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All Journal Medicina E-Jurnal Medika Udayana Medical Journal of Indonesia Sari Pediatri Paediatrica Indonesiana Bali Journal of Anesthesiology Jurnal ARSI (Administrasi Rumah Sakit Indonesia) ISM (Intisari Sains Medis) : Jurnal Kedokteran

I Nyoman Budi Hartawan

Departemen Ilmu Kesehatan Anak, Universitas Udayana, Bali, Indonesia

Author-ID : 276885

Biochemistry, Genetics & Molecular Biology Education Environmental Science Health Professions Medicine & Pharmacology Public Health Other

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Early mannitol administration improves clinical outcomes of pediatric patients with brain edema Sekarningrum, Putu A.; Wati, Dyah K.; Suwarba, IGN Made; Hartawan, I Nyoman B.; Mahalini, Dewi S.; Suparyatha, IB Gede
Medical Journal of Indonesia Vol 27, No 4 (2018): December
Publisher : Faculty of Medicine Universitas Indonesia

Background: Mannitol 20% is used to treat patients with decreased consciousness and as the first line of treatment to reduce intracranial pressure (ICP). However, its application in pediatric patients is still based on minimal evidence. This study was performed to determine the predictive factors of clinical outcomes in pediatric patients with brain edema in the pediatric intensive care unit (PICU).Methods: This prospective cohort study was conducted in the PICU, Sanglah Hospital Denpasar, Bali, Indonesia. The subjects were chosen by consecutive sampling from July 2016 to July 2017. The primary outcome variable was the patient’s clinical outcome. A chi-square test was used to evaluate the association between the timing of mannitol administration and the patient’s clinical outcome. Multivariate analysis was performed on all variables with p≤0.25.Results: Forty-one patients were included in the study, 65% of them were male, 65% had good nutritional status, 90% had non-traumatic brain injury, and 73% had confirmed intracranial infection. The risk of sequelae or death for patients in a coma was 1.8 times greater than that of non-comatose patients (p=0.018; CI 95% 1.119–3.047). Based on the timing of mannitol administration from the onset of decreased consciousness, the risk of sequelae or death in patients who received mannitol after 24 hours was 2.1 times higher than that in patients who received mannitol within 24 hours (p=0.006; CI 95% 1.167–3.779). Based on multivariate analysis, only two variables were associated with the patient’s clinical outcome: pediatric Glasgow coma scale (PGCS) ≤3 (p=0.03) and timing of mannitol administration >24 hours (p=0.01).Conclusion: Early administration (<24 hours) of mannitol and high PGCS are related to favorable outcomes in patients with brain edema in the PICU.

The role of endothelial glycocalyx in sepsis Hartawan, I Nyoman Budi; Wiryana, Made
Bali Journal of Anesthesiology Vol 3, No 1 (2019)
Publisher : DiscoverSys Inc.

ABSTRACTThe surface of endothelial cells is filled with various membrane-bound molecules that form the glycocalyx. The endothelial glycocalyx is a surface layer mainly consisted of glycosaminoglycans that include heparan sulfate, chondroitin sulfate, and hyaluronic acid and its core proteins. Previous studies suggest that endothelial surface glycocalyx shedding could play a role in endothelial dysfunction and inflammation. This article will review the endothelial glycocalyx and its role in sepsis.

Characteristics of patients requiring non-invasive ventilation in pediatric intensive care unit Estina, Vania Catleya; Wati, Dyah Kanya; Suparyatha, Ida Bagus; Hartawan, I Nyoman Budi
Bali Journal of Anesthesiology Vol 3, No 2 (2019)
Publisher : DiscoverSys Inc.

