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Abstrak :
ABSTRAK
Latar Belakang: Hiponatremia ditemukan pada 15-20 admisi rumah sakit. Hiponatremia berhubungan dengan adverse outcome pada pasien gagal jantung. Penggunaan akuaretik dipertimbangkan untuk tatalaksana hiponatremia pada gagal jantung. Adverse outcomes akibat hiponatremia berdampak terhadap pembiayaan, dan merupakan target potensial untuk intervensi. Studi ini bertujuan menilai efektivitas klinis tatalaksana hiponatremia pada gagal jantung serta menganalisis biaya medis antar metode tatalaksana. Metode: Penelitian ini merupakan studi potong lintang pada pasien dengan gagal jantung dekompensasi akut dengan hiponatremia pada Januari 2014 ndash; Mei 2017. Hasil Penelitian: Total subjek 128 pasien, dengan 71 55.5 subjek mendapatkan terapi konvensional ditambah antagonis reseptor AVP. Terdapat perbedaan bermakna p = 0.041 kenaikan natrium median kelompok antagonis reseptor AVP 4 -8 ndash; 26 dan tanpa antagonis reseptor AVP 3 -16 ndash; 16 , dan perbedaan bermakna p < 0.0001 lama masa rawat median 10.50 3-40 hari pada kelompok antagonis reseptor AVP dan 6 3-71 hari pada kelompok tanpa antagonis reseptor AVP . Analisis biaya parsial tidak menunjukkan perbedaan bermakna pada biaya rerata harian antar kedua kelompok. Kesimpulan: Terdapat perbedaan kenaikan kadar natrium darah di hari ketiga pengobatan dan lama masa rawat antar metode tatalaksana hiponatremia pada gagal jantung dekompensasi akut. Tidak terdapat perbedaan biaya bermakna antar metode tatalaksana hiponatremia pada gagal jantung dekompensasi akut.

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ABSTRACT
Background Hyponatremia is found in 15 20 of hospital admissions and is associated with adverse outcomes in heart failure, where aquaretics may be considered in its management. Adverse outcomes due to hyponatremia affects funding, and is a potential target for intervention to decrease expenses. We aim to evaluate the clinical effectiveness of hyponatremia treatment methods in heart failure and analyze medical costs between them. Method This is a cross sectional study among acute decompensated heart failure patients with hyponatremia in NCCHK from January 2014 until May 2017. Result 128 subjects were analyzed, with 71 55.5 subjects receiving conventional therapy and AVP receptor antagonist and 57 44.5 receiving conventional therapy only. There was a significant difference in sodium increase 4 8 ndash 26 in AVP receptor antagonist patients and 3 16 ndash 16 in those without, p 0.041 , and in length of stay 10.50 3 40 days in AVP receptor antagonist patients and 6 3 71 in those without, p 0.0001 . Cost analysis showed no significant difference in average daily cost. Conclusion There is a significant difference in sodium increase after three days of therapy and in length of stay. There is no significant cost difference with the addition of AVP receptor antagonist.

