Systemic inflamation in sepsis could leads to an imbalance homeostatic mechanisms including elevated coagulation activity, decreasing level of natural anticoagulant, and decreased fibrinolysis activity. This could leads to formation of microvascular thrombus which eventually will cause tissue hypoperfusion, organ dysfunction and death. The aim of this research is to understand the role of d-dimer and fibrin degradation products (FDP) and FDP/d-dimer ratio in predicting 14-days mortality rate on sepsis patient. The morbidity and mortality rate on this research were based on APACHE II scoring system. This is a cross sectional research and all data are presented in a descriptive report. Participant of this research was 55 people (32 male and 23 female), average age was 51,62 years old. This research evaluate the correlation between FDP level, d-dimer level and FDP/d-dimer ratio with APACHE II scoring system. From all the participant we had 20 subject alive and 35 died during this research. The median level of FDP (12,9μg/mL) and d-dimer (7μg/mL) in those who die were higher than those who live (10,9μg/mL and 5,2 μg/mL). The median FDP/d-dimer ratio in those who die (1,9) was lower comparing to those who live (2,1). Spearman coefficient of correlation between FDP level, d-dimer level and FDP/d-dimer ratio with APACHE II scoring system were 0.176; 0.187; and -0.182 repectively. This was not significant statistically (p ≥ 0,05). This research has come to a conclusion that FDP and d-dimer level, and FDP/d-dimer ratio cant be used as a prognostic outcome in sepsis on 14 days mortality."

"Pada sepsis terjadi inflamasi sistemik yang menyebabkan ketidakseimbangan mekanisme hemostasis, yaitu, peningkatan aktivasi koagulasi, penurunan antikoagulan alamiah, dan penurunan aktivitas fibrinolisis. Ketidakseimbangan ini bermanifestasi pada pembentukan trombus mikrovaskular yang menyebabkan perfusi jaringan menurun, terjadi disfungsi organ dan kematian. Tujuan penelitian ini mengetahui peranan kadar D-dimer, kadar FDP dan rasio FDP/D-dimer dalam memprediksi mortalitas 14 hari pada pasien sepsis. Penilaian skor Acute physiology and Chronic Health Evaluation II (APACHE II) digunakan untuk memprediksi morbiditas dan mortalitas. Desain penelitian potong lintang, penyajian data secara deskriptif. Subjek penelitian berjumlah 55 orang yang terdiri dari 32 laki-laki dan 23 perempuan dengan rerata usia 51,62 tahun. Pada subjek penelitian, dinilai korelasi kadar FDP, kadar D-dimer, dan rasio FDP/D-dimer dengan skor APACHE II. Pada hasil penelitian, didapatkan 20 pasien hidup dan 35 pasien meninggal. Median kadar FDP (12,9μg/mL) dan kadar D-dimer (7μg/mL) subjek meninggal lebih tinggi dibandingkan median kadar FDP (10,9μg/mL) dan kadar D-dimer (5,2 μg/mL) subjek hidup. Median rasio FDP/D-dimer subjek meninggal (1,9) lebih rendah dibandingkan subjek hidup (2,1). Koefisien korelasi Spearman antara kadar FDP, kadar D-dimer, dan rasio FDP/D-dimer dengan skor APACHE II berturut-turut 0,176, 0,187, dan -0,182. Ketiga korelasi itu secara statistik tidak bermakna (p ≥ 0,05). Pada penelitian ini disimpulkan bahwa kadar FDP, kadar D-dimer, dan rasio FDP/D-dimer tidak dapat digunakan sebagai prognosis keluaran sepsis pada mortalitas 14 hari.

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Systemic inflamation in sepsis could leads to an imbalance homeostatic mechanisms including elevated coagulation activity, decreasing level of natural anticoagulant, and decreased fibrinolysis activity. This could leads to formation of microvascular thrombus which eventually will cause tissue hypoperfusion, organ dysfunction and death. The aim of this research is to understand the role of d-dimer and fibrin degradation products (FDP) and FDP/d-dimer ratio in predicting 14-days mortality rate on sepsis patient. The morbidity and mortality rate on this research were based on APACHE II scoring system. This is a cross sectional research and all data are presented in a descriptive report. Participant of this research was 55 people (32 male and 23 female), average age was 51,62 years old. This research evaluate the correlation between FDP level, d-dimer level and FDP/d-dimer ratio with APACHE II scoring system. From all the participant we had 20 subject alive and 35 died during this research. The median level of FDP (12,9μg/mL) and d-dimer (7μg/mL) in those who die were higher than those who live (10,9μg/mL and 5,2 μg/mL). The median FDP/d-dimer ratio in those who die (1,9) was lower comparing to those who live (2,1). Spearman coefficient of correlation between FDP level, d-dimer level and FDP/d-dimer ratio with APACHE II scoring system were 0.176; 0.187; and – 0.182 repectively. This was not significant statistically (p ≥ 0,05). This research has come to a conclusion that FDP and d-dimer level, and FDP/d-dimer ratio cant be used as a prognostic outcome in sepsis on 14 days mortality."

