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Abstrak :
Latar belakang : Ventilator mekanik masih diperlukan pada neonatus untuk menyelamatkan bayi dalam kondisi distress napas yang berat. Ekstubasi dini sangat diperlukan untuk menghindari komplikasi karena pemakaian ventilator yang lama. Oleh karena itu diperlukan prediktor untuk mengetahui faktor risiko yang mengakibatkan kegagalan ekstubasi dini. Metode : Penelitian kohort retrospektif yang dilakukan di Unit NICU RSCM. Data diperoleh dari RM selama periode waktu 2017 – 2022. Penelitian dilakukan terhadap subyek yang memerlukan ventilator mekanik dan dapat diekstubasi dalam waktu 5 hari (ekstubasi dini). Subyek yang memerlukan reintubasi dalam waktu 72 jam dikategorikan sebagai kelompok yang gagal ekstubasi. Hasil : Kegagalan ekstubasi dini di NICU RSCM sebesar 70/180 (38,9%). Hasil analisis regresi logistik (AUC 0,824): usia gestasi < 28 minggu (p = 0,006, RR 3,39; IK 95%: 1,64-19,02), Usia gestasi (28–32) minggu (p = 0,228, RR 0,29; IK 95%: 0,67-5,52), pH < 7,35 (p = 0,541, RR 1,23: IK 95%; 0,58-2,85), pH > 7,45 (p = 0,022, RR 0,15; IK 95%: 0,02-0,79), dan kadar Hb < 11,5 g/dl (p = 0,001, RR 5,01; IK 95%: 5,58-38,52). Simpulan : Makin rendah Usia gestasi dan Hb makin besar risiko kegagalan ekstubasi dini pada bayi prematur. ......Background : Mechanical ventilators still needed to rescue severe respiratory distress neonates. Early extubation is necessary to avoid complications due to prolonged use of the ventilator. Therefore, predictors are needed to determine the risk factors that result in early extubation failure. Methods : The study was conducted at the NICU Unit of Cipto Mangunkusumo National Hospital. Retrospective data were obtained from medical records during 2017 – 2022 on subjects required mechanical ventilator and extubated within 5 days (early extubation). Early extubation failure defined as reintubation within 72 hours. Results : Early extubation failure at NICU Unit of Cipto Mangunkusumo National Hospital were 70/180 (38.9%). The results of logistic regression analysis (AUC 0.824): gestational age < 28 weeks (p = 0.006, RR 3.39; 95% CI: 1.64-19.02), gestational age (28-32) weeks (p = 0.228, RR 0.29; 95% CI: 0.67-5.52), pH < 7.35 (p = 0.541, RR 1.23: 95% CI; 0.58-2.85), pH > 7, 45 (p = 0.022, RR 0.15; 95% CI: 0.02-0.79), and Hb level < 11.5 g/dl (p = 0.001, RR 5.01; 95% CI: 5.58-38.52).

Abstrak :
Latar belakang: Enterokolitis nekrotikans merupakan salah satu komplikasi pada bayi prematur dengan angka mortalitas tinggi. Patogenesis terjadinya enterokolitis nekrotikans hingga kini belum dipahami namun bersifat multifaktorial. Berbagai penelitian mengaitkan enterokolitis nekrotikans dengan transfusi sel darah merah. Salah satu upaya untuk mencegahnya adalah dengan melakukan puasa saat transfusi, namun hingga kini masih bersifat kontroversial. Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan puasa saat menjalani transfusi sel darah merah dengan kejadian enterokolitis nekrotikans pada bayi prematur. Metode: Penelitian menggunakan desain studi kohort retrospektif dilakukan di Rumah Sakit Cipto Mangunkusumo menggunakan data rekam medis. Bayi prematur yang dirawat di Unit Perinatologi RSCM dalam periode Januari 2019 hingga Desember 2023 dan menjalani transfusi sel darah merah, serta memenuhi kriteria inklusi dan eksklusi diikutsertakan dalam penelitian. Subyek kemudian dikelompokkan berdasarkan puasa atau tidak puasa saat menjalani transfusi sel darah merah. Diagnosis enterokolitis nekrotikan ditegakkan melalui hasil foto polos abdomen. Dilakukan pula pencatatan terhadap status maternal, usia gestasi, data antropometri saat lahir, skor APGAR usia 5 menit, jenis nutrisi enteral saat dilakukan transfusi sel darah merah. Hasil: Sebanyak 240 bayi prematur yang menjalani transfusi sel darah merah diikutsertakan dalam analisis. Seratus empat puluh empat bayi lelaki (60,0%), dengan rerata usia gestasi 31 (SD 2,69) minggu dan median berat lahir 1.256 (RIK 1.005-1.653) gram. Enterokolitis nekrotikans ditemukan pada 23,75% subyek dan EKN awitan dini lebih banyak ditemukan yaitu sebanyak 54,39% subyek. Proporsi bayi yang dipuasakan mengalami EKN lebih rendah dibandingkan yang tidak dipuasakan (22,09% dan 27,94%). Tidak ditemukan hubungan bermakna secara statistik antara kejadian EKN pada kelompok puasa dibandingkan kelompok tidak puasa saat menjalani transfusi sel darah merah (RR 1,081 (IK 95% 0,913-1,279). Kesimpulan: Puasa saat transfusi sel darah merah tidak memiliki hubungan bermakna secara statistik menurunkan kejadian enterokolitis nekrotikans. ......Background: Complications due to prematurity are major problems for premature infants. Necrotizing