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"This popular book covers the “how-to” of the respiratory care of newborns in outline format. It includes case studies for self-review and is illustrated with high quality radiographic images, figures, tables, and algorithms. Written and edited by international experts, the Third Edition is a thorough update and remains a convenient source of practical information on respiratory physiology, exam techniques, tips for performing procedures, radiography, ventilation, pain management, transport, and discharge planning.·Up-to-date clinical information from world experts.·Case studies.·Easy-to-consult outline format.·Condensed information about all of the major mechanical ventilators (e.g., modes, displays, and alarms)."

"The first section of Functional respiratory disorders : when respiratory symptoms do not respond to pulmonary treatment will help clinicians recognize functional respiratory symptoms that can arise as a result of both organic and psychological causes. The second section of this book provides detailed discussions of such disorders, links to video examples of laryngoscopic evaluation of patients with vocal cord issues, case studies and quizzes. Examples and exercises that should strengthen the clinician’s confidence in identifying and treating these functional conditions are also provided. Finally, the third section of the book will help the clinician differentiate the patients for whom referral to a mental health provider is mandatory from those for whom other approaches may be useful. For the latter group, the book teaches clinicians to empower themselves by learning how to incorporate various therapies for functional disorders into their practice, including biofeedback, breathing techniques, basic cognitive behavioral therapy techniques, and hypnosis. Links are provided to instructive video examples of biofeedback, hypnosis, and speech therapy. Practical strategies for obtaining training in these modalities are provided in the appendix. "

"ABSTRAKPasien yang terpasang ventilator mengalami kesulitan berbicara sehingga mengalami gangguan dalam berkomunikasi dan menggunakan suatu metode dalam berkomunikasi. Penelitian ini menggunakan desain crossectional dengan sampel 45 responden dan tekhnik pengumpulan data purposive sampling. Hasil penelitian menunjukkan metode komunikasi yang digunakan pasien yaitu menunjuk atau membuat isyarat dengan tangan yang digunakan 100% responden, menulis atau menggambar yang digunakan 40% responden, menggerakkan bibir atau mencoba untuk berbisik yang digunakan 91% responden, ekspresi wajah yang digunakan 84% responden, dan menggerakkan kepala, ya atau tidak yang digunakan 93% responden. Metode komunikasi lain yang digunakan adalah mengetuk tempat tidur. Perawat diharapkan mengetahui metode komunikasi yang digunakan pasien yang terpasang ventilator sehingga dapat memberikan penjelasan tentang pilihan metode komunikasi sesuai keadaan pasien serta menyediakan media sesuai metode komunikasi yang dipilih.

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ABSTRAKPatients who have difficulty speaking with mechanical ventilation so that impaired communication and uses a method of communicating. This study used crosssectional design with a sample of 45 respondents and data collection purposive sampling technique. The results showed that method of communication used by patients to refer or make a gesture with the hand were used 100% by the respondents, writing or drawing were used 40% by respondents, moving his lips or trying to whisper were used 91% by respondents, the facial expression were used 84% by respondents, and move his head, yes or not were used 93% by respondents. Another communication method which was used by the patient is knocking on the bed. Nurses are expected to know the method of communication used by patients with mechanical ventilation in order to provide an explanation of the preferred method of communication according to the situation of patients and provide appropriate media communication method selected."

"Merenstein &​ Gardner's Handbook of Neonatal Intensive Care, 8th Edition, is the leading resource for collaborative, interprofessional critical care of newborns. Co-authored by physicians and nurses, it offers concise, comprehensive coverage with a unique multidisciplinary approach and real-world perspective that make it an essential guide for both neonatal nurses and physicians. The 8th edition features the latest neonatal research, evidence, clinical guidelines, and practice recommendations - all in a practical quick-reference format for easy retrieval and review of key information. UNIQUE!This book is the leading resource for collaborative, interprofessional critical care of newborns. Co-authored by physicians and nurses, it offers concise, comprehensive coverage with a unique multidisciplinary approach and real-world perspective that make it an essential guide for both neonatal nurses and physicians."