"Latar belakang: Sepsis infeksi intra-abdomen SIA merupakan masalah klinik yang sampai saat ini merupakan mortalitas yang tinggi dan tantang tersendiri spesialis bedah. Dari data yang ada, insiden di Amerika Serikat pada tahun 2012 tercatat 3,5 juta penderita dengan mortalitas mencapai 60 , sedangkan di Eropa barat 30 . Timbul pertanyaan, faktor apa yang paling berperan dalam rantai perkembangan sepsis intra-abdomen. Dari informasi terkini tertuju pada biophenotype. Pada tahun 2007 istilah biophenotype diajukan oleh Human Nature Natural Health untuk menjelaskan suatu molekul yang terproyeksi dan melapisi permukaan seluruh sel yang ada di tubuh manusia. Tujuan Penelitian: Diketahuinya hubungan golongan darah tertentu dengan kejadian sepsis intra-abdomen pada pasien trauma abdomen dan infeksi gastrointestinal. Metode Penelitian: Penelitian ini merupakan penelitian deskriptif dan analtik dengan desain potong lintang. Subjek yang diambil merupakan pasien yang mengalami trauma abdmen dan infeksi gastrointestinal di RSCM melalui data rekam medis. Data yang diambil adalah usia, jenis kelamin, riwayat transfusi dengan golongan darah ABO, dan hasil kultur jaringan. Data tersebut dianalisis menggunakan SPSS dan dilakukan uji chi-square untuk mengetahui hubungan antara golongan darah ABO dengan kejadian sepsis. Hasil Penelitian: Pada penelitian ini ditemukan terdapat 22 subjek 9,6 pasien yang mengalami sepsis intra abdomen pasca operasi selama periode Januari 2014 ndash; Maret 2016. Studi ini mendapatkan hubungan yang bermakna antara pemberian transfusi OR = 0.02; p < 0.001 dan grup diagnosis OR = 4.7; P = 0.015 terhadap terjadinya sepsis intra abdomen. Namun demikian, tidak ditemukan hubungan yang bermakna pada usia, jenis kelamin, dan golongan darah terhadap terjadinya sepsis intra abdomen. Kesimpulan: Dari hasil penelitian ini belum dapat dibuktikan golongan darah tertentu berpotensi menyebabkan sepsis intra abdomen pada pasien dengan riwayat trauma abdomen dan infeksi gastro intestinal.

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Background: Intra abdominal sepsis is a clinical problem with high mortality and a special challenge for surgeons. Based on research about glycocalyx, we obtained information regarding the differences of biophenotype on glycocalyx. So far, the research that leads to the difference in biophenotype is only focused on the ABO blood type system. Until recently there has been no data on the relationship between sepsis especially intra abdominal sepsis with blood type.

Methods: This is a descriptive and analytic research with cross sectional design in patients with abdominal trauma and gastrointestinal infections at dr. Cipto Mangunkusumo General Hospital RSCM that fulfilled the inclusion and exclusion criteria.

Results: There were 230 subjects, who underwent post traumatic abdominal surgery as well as gastrointestinal infections at RSCM. There were 22 subjects incidence 9.6 who had postoperative intraabdominal sepsis. Most subjects who underwent surgery were aged around 41 60 years 50 , were men 56.1 , did not get transfusions 90.9 , had surgery caused by mechanical intestinal obstruction 24.8 , had blood type O 46.1 , had gastrointestinal infection 92.6 , and were living as the outcome of the procedure 96.5 . There was a significant correlation p 0,05 between transfusion p 0,0001 and diagnostic group p 0,015 on the occurrence of intra abdominal sepsis. In subjects receiving transfusion, the odds ratio OR was 0.02 and the group diagnosis OR was 4.7 at 95 confidence interval.