Background: Non-invasive ventilation (NIV) has become an essential tool in the treatment of both acute and chronic respiratory failure in children. This study aimed to determine the efficacy of NIV usage in pediatric patients who were admitted to the Pediatric Intensive Care Unit (PICU) with respiratory failure.Patients and Methods: This study is a retrospective, cross-sectional review. The data were collected from the medical record of PICU patients at our hospital from 2017 to 2018. Successful NIV was defined as patients who survived without intubation. Failure was defined as worsened patients and needed intubation for the rescue.Results: The total subjects of this study was 78 patients. The most common indication for NIV was ARDS (78.1%), and CPAP was the most common frequently used (78.68%). The data shows that the NIV was commonly used after extubation (52.56%) than for the first-time rescue (47.44%). The success rate of NIV after extubation were 65.85% and 34.15% failed and shifted to mechanical ventilation. The duration of NIV usage was less than three days (73.77%).Conclusion: NIV is a useful tool for the treatment of respiratory failure in pediatrics. The use of post-extubation NIV may be a valuable tool to prevent reintubation.

HUBUNGAN ANTARA KADAR ALBUMIN DAN MORTALITAS PASIEN DI UNIT PERAWATAN INTENSIF ANAK RSUP SANGLAH DENPASAR Indradjaja, Alice; Suparyatha, Ida Bagus; Budi Hartawan, I Nyoman
Medicina Vol 45 No 1 (2014): Januari 2014
Publisher : Medicina

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Hipoalbuminemia berhubungan dengan luaran yang buruk pada pasien dewasa yang sakit berat namun hubungan ini pada pasien anak hingga saat ini belum jelas. Tujuan penelitian ini adalah untuk mengetahui hubungan kadar albumin serum dengan mortalitas pasien anak yang di rawat di Unit Perawatan Intensif Anak (UPIA) RSUP Sanglah Denpasar. Dengan desain kohort prospektif dilakukan penelitian di divisi Pediatri Gawat Darurat Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Udayana RSUP Sanglah dari periode Mei hingga Juli 2012. Pasien dikelompokan berdasarkan kadar albumin awal menjadi tiga kelompok, kelompok I dengan kadar albumin <2,5g/dl, kelompok II e”2,52,9g/dl dan kelompok III >3g/dl. Data dianalisis dengan uji Kai-kuadrat dan analisis multivariat (regresi logistik) dengan tingkat kemaknaan á=0,05 (IK 95%). Dari 60 pasien, 20 pasien (33,3%) mengalami hipoalbuminemia dengan kadar albumin < 3 g/dl pada awal perawatan, terdapat 10 pasien(16,7%) pada kelompok I, sepuluh pasien (16,7%) terdapat pada kelompok II, dan kelompok III sebanyak 40 pasien (66,7%). Mortalitas pada kelompok I dibandingkan kadar albumin normal menunjukkanperbedaan bermakna {RR 12,00 (IK95% 3,96 sampai 36,33), P<0,0001}, begitu juga untuk kelompok II bila dibandingkan dengan kelompok kadar albumin normal {RR 9,33 (IK 95% 2,92 sampai 29,81),P<0,0001}. Disimpulkan bahwa semakin rendah kadar albumin serum semakin tinggi angka mortalitas di UPIA RSUP Sanglah. [MEDICINA.2014;45:13-18].

EARLY GOAL DIRECTED THERAPY AT SEPTIC SYOK Widyanti, Ayu; Hartawan, Budi; Suparyatha, IB
Medicina Vol 43 No 2 (2012): Mei 2012
Publisher : Medicina

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Sepsis is the most commom cause of death in children with critically ill. Using WHO criteria (severe sepsis defined as sepsis with acidosis, hypotension or both), it was determined that in 1995 there were more than 42.000 cases of severe sepsis in children in the United States with mortality rate was 10.3%. To answer that finding, evicende based protocol was made, it called early goal directed therapy (EGDT). EGDT is a comprehensive strategy to evaluate patient with septic shock include, challenge of fluid, antibiotic, vasopressor, measurement of central vein oxygen saturation, PRC transfusion, administering inotropic dan mechanic ventilation. All of these must be done in the first 6 hours since sepsis or septic shock was found, because if there is a delay of resuscitation, anything we do to increase oxygenation level of the cell will be useless.

