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Abstrak :
Demam berdarah dengue (DBD) masih menjadi masalah kesehatan utama di Asia dan Pasifik khususnya Indonesia. Angka kematian sindom syok dengue (SSD) di rumah sakit masih tinggi. Data di Departemen Ilmu Kesehatan Anak FKUI/RSCM antara 1 Januari 2003 sampai dengan 30 Juni 2004 didapatkan jumlah kasus DBD yang dirawat sebanyak 263 pasien. Jumlah kasus SSD pada periode tersebut sebesar 31,7% DBD derajat III, diikuti DBD derajat II sebesar 30,7% dan DBD ensefalopati pada DBD derajat 1V sebesar 1%. Salah satu gangguan keseimbangan asam basa adalah asidosis laktat, suatu bentuk asidosis metabolik. Kondisi ini terjadi akibat akumulasi laktat yang disebabkan oleh hipoksia atau iskemia jaringan. Asidosis laktat erat hubungannya dengan akumulasi laktat di dalam cairan ekstraseluler, akibat ketidakseimbangan antara suplai oksigen dengan pemakaian oksigen untuk kebutuhan metabolik. Kadar laktat darah telah banyak dipelajari dan digunakan sebagai petanda biokimia adanya hipoksia jaringan pada keadaan sakit gawat. Asidosis laktat dibuktikan sebagai faktor penyebab umum dan tersering dari berbagai keadaan sakit gawat. Hipoperfusi/hipoksia jaringan menjadi dasar patogenesis dari berbagai kasus asidosis laktat. Pengukuran laktat serial dapat memprediksi kemungkinan timbulnya syok septik dan gagal organ multipel lebih baik dibandingkan pengukuran variabel-variabel transpor oksigen. Beratnya asidosis laktat dapat dilihat dari nilai pH darah, senjang anion, dan kadar laktat darah dengan metode kuantitatif. Pemantauan kadar laktat darah dapat membedakan pasien-pasien yang akan tetap hidup dan pasien yang akan meninggal. Kadar laktat darah juga merupakan indikator yang lebih sensitif untuk daya tahan hidup dibandingkan dengan nilai curah jantung, hantaran oksigen, tumor necrosis factor a (TNF a), dan interleukin-6 (TL-6).

Abstrak :
Air susu ibu (ASI) merupakan makanan bayi yang paling baik dan bersifat unik karena spesifik untuk spesies manusia. Pemberian ASI secara eksklusif (ASI eksklusif) adalah pemberian nutrisi yang ideal dan cukup untuk bayi sampai berusia 6 bulan. Pada tahun 1992, UNICEF dan WHO meluncurkan apa yang disebut "Baby Friendly Hospital Initiative" (Rumah Sakit Sayang Bayi = RSSB), yang bertujuan memperbaiki pelayanan maternal dan neonatal di rumah sakit sehingga para ibu dapat menyusui bayinya dengan balk melalui penerapan "Ten Steps to Successful Breastfeeding" (Sepuluh Langkah Menuju Keberhasilan Menyusui = 10 LMKM). Dalam kenyataan sehari-hari di masyarakat, para ibu umurnnya sudah mulai menyusui sejak bayinya lahir, tetapi sebelum bayi berusia 6 bulan mereka telah menghentikan pemberian ASI atau ditambah dengan makanan lain. Angka cakupan ASI eksklusif 0-4 bulan menurut Survei Demografi Kesehatan Indonesia (SDKI) 2002 masih rendah yaitu sebesar 55%, sedangkan target yang akan dicapai pada tahun 2010 pemberian ASI eksklusif adalah sebesar 80%. Sejauh ini, angka pemberian ASI eksklusif yang sebenarnya di lapangan tidak diketahui dengan pasti. Pencatatan yang dilakukan oleh Puskesmas adalah jumlah kunjungan ibu yang memberikan ASI eksklusif tanpa verifikasi apakah benar ASI diberikan secara eksklusif kepada bayi. Di samping itu, data jumlah kunjungan tidak mencerminkan jumlah ibu yang memberikan ASI eksklusif. Oleh karena itu, diperlukan penelitian yang cerrnat dengan pertanyaan-pertanyaan untuk memverifikasi perilaku menyusui ibu di lapangan. Faktor-Faktor yang Menghambat Pemberian ASI Eksklusif Banyak alasan mengapa ibu tidak memberikan AST kepada bayinya. Suatu survei mengungkapkan beberapa alasan ibu memberikan susu formula atau makanan tambahan, antara lain: ASI kurang atau tidak keluar (38,0%), dianggap sudah waktunya (27,1%), ibu bekerja (18,6%), dan bayi tidak mau (6,1%). Faktor-faktor yang mempengaruhi angka menyusui tidak hanya beragam dan kompleks, tetapi juga berpengaruh secara berlainan dalam situasi yang berbeda. Pendidikan ibu misalnya, berkaitan dengan angka