Abstrak :
Latar belakang: Kejadian hiponatremia pada anak pasca-operasi berkisar antara 20-40 . Kegagalan dalam mengenali hiponatremia dapat meningkatkan mortalitas dan menyebabkan luaran neurologis yang buruk. Terdapat beberapa mekanisme yang berperan, di antaranya sindrom hormon antidiuretik tidak tepat dan sick cell syndrome. Risiko hiponatremia pasca-operasi dan potensi bahaya yang ditimbulkan belum banyak disadari oleh para dokter. Tujuan: Mengetahui insidens hiponatremia pada anak pasca-operasi di Rumah Sakit Ciptomangunkusumo RSCM , kemungkinan penyebab yang terjadi, serta faktor-faktor yang berhubungan. Metode: Penelitian potong lintang analitik di ruang perawatan intensif anak RSCM selama bulan Mei sampai Desember 2016. Hasil: Terdapat 65 subyek yang menjalani operasi-mayor, sebagian besar operasi 87,69 dilakukan secara elektif dengan jenis operasi yang paling banyak adalah operasi hepatogastrointestinal 38,46 dan muskuloskeletal 20,00 . Terdapat penurunan bermakna kadar natrium plasma pasca-operasi, dengan kejadian hiponatremia adalah 43,07 dan 26,16 pada 12 dan 24 jam pasca-operasi. Seluruh subyek yang mengalami hiponatremia memiliki nilai osmolalitas plasma yang normal atau meningkat dan osmolalitas urin >100 mOsm/kg. Sebanyak 70 subyek dengan hiponatremia memiliki natrium urin >30 mEq/L. Faktor-faktor yang berhubungan dengan hiponatremia pada 12 jam pasca-operasi adalah status kegawatdaruratan operasi p=0,007 dan perdarahan intraoperatif p=0,024 , sedangkan pada 24 jam pasca-operasi hanya status kegawatdaruratan operasi p=0,001. Simpulan: Terdapat 43,07 dan 26,16 subyek yang mengalami hiponatremia pada 12 dan 24 jam pasca-operasi mayor. Sindrom hormon antidiuretik tidak tepat tidak terbukti menjadi penyebab utama terjadinya hiponatremia pasca-operasi, dan hiponatremia translokasional pada sick cell syndrome mungkin berperan. Hiponatremia pasca-operasi berhubungan dengan status kegawatdaruratan operasi dan jumlah perdarahan intraoperatif.

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Background The incidence of hyponatremia in post surgery pediatric patients is 20 40 . Undetected hyponatremia correlates with higher mortality and bad neurology outcomes. There are several mechanisms in post surgery hyponatremia, such as syndrome of inappropriate antidiuretic hormone and sick cell syndrome. Unfortunately, doctors rsquo awareness of hyponatremia and its dangerous complications is still low. Objective To establish the incidence of hyponatremia in post surgery pediatric patients in Cipto Mangungkusuomo CM Hospital, possible etiologies, and its related factors. Design Observational analytic study in CM hospital pediatric intensive care unit was held between May and December 2016. Results There were 65 subjects underwent mayor surgery, which mostly 87.69 was elective surgery. The most common surgeries were gastrointestinal 38,46 and musculoskeletal 20,00 surgery. There was significant decrease of natrium plasma after surgery, with hyponatremia incidence at 12 and 24 hours post surgery were 43.07 and 26.16 . All subjects with hyponatremia had normal or increased plasma osmolality and urine osmolality 100 mOsm kg. More than 70 subjects with hyponatremia had sodium urine 30 mEq L. Hyponatremia in 12 hours post surgery was related to surgery emergency status p 0.007 and intraoperative bleeding p 0.024 , while hyponatremia in 24 hours post surgery was related only to surgery emergency status p 0.001. Conclusion There was 43.07 and 26.16 subjects with hyponatremia at 12 and 24 hours post surgery. Syndrome of inappropriate antidiuretic hormone was not proven to cause hyponatremia in post surgery, and translocational hyponatremia in sick cell syndrome might be involved. Hyponatremia in post surgery was related to surgery emergency status and intraoperative bleeding.

Abstrak :
Polidipsia non psikogenik dengan hiponatremia adalah kondisi klinis yang jarang ditemukan. Hiperparatiroidisme primer merupakan kelainan kalsium, fosfat, serta metabolism tulang akibat kelebihan hormon paratiroid. Angka insiden kejadian hiperparatiroidisme adalah 21,6 dari 100.000 orang setiap tahunnya. Artikel ini melaporkan seorang pasien laki-laki 45 tahun dengan polidipsia non psikogenik. Pasien ini meminum air yang banyak untuk menghindari batu ginjal berulang. Pasien tersebut memiliki riwayat batu ginjal berulang disertai dengan hiperkalsemia. Evaluasi lebih lanjut penyebab hiperkalsemia pada kasus tersebut disebabkan oleh hiperparatiroidisme primer.