"Inadequate humidification of inspired gases can cause a variety of serious problems, and humidification has accordingly become an important aspect of modern intensive care medicine. This book is designed to serve as a practical guide for clinicians, providing information on the theoretical background of humidification, the equipment, and its optimal use. The book starts by examining the physiological basis of humidification. Current devices are then discussed, with careful attention to factors influencing their performance and methods to evaluate their effectiveness. The two scenarios of mechanical and non-mechanical ventilation are considered, and the issue of ventilator-associated pneumonia is addressed in detail. Further chapters focus on such topics as humidification following tracheostomy, humidification of the artificial airway during secretion management, measurement of inspired gas temperature in the ventilated neonate, and humidification in the home care setting."

"Respiratory Distress Syndrome (RDS) adalah salah satu masalah utama pada bayi baru lahir dan menjadi salah satu penyebab kontribusi peningkatan morbiditas dan mortalitas pada bayi. Salah satu tata laksana bayi dengan RDS adalah dengan pemberian non invasive respiratory support dan ventilasi mekanik. Namun hal tersebut butuh penatalaksanaan yang tepat untuk mencegah komplikasi dan meningkatkan efektifitas ventilasi dan perfusi, serta menyokong terapi oksigen yaitu dengan positioning. Hasil penelitian menunjukkan bahwa posisi pronasi memiliki efek positif pada bayi prematur dengan RDS, namun ketepatan posisi pronasi masih belum diteliti. Tujuan penelitian ini adalah untuk mengidentifikasi faktor-faktor yang mempengaruhi ketepatan perawat melakukan posisi pronasi pada bayi prematur dengan RDS. Desain penelitian yang digunakan adalah cross sectional dengan jumlah sampel 128 perawat. Lama penelitian untuk tiap responden adalah satu hari. Data hasil penelitian dianalisis dengan multivariat regresi logistic dengan hasil faktor yang mempengaruhi ketepatan perawat melakukan posisi pronasi adalah pengetahuan dan caring  p = 0,002; Alfa 0,05 %. Faktor yang tidak mempengaruhi antara lain pengalaman klinis, efikasi perawat, BB bayi, Usia gestasi, Bayi dirawat diinkubator, Terintubasi dan Keputusan DNR. Diperlukan upaya peningkatan pengetahuan dan caring untuk meningkatkan ketepatan pemberian posisi pronasi pada bayi prematur dengan RDS.

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Background: Respiratory Distress Syndrome (RDS) is one of the main problems in newborns and is one of the causes of contributing to increased morbidity and mortality in infants. One of the procedures of infants with RDS is by giving Non-invasive respiratory support and mechanical ventilation. However, this requires proper management to prevent complications and increase the effectiveness of ventilation and perfusion, and to support oxygen therapy by positioning. The results showed that the prone position has a positive effect on preterm infants with RDS, but the accuracy of prone position has not been studied. Aims: The purpose of study was to identify the factors that influence the nurses accuracy of  implementing  prone positions in preterm infants with RDS. Method: The study design used was a cross-sectional with a sample of 128 nurses. The duration of the study for each respondent is one day. Results: The research data were analyzed by multivariate logistic regression with the results of factors that influenced the nurses accuracy of implementing prone positions were knowledge and caring (p = 0.002; alpha 0.05%). Factors that did not influence included clinical experience, nurse efficacy, baby weight, gestational age, incubated infants, intubated and DNR decisions. More nowledge and caring are needed to improve the accuracy of implementing prone position in preterm infants with RDS."