PREVALENSI KONSTIPASI DAN GAMBARAN ASUPAN SERAT MAKANAN DAN CAIRAN PADA ANAK REMAJA I Made Pramana Dharmatika; Ni Nyoman Metriani Nesa; I Nyoman Budi Hartawan; I Gusti Ngurah Sanjaya Putra; I Putu Gede Karyana
E-Jurnal Medika Udayana Vol 8 No 7 (2019): Vol 8 No 7 (2019): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

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Penelitian ini dilakukan untuk mengetahui prevalensi konstipasi serta mempelajari asupan serat makanan dan cairan pada anak remaja. Penelitian ini menggunakan metode potong lintang yangdilakukan pada Mei hingga September 2017. Jumlah sampel sebesar 63 anak remaja di SMP Negeri 1Denpasar yang berusia 13-15 tahun. Penelitian ini menggunakan kuisioner yang diisi secara langsungoleh sampel. Konstipasi ditegakkan berdasarkan kriteria Rome III. Asupan serat makanan diketahuimelalui food record yang telah diisi selama tiga hari.Prevalensi konstipasi pada anak remajaditemukan sebesar 11,1%. Rerata asupan serat makanan pada anak remaja ditemukan sebesar 8,75 ±3,01 gram. Kelompok konstipasi memiliki rerata asupan serat makanan sebesar 5,7 gram (SB ± 2,2)dan kelompok tanpa konstipasi sebesar 9,1 gram (SB ± 2,1). Asupan cairan sebanyak ?7 gelasditemukan pada 66,7% anak remaja. Penelitian ini menunjukkan bahwa konstipasi masih ditemukanpada beberapa anak remaja. Mayoritas anak remaja memiliki asupan serat makanan yang rendah.Asupan serat makanan pada anak remaja perlu ditingkatkan sesuai dengan rekomendasi harian untukmenjaga kesehatan anak remaja.Kata kunci: Konstipasi, serat makanan, cairan, food record, anak remaja

KARAKTERISTIK PENYAKIT JANTUNG BAWAAN ASIANOTIK TIPE ISOLATED DAN MANIFESTASI KLINIS DINI PADA PASIEN ANAK DI RUMAH SAKIT UMUM PUSAT SANGLAH Karmelia Kumala; Ni Putu Veny Kartika Yantie; I Nyoman Budi Hartawan
E-Jurnal Medika Udayana Vol 7 No 10 (2018): Vol 7 No 10 (2018): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

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Abnormalitas struktur dan fungsi jantung yang sudah didapatkan sejak bayi lahir, disebabkan kegagalan pembentukan struktur jantung pada masa awal pembentukanjanin di dalam kandungan merupakan definisi penyakit jantung bawaan (PJB). Manifestasinya beragam dari ringan sampai berat. Penyakit jantung bawaan dapat terjadi karena dua faktor, faktor genetik dan faktor lingkungan. PJB secara garis besar dibagi dua, yaitu asianotik dan sianotik. PJB asianotik tipe isolated yang paling sering ditemukan merupakan defek septum atrium (DSA), defek septum ventrikel (DSV), dan duktus arteriosus paten (DAP). Asia memiliki prevalens penyakit jantung bawaan asianotik tertinggi dibandingkan benua lainnya, yaitu 9,3/1.000 kelahiran hidup. Penelitian ini merupakan penelitian deskriptif cross-sectional dengan metode consecutive sampling pada pasien dalam rentang waktu November 2016 sampai dengan April 2017. Penelitian ini bertujuan untuk mencari karakteristik dan manifestasi klinis dini penyakit jantung bawaan asianotik tipe isolated DSV, DSA, dan DAP pada pasien anak di RSUP Sanglah. Karakteristik PJB asianotik tipe isolated pada pasien anak di Rumah Sakit Umum Pusat Sanglah yaitu DSV sebanyak 22 anak (51,2%), DAP sebanyak 15 anak (34,9%), dan DSA sebanyak 6 anak (14%). Manifestasi klinis yang ditemukan pada pasien anak dengan penyakit jantung bawaan asianotik di RSUP Sanglah yaitu sesak, sulit minum, batuk, kebiruan, berkeringat, dan lain-lain. Kata kunci: Penyakit Jantung Bawaan Asianotik, DSA, DSV, DAP, Anak