enterocolitis has been one of the most considered complication with high mortality rate. Pathogenesis of necrotizing enterocolitis yet to be fully understood, however multiple factors were proven to be associated. Transfusion associated necrotizing enterocolitis has been studied in many researches. Withholding feeds during red blood cell transfusion were postulated to decrease the rate of necrotizing enterocolitis in premature infants, however controversy still found among the research published. Objective: This study aimed to evaluate the association between withholding feeds during red blood cell transfusion and incidence of necrotizing enterocolitis in premature infants. Method: We conducted a retrospective cohort study in Cipto Mangunkusumo Hospital. Premature infants admitted from January 2019 to December 2023 who received red blood cell transfusion were selected according to inclusion and exclusion criteria. Subjects were divided into two group by looking at withholding feeds status during transfusion or fed during transfusion. Necrotizing enterocolitis was diagnosed by radiologist using abdominal radiograph. Maternal status, gestational age, birth anthropometric measurement, 5-minutes APGAR score, and type of enteral nutrition (breast milk or formula) while receiving red blood cell transfusion were recorded. Results: Two hundred and forty subjects included in this study. Among all subjects, male infants 144 (60%), mean gestational age was 31 (SD 2,26) weeks, and median birthweight was 1.256 (IQR 1,005-1.653) grams. Necrotizing enterocolitis were slightly lower in withholding feeds during transfusion group compared to fed group (22,09% and 27,94%, respectively). No association was found between withholding feeds during red blood cell transfusion compared to fed during transfusion with incidence of necrotizing enterocolitis (RR 1,081 (95% CI 0,913-1,279). Conclusion: Withholding feeds during red blood cell transfusion did not significantly decrease the incident of necrotizing enterocolitis in this study.

Abstrak :
Latar belakang: Perdarahan sendi berulang merupakan morbiditas utama pada pasien hemofilia karena dapat menimbulkan artropati hemofilik yang menyebabkan keterbatasan gerak dan disabilitas sehingga menurunkan kualitas hidup. Penelitian bertujuan mengetahui korelasi pemeriksaan klinis sendi, penilaian aktivitas fungsional dan kualitas hidup pada anak hemofilia. Metode: Penelitian dengan desain potong lintang di RSCM pada Agustus−November 2022 pada anak 4−16 tahun, hemofilia A atau B derajat sedang atau berat yang mengalami perdarahan sendi berulang. Penelitian dilakukan dengan menilai HJHS, PedHALshort serta Haemo-QoL dan mencari korelasi skor HJHS dengan skor PedHALshort dan Haemo-QoL. Hasil: Sebanyak 95 subyek hemofilia, dengan hemofilia A (77,3%) dan 70,1% hemofilia berat. Skor HJHS median 4 (1−9), skor PedHALshort median 74,5 (62,73-89,09), skor Haemo-QoL mean (SD) 74,51 (15,58). Skor HJHS berkorelasi negatif sedang dengan PedHALshort (r= -0,462, p< 0,0001), skor HJHS berkorelasi sedang dengan Haemo-QoL (r= 0,469, p< 0,001). Simpulan: Semakin tinggi skor HJHS menunjukkan adanya kerusakan pada sendi maka semakin rendah skor PedHALshort dan semakin tinggi skor Haemo-QoL yang menunjukkan semakin terganggu aktivitas fungsional serta kualitas hidupnya. ......Background: Recurrent joint bleeding is the major morbidity in patient with hemophilia that can cause hemophilic arthropathy causes limitation of daily activities, disability, and reducing quality of life. Research objective are to determine the relationship between the clinical evaluation of joints, the assessment of functional activity determined and assessment of the quality of life with HJHS, so we can diagnose arthropathy, prevent disability and better management. Methods: Study with cross-sectional design at RSCM on August-November 2022, children aged 4-16, with moderate or severe hemophilia A and B with recurrent joint bleeding. The study was conducted by assessing HJHS, PedHALshort and Haemo-QoL, determine the relationship between HJHS with PedHALshort and Haemo-QoL score. Result: A total of 95 hemophilia subjects, with hemophilia A (77.3%) and 70.1% severe hemophilia. HJHS median score 4 (1-9), PedHALshort median score 74.5 (62.73-89.09), Haemo-QoL mean (SD) 74.51 (15.58). The HJHS score had a moderate negative correlation with PedHALshort (r= -0.462, p<0.0001), the HJHS score had a moderate correlation with Haemo-QoL (r= 0.469, p<0.001). Conclusion: The higher of HJHS score indicates a joint disorder, the lower of PedHALshort and the higher of Haemo-QoL indicates the more impaired functional activity and poorer quality of life.