ABSTRAKTata laksana adekuat sepsis dapat memperbaiki luaran pasien. Surviving sepsis campaign (SSC) guidelines 2012 merupakan panduan internasional tata laksana sepsis berat dan syok septik, namun implementasinya dipengaruhi oleh sumberdaya dan fasilitas kesehatan. Penelitian ini mengevaluasi implementasi SSC di rumah sakit. Studi prospektif dilakukan antara Februari-Juni 2013 pada seluruh pasien usia 1 bulan-18 tahun yang memenuhi kriteria sepsis, dengan menilai penggunaan cairan resusitasi dan obat vasoaktif, waktu pemberian antibiotika, waktu pengambilan kultur, pemberian nutrisi, penggunaan ventilator, dan angka kematian. Di antara 40 pasien, 34 merupakan kasus syok septik. Seluruh pasien syok septik mendapatkan resusitasi cairan dan obat vasoaktif. Obat vasoaktif diberikan kurang dari 6 jam pada 21 pasien. Hanya 14 pasien mendapatkan antibiotika pada jam pertama, dan hanya 6 pasien dilakukan pemeriksaan kultur darah sebelum pemberian antibiotika awal. Sebanyak 28 pasien membutuhkan ventilator, namun 13 pasien tidak bisa mendapatkannya.Hal ini meningkatkan risiko mortalitas 2,1 kali (95% IK 1,2; 3,7). Saat perawatan di unit intensif, 27 pasien mendapatkan nutrisi pada 6-24 jam pertama, namun sebagian besar (32 pasien) mendapatkan kalori kurang dari 80% dalam 48 jam pertama yang meningkatkan risiko mortalitas 3 kali (95% IK 1,1; 8,2). Mortalitas terjadi pada 24 pasien. Hal ini menunjukkan adanya hambatan pelaksanaan SSC guidelines 2012 dalam hal pemberian antibiotika, pemeriksaan kultur darah, penggunaan ventilator, dan pemberian nutrisi adekuat. Ketidaktersediaan ventilator dan terapi nutrisi inadekuat meningkatkan risiko mortalitas.
The development of current environmental problems raises the concerns of investors or hospital lenders about the potential financial problems resulting from current environmental problems. A sustainable health care system can achieve high-quality care and improve public health without wasting resources. The health service sector is continuously encouraged to apply the concept of "Green Hospital" which is one example of the continuity of health services. This research focuses on emission reduction management in health care facilities. This study examines several published papers containing the terms sustainable, green infrastructure, and energy management. Guidelines for Efficient and Sustainable Energy Management in Hospital Buildings is the selected article. The articles used were obtained from the Google Scholar database. Data analysis was carried out descriptively using tables. This study took data from three countries, namely Thailand, Taiwan, and Indonesia, based on our team's observations during a virtual hospital visit to the two countries (Thailand and Taiwan), which we then compared with most hospitals in Indonesia. Currently, there is no Green Hospital standard for each of these countries. The application of the green infrastructure concept can have a positive impact on cost efficiency and hospital sustainability. Energy Saving Opportunities (PHE) is one method that can be used to save energy use in hospitals. The way to do this is to control the use of infrastructure that consumes a lot of energy, such as the use of lights and Air Conditioners (AC), as well as other infrastructure that is not included in vital equipment.
Bayi yang mengalami gangguan pada masa prenatal, natal dan paska natal mempunyai risiko tinggi untuk mendapatkan hambatan tumbuh kembang secara optimal dibandingkan bayi lainnya. IL-6 dan TNF-α merupakan salah satu sitokin yang diproduksi saat terjadi sepsis dan mempunyai peranan pada perkembangan otak sebagai sinyal proinflamasi. Tujuan penelitian ini adalah untuk mengetahui pengaruh sepsis terhadap luaran neurodevelopmental, melalui peningkatan kadar IL-6 dan TNF α. Dua puluh neonatus yang memenuhi kriteria sepsis pada ruang perinatologi RSSA dimasukkan dalam subjek penelitian, diukur kadar IL-6 dan TNF-α saat sepsis neonatal dengan menggunakan metode ELISA, dan dinilai perkembangannya pada usia 9 bulan dengan menggunakan Bayley 3. Analisis data diolah dengan menggunakan PLS untuk menentukan pengaruh sepsis neonatal terhadap luaran neurodevelopmental. Hasil penelitian menunjukkan peningkatan IL-6 dan TNF-α pada sepsi dan penurunan luaran neurodevelopmental usia 9 bulan terutama pada aspek kognitif diikuti motorik, dan bahasa, namun tidak didapatkan pengaruh bermakna pada peningkatan TNF-α dengan luaran neurodevelopmental. Dapat disimpulkan bahwa sepsis neonatal dapat berpengaruh pada luaran neurodevelopmental usia 9 bulan melalui peningkatan IL-6 dan bukan TNF-α.
Hospitalization disturbs kids' lives and may create feelings such as pressure, stress, or torment. Betting is a fundamental portion of children's lives. Subsequently, it's distant basic to guarantee all-encompassing care amid the framework, which incorporates play cure. to analyze the effect of recuperating play in hospitalized children. a logical appraisal was done. The journey was conducted in Google Researcher and PubMed (Medline). The chase condition was pediatric nurture and played treatment. The journey got to be completed in December 2022. n = 14 considers been covered interior the assessment. The inquiry uncovers that the utility of mending play in hospitalized kids diminishes post-operative hurts, makes strides in conduct and state of mind, and diminishes pressure during clinic life. Play remedy has a beneficial impact on the care of hospitalized youngsters. It ought to be carried out in pediatric gadgets after assessing the assets and education wanted for pediatric nurses.
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