menyusui yang lebih tinggi di negara-negara maju tetapi lebih rendah di negara-negara berkembang. Pengaruh budaya dan kepercayaan diri ibu terhadap kemampuannya menyusui juga dapat berbeda dan mempengaruhi sikap ibu terhadap menyusui. Faktor-faktor yang diketahui berkaitan dengan penghentian pemberian ASI antara lain merokok, paparan terhadap asap rokok, ibu sedang mendapat obat, problem fisik seperti obesitas dan masalah kejiwaan seperti depresi, serta keadaan yang membuat sulit menyusui, seperti kembali bekerja atau sekolah. Promosi susu formula dalam bentuk paket-paket edukasi dari perusahaan susu formula pada kunjungan antenatal telah terbukti meningkatkan penghentian pemberian ASI dalam 2 minggu pertama pasca bersalin. Ironisnya, paket-paket tersebut diberikan oleh para tenaga kesehatan yang melayani pelayanan antenatal para ibu hamil.

Abstrak :
Demam berdarah dengue (DBD) masih menjadi masalah kesehatan utama di Asia dan Pasifik khususnya Indonesia. Angka kematian sindom syok dengue (SSD) di rumah saldt masih tinggL Data di Departemen Jimu Kesehatan Anak FKUI/RSCM antara 1 Januari 2003 sampai dengan 30 Juni 2004 didapatkan jumlah kasus DBD yang dirawat sebanyak 263 pasien. Jumlah kasus SSD pada periode tersebut sebesar 31,7% DBD derajat III, diikuti DBD derajat 11 sebesar 30,7% dan DBD ensefalopati pada DBD derajat IV sebesar 1%. Salah satu gangguan keseimbangan asam basa adalah asidosis laktat, suatu bentuk asidosis metabolik. Kondisi ini terjadi akibat akumulasi laktat yang disebabkan oleh hipoksia atau iskernia jaringan. Asidosis laktat erat hubungannya dengan akumulasi laktat di dalam cairan ekstraseluler, alcibat ketidakseimbangan antara suplai oksigen dengan pemakaian oksigen untuk kebutuhan metabolik. Kadar laktat darah telah banyak dipelajari dan digunakan sebagai petanda biokimia adanya hipoksia jaringan pada keadaan sakit gawat. Asidosis laktat dibuktikan sebagai faktor penyebab umum dan tersering dari berbagai keadaan sakit gawat. Hipoperfusi/ hipoksia jaringan menjadi dasar patogenesis dari berbagai kasus asidosis laktat. Pengukuran laktat serial dapat memprediksi kemungkinan timbulnya syok septik dan gagal organ multipel Iebih baik dibandingkan pengukuran variabel-variabel transpor oksigen. Beratnya asidosis laktat dapat dilihat dari nilai pH darah, senjang anion, dan kadar laktat darah dengan metode kuantitatif. Pemantauan kadar laktat darah dapat membedakan pasienpasien yang akan tetap hidup dan pasien yang akan meninggal. Kadar laktat darah juga merupakan indikator yang lebih sensitif untuk daya tahan hidup dibandingkan dengan nilai rush jantung, hantaran oksigen, tumor necrosis factor a (TNF a), dan interleukin-6 (IL-6). Kadar laktat darah dapat digunakan untuk evaluasi penilaian terhadap terapi syok. Pada syok septik penurunan kadar laktat darah saat terapi menandakan prognosis yang baik. Pemantauan kadar laktat darah langsung di sisi pasien penting untuk evaluasi terapi. Penelitian kadar laktat darah serial pada penderita demam berdarah dengue sangat jarang dilaporkan. Setiati dkk dalam penelitiannya melaporkan pemeriksaan kadar laktat darah sebagai prediktor mortalitas DBD berat yang dirawat di pediatric intensive care unit (PICLI) maupun di intermediate emergency care unit. Parameter yang diperiksa meliputi kadar laktat darah, analisis gas darah, elektrolit, hemoglobin, hematokrit dan trombosit yang diperiksa saat masuk, saat perburukan dan saat pasien keluar dari unit perawatan. Didapatkan peningkatan kadar laktat darah pada penderita dengan serologi dengue blot yang positif. Pada keadaan hipoksia terjadi metabolisme anaerob diikuti peningkatan senjang anion. Didapatkan korelasi kuat antara kadar laktat darah dengan saturasi 02 (r = -0,77) dan senjang anion (r = 0,79). Rumusan masalah pada penelitian ini adalah : 1. Apakah terdapat perbedaan kadar laktat darah serial pada penderita DBD tanpa syok dan SSD? 2. Apakah terdapat hubungan kadar laktat darah dengan variabel faktor terjadinya syok pada DBD (kadar hemoglobin, hematokrit, trombosit, Pa02, saturasi 02, dan senjang anion darah) ? 3. Berapa kadar laktat darah pada penderita DBD anak yang dapat digunakan sebagai petanda memburuknya perjalanan penyakit/syok pada DBD?