"Latar belakang: Dukungan respiratori pada neonatus saat lahir dan stabilisasi bertujuan mencegah terjadinya hipoksia. Hingga saat ini, pemantauan status oksigenasi masih menggunakan saturasi oksigen perifer (SpO2). Akan tetapi, SpO2 dan tekanan parsial oksigen (PaO2) tidak berhubungan secara linier sehingga apabila terjadi peningkatan PaO2 >80 mmHg, maka SpO2 akan mengalami plateau >95%. Oxygen reserve index (ORI) merupakan parameter baru yang dapat menilai simpanan oksigen di jaringan. Pengaplikasian ORI diharapkan dapat melengkapi kelemahan SpO2 untuk mencegah hiperoksia. Namun, penelitian mengenai ORI pada neonatus masih sangat terbatas. Metode: Rancangan penelitan ini menggunakan analitik korelatif dengan desain penelitian potong lintang. Kriteria inklusi adalah neonatus mendapatkan dukungan respiratori dengan pemantuan SpO2 secara kontinu pada monitor >95% dan direncanakan pemeriksaan gas darah arteri. Nilai ORI diambil selama 30 menit. Setiap perubahan nilai ORI dan SpO2 dicatat dan dihitung untuk mendapatkan rerata nilai. Data diolah berdasarkan uji korelasi. Hasil: Dari 205 neonatus yang lahir/dirujuk ke Unit Neonatologi RSUPN Cipto Mangukusumo diperoleh 23 subyek yang memenuhi kriteria inklusi. Diperoleh total 70 pengukuran dari 23 subyek. Insidens hiperoksia ditemukan pada 40 pengukuran (57%). Kekuatan korelasi antara ORI dan PaO2 diperoleh r = 0,687 dengan p <0,001. Analisis multivariat memerlihatkan apabila ORI digunakan bersama SpO2 menunjukkan hasil koefisiens determinasi yang cukup rendah (R2 adjusted = 28,4%). Nilai cut-off ORI 0,21 dapat memprediksi PaO2 >80 mmHg dengan dengan sensitivitas 82,5% dan spesifisitas 76,6%. Simpulan: Terdapat korelasi yang bermakna antara ORI dan PaO2. Pengaplikasian ORI secara klinis dapat memprediksi PaO2 pada neonatus dalam rentang hiperoksia yang tidak dapat ditunjukkan SpO2. ORI tidak dapat menggantikan SpO2.

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Background: Respiratory support in the delivery room and NICU is an effort to prevent hypoxia at birth and during stabilization. Until recently, peripheral oxygen saturation (SpO2) is used to monitor oxygenation status non-invasively. However, the relationship between SpO2 and arterial partial pressure of oxygen (PaO2) is not linear but sigmoidal. If the level of PaO2 >80 mmHg, SpO2 reaches a plateau at the range >98-100%. Oxygen reserve index (ORI) could assess oxygen reserve at the tissue level which is undetected using pulse oximetry. ORI application may complete SpO2 weakness in detecting hyperoxia. Nevertheless, studies about ORI in neonate is still limited. Method: In this cross-sectional correlational study, we included neonates receiving oxygen therapy whose SpO2 monitor continuously showed >95%. Arterial blood gas analysis was done according to the attending’s order. The ORI value was taken for 30 minutes. Any change in the ORI and SpO2 value was recorded and calculated to get an average value. Data were analyzed based on a correlation test. Result: From 205 inborn and outborn at Neonatal Unit Cipto Mangunkusumo Hospital, 23 subjects met the inclusion criteria. There were 70 measurements of ORI, SpO2 and PaO2 in 23 subjects. Hyperoxia was observed in 40 measurements (57%). The correlation between ORI and PaO2 was r = 0,687 (p <0,0001). Multivariate analysis showed ORI together with SpO2 has a low coefficient of determination of R2 adjusted = 28,4%. The cut-off ORI value to predict PaO2 >80 mmHg when SpO2 >95% was 0,21 with a sensitivity of 82,5% and specificity of 76,6%. Conclusion: ORI and PaO2 are significantly strongly correlated in neonates. ORI is able to predict hyperoxia that goes undetected by SpO2. However, ORI cannot replace the role of SpO2."