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Abstract
Non-psychogenic polydipsia with hyponatremia is a rare clinical presentation. Primary hyperparathyroidism is a disorder of calcium, phosphate, and bone metabolism caused by increased level of parathyroid hormone (PTH). It is estimated the incidence of primary hyperparathyroidism are 21.6 per 100,000 person a year. This case report describe a 45-year-old man presented with non-psychogenic polydipsia. This patient drank a lot of water out of the fear of recurrent kidney stones. He had history of recurrent nephrolithiasis with hypercalcemia. We investigate further the cause of hypercalcemia and we diagnosed primary hyperparathryoidism as the cause.

Abstrak :
Tujuan Kekerapan hiponatremia pada usia lanjut cukup tinggi disebabkan adanya peningkatan kadar ADH, dan ANP yang merupakan bagian dari 8 perubahan fisiologi. Komplikasi yang ditimbulkan cukup spesifik yaitu meningkatnya risiko patah tulang, penurunan kesadaran hingga kejang-kejang. Penyebab tersering hiponatremia pada usia lanjut adalah asupan air yang tinggi. Mendapatkan asupan air optimal yaitu volume asupan air tertinggi yang tidak menimbulkan hiponatremia dan hipovolemia. Metode Dilakukan penelitian pada 31 orang usia lanjut sehat setelah melalui pemilihan dari 107 usia lanjut secara simple random sampling dan kriteria eksklusi. Kemudian dibagi secara Randomisasi Blok dalam 5 kelompok asupan air (1000-2500 mL). Hasil Dapat dibuktikan bahwa 1000 mL merupakan asupan air optimal pada usia lanjut sehat. Diperlihatkan juga bahwa kadar ADH plasma memiliki gambaran hubungan dengan volume asupan air yang tidak menimbulkan hiponatremia dan kadar NT-proBNP tidak berkorelasi dengan kadar natrium urin sewaktu. (Med J Indones 2009; 18: 18-25) Kesimpulan Asupan air optimal pada usia lanjut adalah 1000 mL/24 jam.

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Aim The prevalence of hyponatremia in the elderly is quite high due to the rising of ADH and ANP concentrations which are part of eight physiologic changes. The complications are quite specific, among others, increased risk of bone fracture, declining of conciousness, and convulsion. The frequent cause of hyponatremia is high water intake. To achieve the optimal water intake designated as the highest water intake that did not cause hyponatremia and hypovolemia. Methods A study was conducted on 31 healthy elderly subjects, selected from 107 persons using simple random sampling and exclusion criteria. By block randomisation were classified into five water-intake groups (1000-2500 mL). Results In this study, it could be proved that 1000 mL was the optimal. It was also unraveled that the ADH levels had a role in determining the water intake volume that did not cause hyponatremia and NT-proBNP concentrations did not correlate with spot urine sodium. Conclusion The optimal water intake for the elderly is 1000 mL per day. Keywords: Hyponatremia, healthy elderly, water intake.