Abstrak :
ABSTRAK
Latar belakang : Sindrom Down merupakan penyakit genetik yang dapat menyebabkan keterlambatan perkembangan motorik, bahasa, kognitif, dan psikososial. Periode perkembangan anak dalam tiga tahun pertama kehidupan sangat penting, karena merupakan dasar untuk hasil perkembangan selanjutnya. Sampai saat ini belum dilakukan penelitian yang menghubungkan kemampuan motorik pasien sindrom Down dengan faktor-faktor yang memengaruhinya. Mengingat prevalensi anak sindrom Down yang cukup banyak di Indonesia, dan belum didapatkan data tersebut maka penelitian dilakukan pada anaksindrom Down sehingga anaksindrom Down mendapatkan hasil optimal dari program intervensi yang dijalankan Tujuan : Mengetahui karakteristik pertumbuhan dan perkembangan motorik anak sindrom Down serta faktor yang memengaruhi tingkat perkembangan motorik kasar untuk menentukan kemampuan anak, kebutuhan terapi dan meningkatkan kualitas pelayanan. Metode: Studi potong lintang deskriptif dan analitik selama Agustus sampai September 2015 pada 103 anak sindrom Down usia 6 bulan - 3 tahun di Poli Anak dan Poli Rehabilitasi medic Rumah Sakit Cipto Mangunkusumo (RSCM). Data orang tua didapat dari autoanamnesis dan pencarian rekam medis, data antropometrik berupa beratbadan, tinggi badan dan lingkar kepala diplot pada kurva pertumbuhan khusus anak sindromDown, perkembangan motorik kasar dinilai berdasarkan milestone khusus anak sindrom Down. Hasil penelitian : Sejumlah 103 subjek (56 laki-laki, 47 perempuan) memenuhi kriteria inklusi. Median subjek adalah 12 bulan. Jumlah subjek yang mengalami gizi baik dan gizi kurang hampir sama. Mikrosefali dialami oleh sebagian kecil subjek 10 (9,6%). Anak sindrom Down dengan tipe klasik ditemukan pada sebagian besar pasien sebanyak 99 (96%) dan tipe translokasi sebanyak 4 (3,9%). Keterlambatan motorik ringan dialami oleh 69,2% subjek, keterlambatan motorik sedang 16,3%, dan keterlambatan motorik ringan 13,5%. Hasil analisis multivariate memperlihatkan faktor risiko yang berhubungan dengan keterlambatan motorik adalah lingkar kepala (p=0,011; OR 6,852; IK95% 1,565-30,038), riwayat asfiksia (p=0,009; OR 4,033; IK95% 1,427-11,4), dan frekuensi program stimulasi (p=0,006; OR 3,845; IK95% 1,460-10,125). Kesimpulan : Lingkar kepala, riwayat asfiksia, dan frekuensi program stimulasi merupakan faktor risiko keterlambatan perkembangan motorik anak sindromDown.ABSTRACT
Background : Down Syndrome is one of genetics disease that could cause delayed motoric, language, cognitive, and psycho-social development. Development of the first three years of life is crucial, because it is a basic for further development. Until recently, there are not study which conducted to correlates motoric capabilities Down Syndromes patients to factors that interfere its. In Indonesia, prevalence of child with Down Syndromes is quite high, there are no data depicted that correlation;hence, this study was conducted in child with Down Syndromes so that they obtained optimal outcome from intervention program conducted. Aim: To know characteristics of motoric growth and development in children with Down Syndromes and factors interfere degree of gross motoric development which to determine children?s capability, needs therapy, and improves quality of service. Methods : A descriptive cross-sectional study was conducted to 103 children with Down Syndromes aged 6 months ? 