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"ABSTRAK Latar belakang: Deteksi dini aterogenesis diperlukan untuk mencari faktor risiko gangguan kardiovaskular pada neonatus.Tujuan: 1 mengetahui sebaran nilai ketebalan tunika-intima aorta abdominalis aIMT pada bayi baru lahir; 2 mengetahui hubungan antara status nutrisi maternal dan berat lahir bayi terhadap aIMT bayi baru lahir.Metode: Penelitian potong lintang pada 86 bayi usi 2-3 kali nilai aIMT menggunakan ultrasonografi vaskular bertransduser linear 13 MHz dengan piranti lunak automatis, kemudian diambil nilai reratanya. Rerata aIMT kemudian dihubungkan dengan indeks massa tubuh ibu trimester pertama kehamilan dan berat lahir.Hasil: Rerata aIMT bayi baru lahir di Unit Perinatologi RSCM adalah 0,621 mm 0,110 mm. Tidak ditemukan korelasi antara indeks massa tubuh ibu trimester pertama kehamilan dengan aIMT bayi r = 0,137, p = 0,207 . Tidak ditemukan korelasi antara berat lahir bayi dengan aIMT bayi r = 0,036, p = 0,742 .Simpulan: Rerata aIMT bayi baru lahir di Unit Perinatologi RSCM adalah 0,621 mm 0,110 mm. Tidak didapatkan korelasi antara indeks massa tubuh ibu maupun berat lahir bayi terhadap aIMT bayi baru lahir. Deteksi dini risiko kardiovaskular pada neonatus melalui aIMT belum perlu dilakukan dalam praktik sehari-hari.Kata kunci: nutrisi maternal, risiko kardiovaskular, ketebalan tunika intima-media aorta

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ABSTRACTBackground Early detection of atherogenesis is needed to evaluate cardiovascular risk factors in newborns.Aim 1 knowing aortic intima media thickness aIMT distribution value in newborns 2 evaluate correlation between maternal nutritional status and birth weight to newborn aIMT.Method A cross sectional study was performed in 86 newborns, aged 0 7 days, with median gestational age of 35 weeks. All aIMT subjects were measured using a 13 MHz linear transducer vascular ultrasound with automatic software. Mean aIMT then correlated with first trimester maternal body mass index and birth weight.Results Newborn mean aIMT in Perinatology division Cipto Mangunkusumo Hospital was 0,621 mm SD 0,110 mm . There was no significant correlation between first trimester maternal body mass index and newborns aIMT r 0,137, p 0,207 . There was no significant correlation between birth weight and newborns aIMT r 0,036, p 0,742 .Conclusions Newborn mean aIMT in Perinatology division Cipto Mangunkusumo Hospital was 0,621 mm SD 0,110 mm . There were no correlations between first trimester maternal body mass index and birth weight to newborns aIMT. Early detection of atherogenesis in newborns through aIMT measurement were not recommended for daily practice yet.Keywords Maternal nutrition, newborns cardiovascular risks, aortic intima media thickness"

"Penyakit jantung bawaan (PJB) merupakan salah satu kelainan kongenital paling umum pada anak. Bedah jantung koreksi dengan cardiopulmonary bypass (CPB) adalah penatalaksanaan definitif untuk banyak kasus PJB. Namun, angka mortalitas dan morbiditas pascabedah jantung tetap tinggi, sehingga pemantauan hemodinamik yang efektif di Cardiac Intensive Care Unit (CICU) menjadi sangat penting. Parameter mikrosirkulasi seperti kadar laktat darah telah lama digunakan untuk mengevaluasi luaran klinis. Namun, metode non-invasif seperti indeks perfusi (IP) kini semakin diminati untuk memantau mikrosirkulasi secara real-time dan berkelanjutan. Tujuan penelitian ini adalah untuk mengetahui korelasi antara IP dan kadar laktat darah pada pasien anak pascabedah jantung koreksi. Penelitian ini menggunakan desain kohort prospektif dilakukan di ruang perawatan jantung intensif Rumah Sakit Cipto Mangunkusumo (RSCM) pada September-Oktober 2024. Subjek penelitian adalah anak berusia 1 bulan hingga 18 tahun yang dirawat setidaknya 8 jam pascabedah jantung koreksi yang memenuhi kriteria inklusi. Pemeriksaan IP dan kadar laktat darah dilakukan pada jam ke-1, 4, dan 8 pascabedah. Data dianalisis menggunakan uji korelasi Spearman dengan bantuan SPSS versi 25.0. Berdasarkan analisis studi yang didapatkan pada 34 anak yang diikutsertakan dalam penelitian ini. Hasil penelitian menunjukkan bahwa karakteristik demografis subjek memiliki usia median 21,5 bulan (rentang interkuartil: 10,25–79,5 bulan). Dengan penyakit jantung bawaan (PJB) asianotik merupakan diagnosis terbanyak, yaitu 20 subjek (58%). Sebagian besar subjek mengalami malnutrisi, dengan distribusi status gizi buruk pada 14,7% dan gizi kurang pada 44,1%. Sebanyak 23 subjek (66%) menjalani operasi bedah jantung koreksi dengan bantuan mesin sirkulasi ekstrakorporeal (CPB). Dari jumlah tersebut, 20 subjek (86%) memiliki durasi CPB di bawah 120 menit, sementara 3 subjek (14%) memiliki durasi CPB lebih dari 120 menit. Selain itu, 6 subjek (18,2%) mengalami Low Cardiac Output Syndrome (LCOS), sedangkan 27 subjek lainnya (81,8%) tidak mengalami LCOS. Sedangkan dari hasil penelitian ini juga ditemukan korelasi negatif yang signifikan antara IP <1,4 dengan kadar laktat darah pada jam ke-4 (-0,455, p=0,038) dan jam ke-8 (-0,515, p=0,017). Sebaliknya, IP ≥1,4 pada jam ke-4 menunjukkan korelasi positif yang kuat dengan bersihan laktat (0,719, p=0,006). Hal ini menunjukkkan bahwa Indeks perfusi memiliki korelasi yang signifikan dengan kadar laktat darah, sehingga dapat menjadi parameter non-invasif yang berguna untuk memantau status mikrosirkulasi pada anak pascabedah jantung korektif.