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[ABSTRAK
Latar belakang: Hiponatremia pasca tindakan operasi mayor pada populasi anak merupakan gangguan elektrolit yang sering terjadi. Penggunaan cairan yang belum tepat sering menimbulkan peningkatan kejadian hiponatremia yang berhubungan erat dengan meningkatnya berbagai komplikasi seperti edema otak, kejang, bahkan kematian. Populasi anak merupakan risiko tinggi karena perbandingan jaringan otak dan tulang tengkorak yang lebih besar sehingga ruang yang tersedia saat terjadi edema otak lebih sempit. Tujuan: Mengetahui insidens hiponatremia pada anak pasca tindakan operasi mayor. Metode: Studi retrospektif potong lintang dilakukan terhadap anak usia 1 bulan hingga 18 tahun yang menjalani tindakan operasi mayor dan masuk ruang perawatan intensif. Penelusuran status medik sesuai kriteria inklusi dilakukan sampai jumlah sampel terpenuhi. Pencatatan terhadap subjek yang meliputi data praoperasi, intraoperasi, serta pemantauan pascaoperasi dilakukan. Subjek yang memenuhi definisi hiponatremia (<135 mEq/L) diklasifikasikan sesuai derajat hiponatremia dan dilakukan pencarian lebih lanjut terhadap komplikasi. Hasil : Studi dilakukan terhadap 90 subjek yang terdiri dari 56,7% lelaki, dengan 51,1% memiliki rentang usia 1 bulan hingga 4 tahun. Sebanyak 47,8% subjek menjalani tindakan laparatomi dengan berbagai indikasi. Hampir semua subjek (93,3%) mendapat cairan hipotonik pascaoperasi. Insidens hiponatremia pascaoperasi sebesar 28,9% dengan 11,1% diantaranya merupakan hiponatremia sedang-berat. Rerata kadar natrium pascaoperasi adalah 130,1 ± 4,1 mEq/L dengan rerata total cairan 79,8 ± 27,4 ml/kg. Sebesar 30,9% subjek yang mendapatkan cairan hipotonik pascaoperasi mengalami kejadian hiponatremia dengan rerata lama rawat 5,6 ± 4 hari. Terdapat 1/26 subjek yang mengalami komplikasi berupa kejang dan edema otak. Simpulan: Insidens hiponatremia pasca tindakan operasi mayor di ruang perawatan intensif hampir mencapai 30% dan sebagian besar mendapat cairan hipotonik pascaoperasi. Penelitian lebih lanjut perlu dilakukan untuk mengevaluasi pemberian cairan pascaoperasi yang tepat untuk mencegah hiponatremia.

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ABSTRACT
Background: Hyponatremia is commonly found post major surgery in pediatric population. The use of improper fluid often leads to increasing incidence of hyponatremia which causes complications such as cerebral edema, seizure, and death. Pediatric is a high risk population due to the large ratio between the brain tissue and skull, so that the availability space. Hyponatremia after major surgery in pediatric population is a common electrolyte disorder. The use of improper fluid often lead to increased incidence of hyponatremia which is closely linked to the increasing variety of complications such as cerebral edema, seizures, and even death. Pediatric is high risk population due to the larger comparison of brain tissue and the skull so that the space available in the event of brain edema narrower. Objective: To describe the incidence of hyponatremia in children after major surgery. Methods: A retrospective cross-sectional study was conducted on children aged 1 month to 18 years who underwent major surgery and entered the intensive care ward. The inclusion subjects was traced from medical records. The data was recorded from preoperative, intraoperative, and postoperative monitoring. Subjects who met hyponatremia (<135 mEq/L) were classified according to the severity of hyponatremia and its complications. Results: Ninety subjects were enrolled in this study (56.7% male, 51.1% age 1 month-4 years). There were 47.8% subjects underwent laparotomy with a variety of indications. Almost all subjects (93.3%) received postoperative hypotonic fluid. The incidence of postoperative hyponatremia was 28.9%, while 11.1% among them were moderate-severe hyponatremia. The mean postoperative sodium levels was 130.1 ± 4.1 mEq/L with a mean total fluid 79.8 ± 27.4 ml/kg. There were 30.9% subjects who received hypotonic fluids and experienced hyponatremia with a mean length of stay 5.6 ± 4 days. One of 26 subjects with hyponatremia suffered from seizures and brain edema. Conclusions: The incidence of postoperative hyponatremia in pediatric intensive care reached nearly 30%, and almost all of them received hypotonic fluid. Therefore, further research should be performed to evaluate the appropriate fluid in order to anticipating postoperative hyponatremia, Background: Hyponatremia is commonly found post major surgery in pediatric population. The use of improper fluid often leads to increasing incidence of hyponatremia which causes complications such as cerebral edema, seizure, and death. Pediatric is a high risk population due to the large ratio between the brain tissue and skull, so that the availability space. Hyponatremia after major surgery in pediatric population is a common electrolyte disorder. The use of improper fluid often lead to increased incidence of hyponatremia which is closely linked to the increasing variety of complications such as cerebral edema, seizures, and even death. Pediatric is high risk population due to the larger comparison of brain tissue and the skull so that the space available in the event of brain edema narrower. Objective: To describe the incidence of hyponatremia in children after major surgery. Methods: A retrospective cross-sectional study was conducted on children aged 1 month to 18 years who underwent major surgery and entered the intensive care ward. The inclusion subjects was traced from medical records. The data was recorded from preoperative, intraoperative, and postoperative monitoring. Subjects who met hyponatremia (<135 mEq/L) were classified according to the severity of hyponatremia and its complications. Results: Ninety subjects were enrolled in this study (56.7% male, 51.1% age 1 month-4 years). There were 47.8% subjects underwent laparotomy with a variety of indications. Almost all subjects (93.3%) received postoperative hypotonic fluid. The incidence of postoperative hyponatremia was 28.9%, while 11.1% among them were moderate-severe hyponatremia. The mean postoperative sodium levels was 130.1 ± 4.1 mEq/L with a mean total fluid 79.8 ± 27.4 ml/kg. There were 30.9% subjects who received hypotonic fluids and experienced hyponatremia with a mean length of stay 5.6 ± 4 days. One of 26 subjects with hyponatremia suffered from seizures and brain edema. Conclusions: The incidence of postoperative hyponatremia in pediatric intensive care reached nearly 30%, and almost all of them received hypotonic fluid. Therefore, further research should be performed to evaluate the appropriate fluid in order to anticipating postoperative hyponatremia]