3 years old in Pediatrics Outpatient Clinics and Medical Rehabilitation Outpatient Clinics of Rumah Sakit Cipto Mangunkusumo (RSCM) during August to September 2015. Data were obtained by their parents (auto-anamnesis) and medical records, anthropometric data comprised body weight, body height, and head circumference which were plotted to special growth curve of children with Down Syndromes, gross motoric developments were assessed by special milestone of children with Down Syndromes. Results : One hundred and three subjects were fulfilled as inclusion criterions. Median subject was twelve months. Amount of subjects with good nutrition and malnutrition were equal. Subjects with microcephaly were 10 (9.6%). Children with classical type of Down Syndromes were 99(96%) and translocation type were 4(3.9%). Children with mild motoric development were 69.2%, intermediate motoric development were 16.3%, and severe motoric development were 13.5%. Multivariate analysis showed risk factors correlates to motoric development were head circumference (p=0,011; OR 6,852; CI 95% 1,565-30,038), history of asphyxia (p=0,009; OR 4,033; CI 95% 1,427-11,4), and frequency of stimulation programs (p=0,006; OR 3,845; CI95% 1,460-10,125). Conclusion : Head circumference, history of asphyxia, and frequency of stimulation programs were risk factors of motoric development in children with Down Syndromes. ;Background : Down Syndrome is one of genetics disease that could cause delayed motoric, language, cognitive, and psycho-social development. Development of the first three years of life is crucial, because it is a basic for further development. Until recently, there are not study which conducted to correlates motoric capabilities Down Syndromes patients to factors that interfere its. In Indonesia, prevalence of child with Down Syndromes is quite high, there are no data depicted that correlation;hence, this study was conducted in child with Down Syndromes so that they obtained optimal outcome from intervention program conducted. Aim: To know characteristics of motoric growth and development in children with Down Syndromes and factors interfere degree of gross motoric development which to determine children?s capability, needs therapy, and improves quality of service. Methods : A descriptive cross-sectional study was conducted to 103 children with Down Syndromes aged 6 months ? 3 years old in Pediatrics Outpatient Clinics and Medical Rehabilitation Outpatient Clinics of Rumah Sakit Cipto Mangunkusumo (RSCM) during August to September 2015. Data were obtained by their parents (auto-anamnesis) and medical records, anthropometric data comprised body weight, body height, and head circumference which were plotted to special growth curve of children with Down Syndromes, gross motoric developments were assessed by special milestone of children with Down Syndromes. Results : One hundred and three subjects were fulfilled as inclusion criterions. Median subject was twelve months. Amount of subjects with good nutrition and malnutrition were equal. Subjects with microcephaly were 10 (9.6%). Children with classical type of Down Syndromes were 99(96%) and translocation type were 4(3.9%). Children with mild motoric development were 69.2%, intermediate motoric development were 16.3%, and severe motoric development were 13.5%. Multivariate analysis showed risk factors correlates to motoric development were head circumference (p=0,011; OR 6,852; CI 95% 1,565-30,038), history of asphyxia (p=0,009; OR 4,033; CI 95% 1,427-11,4), and frequency of stimulation programs (p=0,006; OR 3,845; CI95% 1,460-10,125). Conclusion : Head circumference, history of asphyxia, and frequency of stimulation programs were risk factors of motoric development in children with Down Syndromes. ;Background : Down Syndrome is one of genetics disease that could cause delayed motoric, language, cognitive, and psycho-social development. Development of the first three years of life is crucial, because it is a basic for further development. Until recently, there are not study which conducted to correlates motoric capabilities Down Syndromes patients to factors that interfere its. In Indonesia, prevalence of child with Down Syndromes is quite high, there are no data depicted that correlation;hence, this study was conducted in child with Down Syndromes so that they obtained optimal outcome from intervention program conducted. Aim: To know characteristics of motoric growth and development in children with Down Syndromes and factors interfere degree of gross motoric development which to determine children?s capability, needs therapy, and improves quality of service. Methods : A descriptive cross-sectional study was conducted to 103 children with Down Syndromes aged 6 months ? 