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Congenital heart disease (CHD) is among the most common congenital disorders in children. Corrective cardiac surgery with cardiopulmonary bypass (CPB) is a definitive treatment for many CHD cases. Despite advances, post-cardiac surgery morbidity and mortality remain significant, emphasizing the importance of effective hemodynamic monitoring in the Cardiac Intensive Care Unit (CICU). Blood lactate levels are well-established microcirculatory indicators for clinical outcomes. Recently, non-invasive methods like the Perfusion index (PI) have gained traction for continuous and real-time microcirculatory assessment. The Objective of this study aimed to evaluate the correlation between PI and blood lactate levels in pediatric patients post-cardiac corrective surgery. An prospective cohort study was conducted in the CICU of Cipto Mangunkusumo Hospital from September to October 2024. Pediatric patients aged 1 month to 18 years who were hospitalized for at least 8 hours post-cardiac surgery were included. PI and blood lactate levels were measured at the 1st, 4th, and 8th hours post-surgery. Data were analyzed using Spearman’s correlation test via SPSS version 25.0. Based on the analysis study from thirty-four children participated in this study. The results showed that from the demography caracteristic the subjects showed that the median age was 21,5 months (interkuartil range: 10,25–79,5 months). With the acyanotic congenital heart disease (CHD) as the most diagnosis are 20 subject (58%). Most of the subject with malnutrision, with the poor nourished distribution was 14,7% and undernourished was 44,1%. With 23 subject (66%) have undergone the heart correction surgery with Cardiopulmonary bypass machine (CPB) with 20 subject (86%) had the CPB time under 120 minutes, 3 subject (14%) with CPB time more than 120 minutes. Beside that, 6 subject (18,2%) had. the Low Cardiac Output Syndrome (LCOS), and another 27 subject (81,8%) didn’t. A significant negative correlation was observed between PI <1.4 and blood lactate levels at the 4th hour (-0.455, p=0.038) and the 8th hour (-0.515, p=0.017). Conversely, PI ≥1.4 at the 4th hour showed a strong positive correlation with lactate clearance (0.719, p=0.006). This results showed that the Perfusion index demonstrates a significant correlation with blood lactate levels, supporting its utility as a non-invasive parameter for monitoring microcirculation in pediatric patients post-cardiac corrective surgery."

"Park's Pediatric Cardiology for Practitioners is the essential medical reference book for the ever-changing field of pediatric cardiology. Comprehensive in its content, it provides the practical guidance you need to diagnose and manage children with congenital and acquired heart disease. From history and physical examination through preventative treatment and the management of special problems, the fully revised 6th edition incorporates all of the latest concepts in cardiology, distilled in a way that is understandable to pediatricians, family practitioners, NPs, and PAs alike. Apply the latest knowledge and methods with coverage of surgical techniques in pediatric cardiology, the application of interventional non-surgical techniques, blood pressure standards, and cardiac arrhythmia treatments. Easily grasp the latest techniques with helpful line drawings throughout. Select the best approaches for your patients with extensive coverage of special problems, including congestive heart failure and syncope.Clinical reference on the diagnosis and management of congenital and acquired heart disease in children."