Abstrak :
Latar Belakang: Insidensi hiponatremia pada infeksi intrakranial sebesar 30-66%. Hiponatremia dapat memperburuk manifestasi neurologis infeksi intrakranial itu sendiri serta dikaitkan dengan peningkatan morbiditas dan mortalitas. Metode: Penelitian dengan studi potong lintang retrospektif untuk mengetahui karakteristik hiponatremia dan hubungannya dengan keluaran klinis pasien infeksi intrakranial di RSUPN Dr. Cipto Mangunkusumo (RSCM) pada April 2019 s/d Oktober 2021. Data dasar diambil dari Indonesian Brain Infection Study (IBIS) kemudian dilengkapi dari rekam medis. Subjek ≥18 tahun dengan diagnosis akhir infeksi intrakranial masuk kriteria inklusi, sedangkan data tidak lengkap dan tidak rawat inap masuk kriteria eksklusi. Hasil: Terdapat 296 subjek dengan mayoritas meningoensefalitis tuberkulosis (51,4%). Hiponatremia pada 66,6% subjek, terbagi menjadi derajat ringan (54%), sedang (24%) dan berat (22%). Hiponatremia banyak terjadi pada HIV positif (59,1%), komorbid penyakit paru (44,9%) dengan keluhan terbanyak sakit kepala (58,1%). Kematian terjadi pada (24,2%) subjek hiponatremia, dimana usia >60 tahun, komorbid, penyakit paru atau ginjal, hiponatremia berat dan status hiponatremia tidak terkoreksi berhubungan dengan kematian (p<0,05). Kesimpulan: Pada infeksi intrakranial, koinfeksi HIV berhubungan dengan kejadian hiponatremia. Tidak ditemukan perbedaan bermakna karakteristik hiponatremia terhadap mortalitas, status fungsional maupun durasi perawatan. Faktor yang berhubungan dengan mortalitas adalah usia, derajat hiponatremia, komorbiditas, dan status koreksi hiponatremia. ......ackground: The incidence of hyponatremia in intracranial infection is 30-66%. Hyponatremia can exacerbate the neurological manifestations of the intracranial infection itself and is associated with increased morbidity and mortality. Methods: This study was a retrospective cross-sectional study to determine the characteristics of hyponatremia and its relationship to the clinical outcome of patients with intracranial infections in Dr. Cipto Mangunkusumo (RSCM) from April 2019 to October 2021. Base data were taken from the Indonesian Brain Infection Study (IBIS) and completed from medical records. Subjects 18 years with a final diagnosis of intracranial infection were included in the inclusion criteria, while incomplete data and no hospitalization were included in the exclusion criteria. Results: There were 296 subjects with the majority of meningoencephalitis tuberculosis (51.4%). Hyponatremia in 66.6% of subjects was divided into mild (54%), moderate (24%), and severe (22%). Hyponatremia was common in HIV positive (59.1%), comorbid lung disease (44.9%) with headache as a common complaint (58.1%). Mortality occurred in (24.2%) hyponatremic subjects, where age >60 years, comorbidities, pulmonary or renal disease, severe hyponatremia, and uncorrected hyponatremic status were associated with mortality (p<0.05). Conclusion: In intracranial infection, HIV coinfection is associated with the incidence of hyponatremia. There were no significant differences in the characteristics of hyponatremia on mortality, functional status, and duration of treatment. Factors associated with mortality were age, degree of hyponatremia, comorbidities, and hyponatremia correction status.