Conclusions. The high risk of sepsis is especially high in the gastrointestinal infection group. Similarly, amongst factors affecting sepsis, history of transfusion may increase the risk of sepsis. Results of this study could not be prove that certain blood groups potentially cause intra abdominal sepsis in patients with a history of abdominal trauma and gastro intestinal infections. "

"Latar belakang: Sepsis (infeksi) intra-abdomen (SIA) merupakan masalah klinik yang sampai saat ini merupakan mortalitas yang tinggi dan tantang tersendiri spesialis bedah. Dari data yang ada, insiden di Amerika Serikat pada tahun 2012 tercatat 3,5 juta penderita dengan mortalitas mencapai 60%, sedangkan di Eropa barat 30%. Timbul pertanyaan, faktor apa yang paling berperan dalam rantai perkembangan sepsis intra-abdomen. Dari informasi terkini tertuju pada biophenotype. Pada tahun 2007 istilah biophenotype diajukan oleh Human Nature Natural Health untuk menjelaskan suatu molekul yang terproyeksi dan melapisi permukaan seluruh sel yang ada di tubuh manusia. Tujuan Penelitian: Diketahuinya hubungan golongan darah tertentu dengan kejadian sepsis intra-abdomen pada pasien trauma abdomen dan infeksi gastrointestinal. Metode Penelitian: Penelitian ini merupakan penelitian deskriptif dan analtik dengan desain potong lintang. Subjek yang diambil merupakan pasien yang mengalami trauma abdmen dan infeksi gastrointestinal di RSCM melalui data rekam medis. Data yang diambil adalah usia, jenis kelamin, riwayat transfusi dengan golongan darah ABO, dan hasil kultur jaringan. Data tersebut dianalisis menggunakan SPSS dan dilakukan uji chi-square untuk mengetahui hubungan antara golongan darah ABO dengan kejadian sepsis.Hasil Penelitian: Pada penelitian ini ditemukan terdapat 22 subjek (9,6%) pasien yang mengalami sepsis intra abdomen pasca operasi selama periode Januari 2014-Maret 2016. Studi ini mendapatkan hubungan yang bermakna antara pemberian transfusi (OR = 0.02; p < 0.001) dan grup diagnosis (OR = 4.7; P = 0.015) terhadap terjadinya sepsis intra abdomen. Namun demikian, tidak ditemukan hubungan yang bermakna pada usia, jenis kelamin, dan golongan darah terhadap terjadinya sepsis intra abdomen. Kesimpulan: Dari hasil penelitian ini belum dapat dibuktikan golongan darah tertentu berpotensi menyebabkan sepsis intra abdomen pada pasien dengan riwayat trauma abdomen dan infeksi gastro intestinal.

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Background: Intra-abdominal sepsis is a clinical problem with high mortality and a special challenge for surgeons. Based on research about glycocalyx, we obtained information regarding the differences of biophenotype on glycocalyx. So far, the research that leads to the difference in biophenotype is only focused on the ABO blood type system. Until recently there has been no data on the relationship between sepsis (especially intra-abdominal sepsis) with blood type. Methods: This is a descriptive and analytic research with cross sectional design in patients with abdominal trauma and gastrointestinal infections at dr. Cipto Mangunkusumo General Hospital (RSCM) that fulfilled the inclusion and exclusion criteria.Results: There were 230 subjects, who underwent post-traumatic abdominal surgery as well as gastrointestinal infections at RSCM. There were 22 subjects (incidence: 9.6%) who had postoperative intraabdominal sepsis. Most subjects who underwent surgery were aged around 41-60 years (50%), were men (56.1%), did not get transfusions (90.9%), had surgery caused by mechanical intestinal obstruction (24.8%), had blood type O (46.1%), had gastrointestinal infection (92.6%), and were living as the outcome of the procedure (96.5). There was a significant correlation (p < 0,05) between transfusion (p = 0,0001) and diagnostic group (p = 0,015) on the occurrence of intra-abdominal sepsis. In subjects receiving transfusion, the odds ratio (OR) was 0.02 and the group diagnosis OR was 4.7 at 95% confidence interval. Conclusions: The high risk of sepsis is especially high in the gastrointestinal infection group. Similarly, amongst factors affecting sepsis, history of transfusion may increase the risk of sepsis. Results of this study could not be prove that certain blood groups potentially cause intra-abdominal sepsis in patients with a history of abdominal trauma and gastro intestinal infections."

