Latar belakang. Sepsis dan klasifikasinya merupakan kondisi yang mengancam nyawa dengan angka kematian mendekati 10% dari seluruh pasien dengan sepsis dan syok septik Angka kematian ini akan meningkat pada anak dengan minimal satu penyakit komorbid yang menyertai dan mendekati angka 76% berdasarkan jumlah organ yang mengalami disfungsi. Sampai saat ini belum ada data pasti yang menunjukan prevalensi dan karakteristik pasien dengan sepsis di Unit Perawatan Intensif (UPIA) Rumah Sakit Umum Pusat (RSUP) Sanglah Denpasar.Tujuan. Mengetahu prevalensi serta karakteristik pasien dengan sepsis pada pasien anak berusia 0-18 tahun di Unit Perawatan Intensif (UPIA) Rumah Sakit Umum Pusat (RSUP) Sanglah Denpasar tahun 2018.Metode. Penelitian ini merupakan penelitian deskriptif retrospektif dengan menggunakan data rekam medis RSUP Sanglah yang dikumpulkan meggunakan metode purposive sampling dengan kriteria inklusi dan eksklusi.Hasil. Penelitian ini sudah berjalan selama 1 tahun dari bulan Januari 2018 sampai dengan Desember 2018. Sampel yang dikumpulkan sebanyak 28 sampel. Kategori usia bayi tertinggi merupakan sampel yang digunakan, yaitu sebesar 57,1%. Diagnosis terbanyak adalah syok sepsis sebesar 60,7%. Skor pediatric sequential failure assesment (pSOFA) didapatkan dengan rerata sebesar 5,94.Kesimpulan. Prevalensi sepsis di UPIA Rumah Sakit Umum Pusat Sanglah Denpasar pada tahun 2018 didominasi oleh pasien dengan kategori usia bayi (<2 tahun).
Latar belakang. Penelitian yang menelaah hubungan faktor risiko jenis kelamin, usia, status gizi, pemakaian jenis terapi oksigen, danpemberian sedini mungkin nutrisi enteral terhadap lama rawat dan luaran perawatan UPIA belum banyak dilakukan.Tujuan. Menilai pengaruh faktor risiko jenis kelamin, usia, status gizi, pemakaian jenis terapi oksigen, pemberian nutrisi enteral diniterhadap lama rawat dan luaran mortalitas pasien.Metode. Penelitian analitik observasional dengan rancang kohort prospektif dilakukan selama periode Mei sampai Juli 2015 terhadap81 pasien usia 1 bulan sampai 12 tahun di rawat di UPIA RSUP Sanglah, Denpasar.Hasil. Terdapat 59,3% pasien laki-laki, 65,4% berusia <5 tahun, berstatus gizi buruk 6,2%, pemakaian jenis terapi oksigen nasalkanula 51,9% dan 60,5% pemberian nutrisi enteral <48 jam. Faktor risiko status gizi dan pemakaian jenis terapi oksigen berbedabermakna (p<0,05) terhadap lama perawatan UPIA. Usia <5 tahun (RR 2,818; IK95% 0,897-8,854), pemakaian jenis terapi oksigen(p<0,001), terutama jenis intubasi (RR 6,000; IK95% 2,775-12,972) dan pemberian nutrisi enteral ≥48 jam (RR 0,003; IK95%1,406-7,830) merupakan faktor risiko terhadap luaran perawatan UPIA, tetapi hanya faktor risiko pengunaan terapi oksigen, terutamajenis intubasi berperan dan berisiko luaran meninggal 16,576 kali terhadap pasien (RR:16,576; IK95% 2,688-102,225).Kesimpulan. Faktor risiko status gizi dan pemakaian alat oksigenasi memperpanjang durasi lama rawat. Usia <5 tahun, pemakaianalat oksigenasi, dan waktu asupan nutrisi ≥48 jam terbukti meningkatkan faktor risiko mortalitas
Background: Sepsis in children could significantly increase the morbidity and mortality rates particularly in the Pediatric Intensive Care Unit (PICU). Moreover, the prevalence of antibiotic resistance is continuously increasing around the world mainly caused by uncontrolled used of antibiotic. Henceforth, this study aimed to determine the relationship between bacterial type and the resistance with clinical outcome of sepsis patients in PICU.Methods: An observational analytic retrospective cohort study using medical record data from January 2015-April 2017 was conducted. All subjects were sepsis patients with positive blood cultures treated at PICU Sanglah Hospital. Factors related to mortality and relative risk (RR) were analyzed using Chi-Square Test with a significance value of p <0.05 with 95% confidence interval (CI).Results: 75 subjects met the inclusion criteria, but only 63 subjects with complete data were enrolled. The gram-negative and MDR bacteria types were detected in 31 (49%) subjects and 33 (52.4%) subjects respectively. The number of deaths was 29 (46%). The most common types of gram-negative bacteria were Pseudomonas aeruginosa (16%) followed by gram-positive Staphylococcus hominis (25%). The most common multi-drug resistant (MDR) bacteria were Staphylococcus hominis. The presence of MDR bacteria significantly increase the mortality (p = 0.015, RR 2.02, 95% CI: 1.096-3.725), whereas gram-negative had no significant mortality impact (p = 0.891: RR 0.96; 95% CI: 0.564- 1.645). Compared to non-MDR bacteria, most MDR related mortality occurred during the first 10 days.Conclusion: MDR bacteria significantly increased the mortality rates in pediatric patient treated in PICU compared to non-MDR ones.Â
The widespread and contagious coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 has become a burden in the global health domain. The subsequent discovery of the virus features and pathogenesis, and prompt and adequate management are still lacking and remain inconclusive. Children usually present milder symptoms than adults, and management focuses on providing symptomatic and respiratory supports. Several treatment modalities, including the utilization of mechanical ventilation (MV), antivirals, immune-modulating drugs, or other agents, may present promising results in reducing the symptoms of COVID-19, particularly in severe cases. Although no randomized clinical trials have been published to date, it is interesting to explore potential modalities for treating COVID-19 in children, based on review articles, case reports, and recent guidelines.
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