HUBUNGAN PERILAKU IBU TERHADAP KEJADIAN DIARE PADA BALITA DI WILAYAH KERJA PUSKESMAS SUKAWATI I PERIODE BULAN NOVEMBER TAHUN 2013 Ni Putu Anggun Laksmi; IGA Trisna Windiani; I Nyoman Budi Hartawan
E-Jurnal Medika Udayana vol 4 no 7(2015):e-jurnal medika udayana
Publisher : Universitas Udayana

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Diare masih tetap potensial berkembang di Indonesia sebagai masalah kesehatan masyarakat. Angka kematian akibat diare cenderung sudah menurun, tetapi kejadian sakit diare, terutama yang menyerang Balita di daerah pedesaan, cenderung masih dominan. Rancangan penelitian ini adalah studi potong lintang analitik untuk mengetahui perilaku berisiko seperti cara memberi makanan pada balita, mencuci tangan, dan memasak air minum sebagai faktor risiko terhadap kejadian diare pada balita di wilayah kerja Puskesmas Sukawati I pada bulan November 2013. Responden dalam penelitian ini adalah ibu balita yang berdomisili di wilayah kerja Puskesmas Sukawati I dan telah memberikan persetujuan untuk mengikuti penelitian ini. Responden berjumlah 120 orang jumlah. Responden terbanyak adalah ibu berusia 21-30 tahun (58,3%), pendidikan rendah (47,5%), dan bekerja (51,7%). Prevalensi diare dalam 6 bulan terakhir adalah sebesar 70%. Balita mengalami diare sebesar 76,7% pada ibu yang memberi makan anaknya dengan makpakang, 84,2% pada ibu yang tidak mencuci tangan dengan sabun, dan 84,6% pada ibu yang tidak memasak air sebelum dikonsumsi. Kebiasaan makpakang dengan kejadian diare pada balita tidak ditemukan hubungan yang bermakna (p=0,358 dan ?2 = 0,847). Kebiasaan mencuci tangan dengan sabun memiliki hubungan yang signifikan dengan kejadian diare pada balita (p=0.001 dan ?2 = 10,44). Memasak air memiliki hubungan yang signifikan dengan kejadian diare pada balita (p=0,015 dan ?2 = 5,877).

KARAKTERISTIK ASMA PADA ANAK DI PUSKESMAS I DENPASAR TIMUR TAHUN 2019-2021 Made Michel Kresnayasa; I Nyoman Budi Hartawan; I Gusti Lanang Sidiartha; Dyah Kanya Wati
E-Jurnal Medika Udayana Vol 10 No 8 (2021): Vol 10 No 08(2021): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2021.V10.i8.P04

Asthma is a chronic inflammatory disease that occurs in the respiratory tract and most commonly seen in children. The prevalence of asthma continues to increase from time to time, according to WHO and GINA, the number of people with asthma in the world reaches 300 million people, this figure is expected to continue to increase to 400 million people in 2025. This study aims to determine the characteristics of children with asthma in puskesmas I East Denpasar, 2019 - 2021. This research was a descriptive study by taking data of medical records from 2019 to 2021 at Puskesmas I East Denpasar. The sample used is a child patient diagnosed with asthma with a total sampling method, that means the whole population is the subject of the study. The results of taking medical record data of 74 samples showed that cases of asthma in children at Puskesmas I East Denpasar in 2019-2021 were more common in males than females and were dominated by children with an age range of 0-4 years. In addition, asthma patients in children were mostly found in children with excess nutritional status without a history of atopic dermatitis. Asthma sufferers in children are mostly found in males and in the age group of 0 - 4 years. The majority of children who suffer from asthma are children with excess nutritional status and only a few have a history of atopic dermatitis. Keywords: Asthma, characteristics, children, nutritional status.