3 years old in Pediatrics Outpatient Clinics and Medical Rehabilitation Outpatient Clinics of Rumah Sakit Cipto Mangunkusumo (RSCM) during August to September 2015. Data were obtained by their parents (auto-anamnesis) and medical records, anthropometric data comprised body weight, body height, and head circumference which were plotted to special growth curve of children with Down Syndromes, gross motoric developments were assessed by special milestone of children with Down Syndromes. Results : One hundred and three subjects were fulfilled as inclusion criterions. Median subject was twelve months. Amount of subjects with good nutrition and malnutrition were equal. Subjects with microcephaly were 10 (9.6%). Children with classical type of Down Syndromes were 99(96%) and translocation type were 4(3.9%). Children with mild motoric development were 69.2%, intermediate motoric development were 16.3%, and severe motoric development were 13.5%. Multivariate analysis showed risk factors correlates to motoric development were head circumference (p=0,011; OR 6,852; CI 95% 1,565-30,038), history of asphyxia (p=0,009; OR 4,033; CI 95% 1,427-11,4), and frequency of stimulation programs (p=0,006; OR 3,845; CI95% 1,460-10,125). Conclusion : Head circumference, history of asphyxia, and frequency of stimulation programs were risk factors of motoric development in children with Down Syndromes. ;Background : Down Syndrome is one of genetics disease that could cause delayed motoric, language, cognitive, and psycho-social development. Development of the first three years of life is crucial, because it is a basic for further development. Until recently, there are not study which conducted to correlates motoric capabilities Down Syndromes patients to factors that interfere its. In Indonesia, prevalence of child with Down Syndromes is quite high, there are no data depicted that correlation;hence, this study was conducted in child with Down Syndromes so that they obtained optimal outcome from intervention program conducted. Aim: To know characteristics of motoric growth and development in children with Down Syndromes and factors interfere degree of gross motoric development which to determine children?s capability, needs therapy, and improves quality of service. Methods : A descriptive cross-sectional study was conducted to 103 children with Down Syndromes aged 6 months ? 3 years old in Pediatrics Outpatient Clinics and Medical Rehabilitation Outpatient Clinics of Rumah Sakit Cipto Mangunkusumo (RSCM) during August to September 2015. Data were obtained by their parents (auto-anamnesis) and medical records, anthropometric data comprised body weight, body height, and head circumference which were plotted to special growth curve of children with Down Syndromes, gross motoric developments were assessed by special milestone of children with Down Syndromes. Results : One hundred and three subjects were fulfilled as inclusion criterions. Median subject was twelve months. Amount of subjects with good nutrition and malnutrition were equal. Subjects with microcephaly were 10 (9.6%). Children with classical type of Down Syndromes were 99(96%) and translocation type were 4(3.9%). Children with mild motoric development were 69.2%, intermediate motoric development were 16.3%, and severe motoric development were 13.5%. Multivariate analysis showed risk factors correlates to motoric development were head circumference (p=0,011; OR 6,852; CI 95% 1,565-30,038), history of asphyxia (p=0,009; OR 4,033; CI 95% 1,427-11,4), and frequency of stimulation programs (p=0,006; OR 3,845; CI95% 1,460-10,125). Conclusion : Head circumference, history of asphyxia, and frequency of stimulation programs were risk factors of motoric development in children with Down Syndromes. ;Background : Down Syndrome is one of genetics disease that could cause delayed motoric, language, cognitive, and psycho-social development. Development of the first three years of life is crucial, because it is a basic for further development. Until recently, there are not study which conducted to correlates motoric capabilities Down Syndromes patients to factors that interfere its. In Indonesia, prevalence of child with Down Syndromes is quite high, there are no data depicted that correlation;hence, this study was conducted in child with Down Syndromes so that they obtained optimal outcome from intervention program conducted. Aim: To know characteristics of motoric growth and development in children with Down Syndromes and factors interfere degree of gross motoric development which to determine children?s capability, needs therapy, and improves quality of service. Methods : A descriptive cross-sectional study was conducted to 103 children with Down Syndromes aged 6 months ? 3 years old in Pediatrics Outpatient Clinics and Medical Rehabilitation Outpatient Clinics of Rumah Sakit Cipto Mangunkusumo (RSCM) during August to September 2015. Data were obtained by their parents (auto-anamnesis) and medical records, anthropometric data comprised body weight, body height, and head circumference which were plotted to special growth curve of children with Down Syndromes, gross motoric developments were assessed by special milestone of children with Down Syndromes. Results : One hundred and three subjects were fulfilled as inclusion criterions. Median subject was twelve months. Amount of subjects with good nutrition and malnutrition were equal. Subjects with microcephaly were 10 (9.6%). Children with classical type of Down Syndromes were 99(96%) and translocation type were 4(3.9%). Children with mild motoric development were 69.2%, intermediate motoric development were 16.3%, and severe motoric development were 13.5%. Multivariate analysis showed risk factors correlates to motoric development were head circumference (p=0,011; OR 6,852; CI 95% 1,565-30,038), history of asphyxia (p=0,009; OR 4,033; CI 95% 1,427-11,4), and frequency of stimulation programs (p=0,006; OR 3,845; CI95% 1,460-10,125). Conclusion : Head circumference, history of asphyxia, and frequency of stimulation programs were risk factors of motoric development in children with Down Syndromes.

Abstrak :
Anak yang dirawat di ICU cenderung mengalami malnutrisi sejak masuk atau selama perawatan yang dapat memperberat penyakit dasar, memperpanjang lama rawat serta meningkatkan mortalitas. Baik underfeeding atapun overfeeding dapat terjadi di ICU Anak selama perawatan. Penelitian ini merupakan penelitian potong lintang, menggunakan data rekam medis. Selama 3 bulan penelitian. didapatkan 45 subjek penelitian. Dari 45 data pasien didapatkan 127 peresepan untuk menilai keseuaian peresepan dengan pemberian nutrisi pada pasien. Pemberian nutrisi pada pasien yang dirawat di ICU Anak merupakan hal yang sangat penting. Perlu perhitungan kebutuhan nutrisi yang cermat, pemberian nutrisi tepat yang sesuai kebutuhan pasien agar tidak terjadi malnutrisi yang lebih berat lagi. ......Children admitted to the Pediatric Intensive Care Unit (PICU) are at risk for poor and potentially worsening nutritional status, a factor that further increases comorbidities and complications, prolongs the hospital stay, increases cost and increases mortality. Both underfeeding and overfeeding are prevalent in PICU and may result in large energy imbalance. This was cross sectional study design, with 3 month consecutive sampling in PICU which met 45 patients as the subject and 127 prescription of nutrition. Nutrition support therapies in PICU is very important .Adequate nutrition therapy is essential to improve nutrition outcomes in critically ill children.