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Hiponatremia merupakan salah satu komplikasi yang sering terjadi pada anak yang mendapat terapi cairan hipotonik. Hiponatremia sering ditemui pada diare dengan dehidrasi. Saat ini standar terapi diare dengan dehidrasi masih menggunakan cairan hipotonik. Tujuan: Mengetahui perubahan kadar natrium darah dan standard base (SB) pasca rehidrasi menggunakan cairan standar atau cairan ringer asetat malat (RAM) Metode: Penelitian uji klinis acak terkontrol membandingkan 2 macam terapi yaitu cairan standar dan cairan RAM, dilakukan di RSUD Dr. Soetomo Surabaya. Hasil: Didapatkan 21 subyek di kelompok cairan standar dan 19 subyek di kelompok RAM. Rerata kadar natrium serum dan SB awal di kelompok cairan standar 140.95 mmol/L dan -10.57 mmol/L, pada kelompok terapi RAM adalah 141.40 mmol/L dan -9.37 mmol/L. Nilai tersebut tidak menunjukan perbedaan bermakna antara 2 kelompok. Pasca rehidrasi didapatkan kadar natrium 138.31 mmol/L dengan SB 6.32 mmol/L pada kelompok cairan standar dan pada kelompok RAM 141.74 mmol/L dan -7.37 mmol/L. Perubahan rerata kadar natrium menunjukkan perbedaan bermakna secara statistik, sedangkan perubahan SB tidak menunjukkan perbedaan yang bermakna. Rerata penurunan kadar natrium pada kelompok terapi standar adalah 2.48 mmol/L dan kenaikan 0.37 mmol/L pada kelompok RAM. Simpulan Didapatkan perubahan kadar natrium darah dan SB pasca rehidrasi menggunakan 2 cairan berbeda.

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Hyponatremia is a common complication in children receiving hypotonic fluid therapy. Hyponatremia is common in diarrhea with dehydration . The current standard treatment of diarrhea with dehydration still using hypotonic solutions. Objective: To determine changes in blood sodium levels and standard base (SB) after rehydration using standard solutions or Ringer's acetate malate solutions (RAM) Methods: The study was a randomized, controlled clinical trial comparing two kinds of therapy that is standard solutions and RAM solutions performed at Dr. Soetomo hospitals. Results: There were 21 subjects in standard group and 19 subjects in groups of RAM group. The mean initial sodium level and SB in standard treatment were 140.95 mmol /L and -10.57 mmol/L, in the RAM treatment group was 141.40 mmol /L and -9.37 mmol/L. These values did not show significant differences between the 2 groups. Post rehydration sodium level was 138.31 mmol/L with SB was -6.32 mmol/L in the standard treatment group and in the group of RAM 141.74 mmol/L and -7.37 mmol/L. Changes in the mean sodium levels showed statistically significant differences, whereas SB changes showed no significant difference. The mean decrease in sodium levels in the standard therapy group was 2.48 mmol/L and the mean increase 0.37 mmol/L in the group of RAM. Conclusions : There were changes in blood sodium levels and SB after rehydration using two different solutions.