PROPORSI IBU DENGAN PERSEPSI BENAR TENTANG STATUS NUTRISI ANAK Luh Wayan Puspa Ningsih; Ni Nyoman Metriani Nesa; Nyoman Budi Hartawan
E-Jurnal Medika Udayana Vol 9 No 4 (2020): Vol 9 No 04(2020): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Malnutrition is a global problem which contributes to children’s mortality and morbidity. One simple effort to reduce malnutrition is involving mothers to help their children to afford optimal nutritional status. The first step is determining the mother’s perception about their children’s nutritional status. The aim of this study was to determine the correct proportion of mother perception about children’s nutritional status. This was a cross sectional study and conducted on August 2016. Subjects and the respondences were 95 children by ages 4 until 5 years old, from TK Kemala Bhayangkari 04, Gianyar with their mother. Nutritional status components were measured objectively. Meanwhile, the mother’s perceptions were measured by body image sillhouette chart in the questionaire. Feel minus ideal discrepancy (FID) and feel minus actual status inconsistency (FAI) indexes were also measured. The proportion of correct mother’s perception about children nutritional status was 41.10%. Whereas, the highest FID proportion was 50.50% with negative value, which mean the mother wanted their children to be chubbier. The proportion of underestimated perception was 30.50% which mean the mother see their children as thinner than they were. Proportion of correct mothers perception about children nutritional status was still low, mothers wanted their children to be chubbier and consider their children were thinner than they were. Based on the study, the general mother’s perception about children nutritional status should be corrected to prevent malnutrition. Keywords: Nutritional status, mother’s perception, Body image sillhouette chart

Co-Authors Abdul Latief Alice Indradjaja, Alice Anak Agung Ngurah Ketut Putra Widnyana Antonius H Pudjiadi Armand Setiady Liwan Ayu Setyorini Mestika Mayangsari Ayu Widyanti Bagus Ngurah Putu Arhana Dewi Sutriani Mahalini Dyah Kanya Wati Eka Gunawijaya Estina, Vania Catleya Hendra Salim Hendy Halim I Gusti Agung Trisna Windiani I Gusti Ayu Putu Eka Pratiwi I Gusti Lanang Sidiartha I Gusti Ngurah Made Suwarba I Gusti Ngurah Sanjaya Putra I Made Arimbawa I Made Bagus Wilaksmana Putra I Made Karma Setiyawan I Made Pramana Dharmatika I Putu Gede Karyana I Wayan Gustawan I. K. G. Suandi Ida Bagus Gede Suparyatha IGN Sanjaya Putra Irene Yuniar, Irene Karmelia Kumala Ketut Ariawati Ketut Dewi Kumara Wati Khema Metta Wijaya Luh Wayan Puspa Ningsih Made Gede Dwi Lingga Utama Made Michel Kresnayasa Made Pande Lilik Lestari Made Refika Widya Apsari Tangkas Made Wiryana Ni Luh Sri Apsari Ni Nyoman Metriani Nesa Ni Putu Anggun Laksmi NP Veny Kartika Yantie Pande Putu Agung Willa Kesawa Putra Putu Diah Pratiwi Putu Dita Arsintha Widma Rismala Dewi Romy Windiyanto S. Yati Soenarto Sekarningrum, Putu A. Siska Permanasari Sinardja Soetjiningsih Soetjiningsih Soetjiningsih Soetjiningsih Sri Wahyuni Djoko Wati, Dyah K. Wayan Sulaksmana Sandhi Parwata

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