"Sepsis neonatorium merupakan sindroma klinis penyakit sistemik akibat infeksi yang terjadi pada bulan pertama kehidupan bayi baru lahir. Insidensi sepsissecara keselurahan 10-12tiap 1000 kelahiran hidup dengan angka kematian 20-30%, di negara maju (Amerika) 1-5 tiap 1000 kelahiran hidup. Berdasarkan SKRT tahun 2001 di Indonesia sepsis termasuk penyebab utama kematian pada neonatus. Angka kematian sepsis neonatorum dipengaruhi pula oleh masa gestasi bayi, organisme yang menginfeksi, dan waktu bayi mendapat infeksi apakah sebelum atau sesudah kelahiran. Pengobata sepsis neonatorum meliputi terapi kausatif (antimikroba), pengobatan suportif (hematologi, tunjangan nutrisi, susum saraf pusat, metabolic), Imunoterapi ( intravenous immunoglobulin, granulobulin, granulocyte colony stimulating faktor (GCSF) dan transfusi tukar). Immunoterapi saat ini sering digunakan sebagai terapi alternatif bila pengobatan dengan antibiotika tidak menunjukan perbaikan, Transfusi tukar tidak hanya menyediakan secara aktif granulosit, immunoglobin, faktor komplemen dan fibronektin, namun juga menghilangkan komponen-komponen yang tidak diinginkan seperti bakteri, toksin dan hasil pemecahan fibrinogen"

"Sepsis adalah disfungsi organ yang mengancam jiwa yang disebabkan oleh respon host yang tidak teratur terhadap infeksi dan menjadi salah satunya penyebab utama kematian di rumah sakit salah satunya di ruang rawat Intensive Care Unit (ICU). Penatalaksanaan yang dapat dilakukan pada pasien sepsis untuk mencegah terjadinya syok adalah dengan melakukan resusitasi awal dan manajemen segera setelah terdeteksi adanya sepsis. Tujuan penulisan karya ilmiah ini adalah untuk menganalisis asuhan keperawatan pada pasien sepsis melalui penerapan hour-1 bundle sepsis untuk mencegah kejadian syok pada pasien sepsis. Metode penulisan yang digunakan adalah case-report. Penerapan hour-1 bundle sepsis merupakan rekomendasi terbaru dari Surviving Sepsis Campaign (SSC) dalam penatalaksanaan sepsis atau syok sepsis. Asuhan keperawatan diberikan pada Ny.YNC (40 tahun) dengan diagnosis keperawatan utama risiko syok. Asuhan keperawatan dilakukan selama 4 hari termasuk di dalamya penerapan hour-1 bundle sepsis yaitu dengan melakukan pemeriksaan kadar laktat, pemeriksaan kultur darah sebelum pemberian antibiotik, pemberian antibiotik, pemberian cairan kristaloid 30 ml/kgBB, dan pemberian vasopressor untuk kasus hipotensi setelah pemberian cairan yang adekuat. Hasil penerapan hour-1 bunde sepsis menunjukkan adanya peningkatan MAP ≥65 mmHg dalam upaya pencegahan syok pada pasien. Melalui hasil tersebut diharapkan penerapan hour-1 bundle sepsis dapat dilakukan sebagai intervensi dalam pemberian asuhan keperawatan pada pasien dengan sepsis di rumah sakit terutama pada ruang Instalasi Gawat Darurat dan Intensive Care Unit.

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Sepsis is a life-threatening organ dysfunction caused by an irregular host response to infection and is one of the main causes of death in hospitals, one of which is in the Intensive Care Unit (ICU) ward. Management that can be done in patients with sepsis to prevent shock is to carry out initial resuscitation and management immediately after detection of sepsis. The purpose of writing this scientific work is to analyze nursing care in septic patients through the application of the sepsis hour-1 bundle to prevent shock in septic patients. The writing method used is case-report. Application of hour-1 sepsis bundle is the latest recommendation from the Surviving Sepsis Campaign (SSC) in the management of sepsis or septic shock. Nursing care was given to Mrs. YNC (40 years) with the main nursing diagnosis of risk of shock. Nursing care is carried out for 4 days including the implementation of hour-1 bundle sepsis, namely by checking lactate levels, checking blood cultures before giving antibiotics, giving antibiotics, giving crystalloid fluids 30 ml/kg, and giving vasopressors for hypotension cases after giving adequate fluids . The results of applying hour-1 sepsis bundle showed an increase in MAP ≥65 mmHg in an effort to prevent shock in patients. Through these results it is hoped that the application of hour-1 sepsis can be carried out as an intervention in providing nursing care to patients with sepsis in hospitals, especially in the Emergency Room and Intensive Care Unit."