Abstrak :
Latar Belakang: Tujuan penelitian untuk melihat neutrophil gelatinase associated lipocalin (NGAL) pada pasien sepsis. Dimana NGAL merupakan biomarker yang dini untuk acute kidney injury (AKI). Metode Penelitian Penelitian kualitatif dengan desain uji diagnostik Pengambilan sampel secara cross sectional dan consecutive sampling pada 50 orang anak yang sepsis yang terdiri dari 28 sepsis, 22 sepsis berat di ruang rawat intensif anak di RS. Ciptomangunkusomo Jakarta dan RS.Wahidin Sudirohusodo Makassar. Hasil: Kadar NGAL urin pada pasien sepsis berat lebih tinggi dibandingkan sepsis. Nilai sensitifitas NGAL urin 100% dan spesifisitas 63,63%. NGAL urin meningkat lebih dulu bila dibandingkan dengan kreatinin serum. Kesimpulan NGAL dapat dipakai sebagai petanda dini terjadinya AKI. ...... Introduction: The aim of this study to observe the neutrophil gelatinase associated lipocalin (NGAL) in pediatric sepsis. From previous study NGAL was early biomarker for AKI. Methods. This study is a qualitative study for diagnostic test. Sample was collected by cross sectional and consecutive sampling on 50 sepsis children, consist of 28 sepsis, 22 severe sepsis in pediatric intensive care unit Ciptomangunkusomo Hospital Jakarta and Wahidin Sudirohusodo Hospital Makassar. Result: The value of urinary NGAL in severe sepsis is higher than sepsis. The Sensitivity and specificity is 100% and 63,63% this study suggest that urinary NGAL increase earlier than serum creatinine. Conclusion. Therefore urinary NGAL can be used as early biomarker for AKI.

Abstrak :
Malnutrisi sering ditemukan pada anak dengan pasca pembedahan dan berhubungan dengan luaran sepsis atau infeksi luka operasi. Penelitian observasional analitik ini bertujuan mengetahui pengaruh malnutrisi terhadap luaran pasien pasca pembedahan dengan mengukur penurunan kadar RBP pada hari pertama dan kelima pasca pembedahan. Dilakukan pengukuran kadar RBP, kortisol, CRP pada hari pertama dan kelima pasca pembedahan, luaran infeksi dinilai berdasarkan skor ASEPSIS. Hasil penelitiaan ini menunjukkan penurunan RBP, peningkatan CRP, usia dan skor ASA berturut-turut memberikan risiko 4,4;3,3;1,2 dan 1,3 kali terjadinya infeksi luka operasi pada pasien pasca pembedahan mayor, namun tidak didapatkan perbedaan yang bermakna. ......Malnutrition is often found in children with post-surgery and associated with poor outcomes such as sepsis or surgical wound infections. This analytic observational study aims to determine the effects of malnutrition on the outcomes of patients after surgery by measuring the decrease in Retinol Binding Protein (RBP) levels on the first and fifth day post-surgery. We measured levels of RBP, cortisol, CRP in the first and fifth day post-surgery and infection outcomes were evaluated according to ASEPSIS score. The results of this study showed a decrease in RBP, an increase in CRP, age and ASA score consecutively provide risk 4.4; 3.3, 1.2 and 1.3 times for occurrence of surgical wound infections in patients after major surgery, but there were no statistically differences.

Abstrak :
Malnutrisi sering ditemukan pada pasien pasca bedah dan berhubungan dengan penurunan fungsi otot, respirasi, imun serta terganggunya penyembuhan luka. Penelitian observasional analitik ini bertujuan mengetahui faktor yang mempengaruhi status nutrisi akut pascabedah. Dilakukan pemeriksaan kadar retinol binding protein (RBP) hari ke-1 dan ke-5 pasca bedah sebagai indikator status nutrisi akut. Asupan nutrisi dan prosentasenya terhadap resting energy expenditure (REE) diukur tiap hari. Dilakukan pemeriksaan kortisol dan C-reactive protein (CRP) sebagai marker respons inflamasi. Dari 35 subyek penelitian sesuai kriteria inklusi disimpulkan kadar RBP hari ke-1, kortisol dan CRP berpengaruh terhadap status nutrisi akut pascabedah. ......Malnutrition is common in postoperative patients and is associated with decreased muscle function, respiratory, immune and disruption of wound healing. This analytic observational study aims to determine the factors that affect the nutritional status of acute post operative patients. We examined the levels of retinol binding protein (RBP) on day 1 and 5 post-operative as an indicator of acute nutritional status. Nutrient intake was calculated for each day and the percentage from resting energy expenditure (REE). We also examined cortisol and C-reactive protein (CRP) as markers of inflammatory response. Of the 35 study subjects who met the inclusion criteria, we can conclude that RBP levels, cortisol and CRP in day 1 are indicators of acute post-operative malnutrition