"[ABSTRAKLatar Belakang: Ketrampilan menghisap dan koordinasi antara menghisap, menelan dan bernafas belum adekuat belum adekuat pada neonatur prematur. Neonatal Oral-Motor Assessment Scale (NOMAS) adalah alat ukur yang telah sahih dan andal dalam menilai oromotor skill pada neonatus prematur. Penelitian ini ingin menguji validitas isi dan reliabilitas interrater dan test-retest yang diterjemahkan kedalam bahasa Indonesia yang belum pernah dilakukan sebelumnya.Metode : Desain penelitian ini adalah uji validasi, terdiri dari 16 subjek yang diambil berdasarkan kriteria penerimaan; neonatus prematur, kondisi umum stabil dan diizinkan oleh orang tua dengan mengisi informed consent. Data berupa video saat menyusu diawali dari saat pertama bertemu peneliti hingga usia koreksi 40 minggu. Oromotor skill dinilai dengan NOMAS yang telah diterjemahkan ke bahasa Indonesia. Validitas isi dilakukan dengan proses non-statistik; keandalan intrarater dinilai dengan uji Cohen?s Kappa dan Inter Class Correlation, keandalan interrater dengan uji Cronbach Alpha dan Inter Class Correlation.Hasil : Dari 16 neonatus didapatkan usia gestasi 32-35 minggu dan BBLR 93,75%. Secara isi NOMAS berbahasa Indonesia telah dinyatakan sesuai dengan NOMAS berbahasa Inggris. Keandalan intrarater bernilai baik hingga sempurna (K= 0,6-1,00 dan ICC= 0,4-1,00). Uji keandalan interrater bernilai rendah hingga hampir sempurna (Cronbach?s Alpha = 0,18-0,84 dan ICC= 0,05- 0,80).Kesimpulan : NOMAS berbahasa Indonesia mempunyai validitas isi dan reliabilitas yang baik untuk digunakan sebagai alat ukur oromotor skill pada neonatus prematur. Sebaiknya mengikuti pelatihan NOMAS agar lebih mengusai penggunaan alat ukur ini.

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ABSTRACTBackground : Sucking skills and the coordination between sucking, swallowing and breathing are inadequate on premature neonates. Neonatal Oral-Motor Assessment Scale (NOMAS) is a measuring instrument that is both valid and reliable in assessing oromotor skills in premature neonates. The study aims to test the content validity and interrater reliability and test-retest reliability of NOMAS translated to Bahasa Indonesia which has never been done before.Methods : This study is a validation test, consisting of 16 subjects who were taken using the inclusion criteria; premature neonates, in stable general condition and allowed by their parents to participate in the study by filling out an informed consent. Data was collected in the form of a video taken during feeding, starting from the first meeting with the researcher until 40 weeks corrected age. Oromotor skills was assessed using NOMAS which has been translated into Bahasa Indonesia. Content validity was performed using non-statistical process; intrarater reliability was assessed using Cohen's Kappa test and Inter Class Correlation, and interrater reliability using Cronbach Alpha test and Inter Class Correlation.Results : Of the 16 neonates, a mean gestation age of 32-35 weeks and low birth weight incidence of 93.75% was found. The content of NOMAS in Bahasa Indonesia has been declared in accordance with NOMAS in English. Intrarater reliability was good to perfect (K= 0,6-1,00 and ICC= 0,4-1,00). Interrater reliability was low to almost perfect (Cronbach?s Alpha = 0,18-0,84 and ICC= 0,05- 0,80)Conclusion : NOMAS in Bahasa Indoensia has good content validity and reliability and can be used as a measuring tool for oromotor skills in premature neonates. NOMAS training is adviced to master the use of this measure., Background : Sucking skills and the coordination between sucking, swallowing and breathing are inadequate on premature neonates. Neonatal Oral-Motor Assessment Scale (NOMAS) is a measuring instrument that is both valid and reliable in assessing oromotor skills in premature neonates. The study aims to test the content validity and interrater reliability and test-retest reliability of NOMAS translated to Bahasa Indonesia which has never been done before.Methods : This study is a validation test, consisting of 16 subjects who were taken using the inclusion criteria; premature neonates, in stable general condition and allowed by their parents to participate in the study by filling out an informed consent. Data was collected in the form of a video taken during feeding, starting from the first meeting with the researcher until 40 weeks corrected age. Oromotor skills was assessed using NOMAS which has been translated into Bahasa Indonesia. Content validity was performed using non-statistical process; intrarater reliability was assessed using Cohen's Kappa test and Inter Class Correlation, and interrater reliability using Cronbach Alpha test and Inter Class Correlation.Results : Of the 16 neonates, a mean gestation age of 32-35 weeks and low birth weight incidence of 93.75% was found. The content of NOMAS in Bahasa Indonesia has been declared in accordance with NOMAS in English. Intrarater reliability was good to perfect (K= 0,6-1,00 and ICC= 0,4-1,00). Interrater reliability was low to almost perfect (Cronbach’s Alpha = 0,18-0,84 and ICC= 0,05- 0,80)Conclusion : NOMAS in Bahasa Indoensia has good content validity and reliability and can be used as a measuring tool for oromotor skills in premature neonates. NOMAS training is adviced to master the use of this measure.]"