Abstrak :
Latar belakang. Pemberian cairan intravena pada pasien anak yang menjalani tindakan bedah berfungsi untuk mempertahankan keseimbangan metabolik tubuh. Pemilihan cairan perioperatif yang tidak tepat dapat menimbulkan komplikasi berupa asidosis metabolik, hiponatremia, hipoglikemi, atau hiperglikemia. Tujuan. Mengetahui profil pemberian cairan perioperatif di Rumah Sakit Cipto Mangunkusumo (RSCM) serta pengaruhnya terhadap keseimbangan asam basa serta kadar elektrolit dan gula darah serum. Metode. Studi deskriptif kohort prospektif pada pasien anak (1 bulan ? 18 tahun) yang menjalani tindakan bedah elektif di RSCM. Jenis dan jumlah cairan perioperatif yang diberikan dicatat, serta dilakukan pemeriksaan laboratorium (analisis gas darah, elektrolit dan gula darah serum) sesaat sebelum tindakan bedah, setelah tindakan bedah, serta 6 jam setelah pemberian cairan postoperatif. Hasil penelitian. Dari 61 subyek yang diteliti, 65,6% tidak mendapat cairan preoperatif. Cairan yang paling banyak digunakan sebagai cairan intraoperatif adalah Ringer asetat malat (RAM) yaitu 77% dan cairan postoperatif adalah kristaloid hipotonik (83,6%). Jumlah cairan preoperatif dan postoperatif sebagian besar sesuai formula Holliday-Segar. Subyek yang mendapat cairan preoperatif D10 1/5 NS + KCl (10) lebih banyak mengalami hiponatremia (13,4% vs 5%) dan gangguan kadar gula darah (20% vs 0%) dibandingkan dengan subyek yang tidak mendapat cairan. Asidosis metabolik terjadi pada kelompok cairan intraoperatif RAM (36,2%) maupun Ringer asetat (36,4%). Hiponatremia pasca pemberian cairan postoperatif terjadi pada 57,1% subyek yang tidak mendapat cairan, 44,4% pada kelompok KA-EN3B®, dan 21,9% pada kelompok D10 1/5 NS + KCl (10). Hiperglikemia terjadi pada 15,6% subyek yang mendapat D10 1/5 NS + KCl (10). Simpulan. Pemberian cairan perioperatif di RSCM bervariasi. Angka kejadian hiponatremia pasca pemberian kristaloid hipotonik adalah 13,4 - 44,4%. Hiponatremia dan gangguan kadar gula darah terjadi pada subyek yang mendapat cairan D10 1/5 NS + KCl (10).

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Background. Intravenous fluid in pediatric surgery patients aimed to maintain acid-base balance and also normal serum electrolyte and blood glucose. Inappropriate perioperative fluid management may cause complications such as metabolic acidosis, hyponatremia, hypoglycemia, or hyperglycemia. Objects. To study the profile of perioperative fluid for pediatric patients in Cipto Mangunkusumo Hospital (CMH) and its effects on acid-base balance, electrolyte, and blood glucose. Method. A descriptive prospective cohort study in children aged 1 month to 18 years old who underwent elective surgery in CMH. The intravenous perioperative fluid given to the patients and their amount were recorded. Laboratory examinations were done 3 times (right before surgery, right after surgery, and 6 hours after postoperative fluid was started), which are blood gas analysis, serum electrolyte, and blood glucose. Results. Among 61 subjects, 65,6% did not receive any preoperative fluid. The most common intravenous fluid were Ringer?s acetate malate (RAM) which is 77% as intraoperative fluid and hypotonic crystalloids (83,6%) as postoperative fluid. The amount of preoperative and postoperative fluid was mostly in accordance with Holliday-Segar formula. Subjects who had D10 1/5 NS + KCl (10) as preoperative fluid had more hyponatremia (13,4% vs 5%) and blood glucose disturbance (20% vs 0%) compared to subjects without preoperative fluid. Metabolic acidosis occurred in subjects who had either RAM (36,2%) or Ringer?s acetate (36,4%) as intraoperative fluid. Hyponatremia 6-hours after postoperative fluid occurred in 57,1% subjects without intravenous fluid, 44,4% subjects who had KA- EN3B®, and 21,9% subjects who had D10 1/5 NS + KCl (10). Hyperglycemia occurred in 15,6% subjects who had D10 1/5 NS + KCl (10). Conclusion. There is a variety in perioperative fluid in CMH. Hyponatremia incidence after receiving hypotonic crystalloid is 13,4 - 44,4%. Hyponatremia and blood glucose disturbances occured in subjects who had D10 1/5 NS + KCl (10).

Abstrak :
Menurut WHO, kualitas hidup adalah persepsi seseorang terhadap posisinya di dalam kehidupan, di dalam konteks budaya dan sistem nilai yang dianutnya, dan berhubungan dengan tujuan, harapan, standar, dan apa yang menjadi perhatiannya. Penilaian kualitas hidup penderita HIV anak dapat menggunakan PedsQL, yang mencakup aspek fisik, emosi, sosial, sekolah, menurut orang tua dan anak. Tujuan penelitian ini adalah untuk mengetahui kualitas hidup anak terinfeksi HIV dan hubungannya dengan tipe caregiver. Metode penelitian ini menggunakan rancangan cross sectional. Subjek penelitian ini adalah pasien anak terinfeksi HIV berusia 2-18 tahun, yang dirawat jalan, dan memenuhi kriteria inklusi dan tidak memenuhi kriteria ekslusi. Teknik penentuan sampelnya adalah consecutive sampling. Hasil penelitian pada 83 responden orang tua dan 72 responden anak diperoleh data bahwa sebanyak 89% responden anak merasa bahwa kualitas hidupnya baik, 11 % responden anak merasa bahwa kualitas hidupnya buruk. Selain itu, sebanyak 66 % responden orang tua merasa kualitas hidup anaknya baik, sedangkan 34% responden orang tua merasa kualitas hidup anaknya buruk. Sebagian besar tipe caregiver utama adalah orang tua pasien. Kesimpulan dari penelitian ini adalah tidak terdapat hubungan antara kualitas hidup anak terinfeksi HIV dengan tipe caregiver utama. ......According to WHO, quality of life is individual perception about his position in live, in cultural context and value system, and related with purpose, expectation , standard, and his focus. Quality of life in HIV infected children is evaluated using PedsQL which includes physical aspect, emotion, social, school, according to parent and children. The purpose of this research is to measure quality of life in HIV infected children and it?s relationship with caregiver type. The methode of this research is cross sectional. The subject of this research is hiv infected children 2-18 years old, inpatient, and fill the inclusion criteria and not fill the exclusion criteria. The sampling methode is consecutive sampling. The result of the research in 83 parent respondent and 72 children respondent, is 89% children respondent think that they have good quality of life, 11 % children respondent think that they have bad quality of life. Besides that, 66 % parent respondent think thet they have good quality of life, while 34% parent respondent think that their children have bad quality of life. Mostly, the major caregiver type is the children?s parent. The conclusion of this research is there is no relationship between quality of live in HIV infected children and major caregiver type.