Garuda - Garba Rujukan Digital

Correlation between urinary albumin to creatinine ratio and systemic glycocalyx degradation in pediatric sepsis Saragih, Rina A.C.; Pudjiadi, Antonius H.; Tambunan, Taralan; Satari, Hindra I.; Aulia, Diana; Bardosono, Saptawati; Munasir, Zakiudin; Lubis, Munar
Medical Journal of Indonesia Vol 27, No 3 (2018): September
Publisher : Faculty of Medicine Universitas Indonesia

Background: Increased capillary permeability in sepsis is associated with several complications and worse outcomes. Glycocalyx degradation, marked by increased serum syndecan-1 levels, alters vascular permeability, which can manifest as albuminuria in the glomerulus. Therefore, elevated urinary albumin to creatinine ratio (ACR) potentially provides an index of systemic glycocalyx degradation. The aim of this study was to analyze the correlation between urinary ACR and serum syndecan-1 levels.Methods: A longitudinal prospective study with repeated cross-sectional design was conducted on children with sepsis in pediatric intensive care unit, we evaluated serum syndecan-1 levels and urinary ACR on days 1, 2, 3, and 7. A descriptive study on healthy children was also conducted to determine the reference value of syndecan-1 in children.Results: 49 subjects with sepsis were recruited. Based on the data of the healthy children group (n=30), syndecan-1 level of >90th percentile (41.42 ng/mL) was defined as systemic glycocalyx degradation. The correlation coefficients (r) between urinary ACR and syndecan-1 levels were 0.32 (p<0.001) from all examination days (162 specimens), 0.298 (p=0.038) on day 1, and 0.469 (p=0.002) on day 3. The area under the curve of urinary ACR and systemic glycocalyx degradation was 65.7% (95% CI 54.5%–77%; p=0.012). Urinary ACR ≥157.5 mg/g was determined as the cut-off point for glycocalyx degradation, with a sensitivity of 77.4% and a specificity of 48%.Conclusion: Urinary ACR showed a weak correlation with systemic glycocalyx degradation, indicating that the pathophysiology of elevated urinary ACR in sepsis is not merely related to glycocalyx degradation.

Peningkatan Kadar Troponin-I Paska Resusitasi Cairan pada Sus Scrofa Sebagai Model Hewan Coba Renjatan Hotber E. R. Pasaribu; Antonius H Pudjiadi; Rismala Dewi
Jurnal Ilmu Kedokteran Vol 12, No 1 (2018): Jurnal Ilmu Kedokteran
Publisher : Fakultas Kedokteran Universitas Riau

Provision large amounts of fluids in a short period is known can cause hypervolemia. Therefore, an examination is needed to find out that the fluid resuscitation being administered does not cause hypervolemia. The purpose of this study is to assess the effect of hypervolemic resuscitation on cardiac contractility. The study was conducted on 10 male Sus Scrofa aged 6-8 weeks, as shocked animal models. There are 3 types of resuscitation treatments : normovolemic, hypervolemic-1, and hypervolemic-2. Cardiac contractility was assessed using DPmax and troponin-i levels. There was an increase in troponin-i levels after hypervolemic fluid resuscitation (p = 0.05). There is a decrease in cardiac contractility after hypervolemic resuscitation. Decreased cardiac contractility is associated with increased troponin-i (r = 0.720; p = 0.020). Based on the results, we conclude hypervolemic resuscitation causes changes in troponin-i levels, which reflect changes in cardiac contractility.

Gambaran Kelistrikan Jantung Anak Babi pada Kondisi Renjatan dengan Resusitasi Hipervolemik Menggunakan Cairan Kristaloid Natrium Chlorida 0,9% Gunanti Gunanti; Soesatyoratih Soesatyoratih; Antonius H Pudjiadi; Melpa Susanti Purba; Galih Satria Kusumanto
Jurnal Veteriner Vol 21 No 1 (2020)
Publisher : Faculty of Veterinary Medicine, Udayana University and Published in collaboration with the Indonesia Veterinarian Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (92.687 KB)

This study aimed to determine the effect of resuscitation and hypervolemic conditions on shocked piglet’s heart electrical system. Animal models that were used in this study are 5 healthy castrated piglets. The piglet’s blood were withdrawn until the mean arterial pressure dropped about 20 % from the baseline condition to make a hypovolemic shock condition. When the piglets reached the hypovolemic shock state, fluid resuscitation using crystalloid (NaCl 0.9 %) as much as 40 ml/kg were given using a 50 ml syringe through the jugular vein. ECG examination were performed before surgery and when it reached the hypervolemic state after being resuscitated. The ECG results indicate no apparent change in cardiac performance due to the absence of ECG waveform changes from waveforms during normal conditions. In conclusion, crystalloid fluid resuscitation (NaCl 0.9 %) until hypervolemic condition does not interfere with cardiac performance.

Citrullinated Histone H3 Level as a Novel Biomarker in Pediatric Clinical Sepsis Ronald Chandra; Antonius Hocky Pudjiadi; Rismala Dewi
The Indonesian Biomedical Journal Vol 13, No 3 (2021)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v13i3.1597

BACKGROUND: Sepsis is still leading cause of death in critically ill children. Early recognition of sepsis and treatments are needed to reduce its mortality. The use of citrullinated Histone H3 (Cit-H3) as an early sepsis marker and outcome predictor has been validated in previous studies among adults. However, only one study in pediatric meningococcal sepsis was reported with contradictory results. This study aims to determine Cit-H3 levels in pediatric clinical sepsis and analyze its association with sepsis severity and survival rate.METHODS: A prospective observational cohort study involving 67 pediatric subjects clinically diagnosed with sepsis was conducted. Cit-H3 levels, Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score, and Pediatric Sequential Organ Failure Assessment (pSOFA) score were assessed at the time of diagnosis (0-hour) and 48 hours later. Pearson Correlation test was used to determine the correlation between Cit-H3 levels with PELOD-2 and pSOFA scores and receiver operating curve to find the cut-off of Cit-H3 levels on clinical sepsis patients.RESULTS: Among clinically sepsis patients, the median Cit-H3 level was 1,210 (800-32,160) ng/mL, with optimal cut-off point ≥1200 ng/mL (sensitivity 83.3% and specificity 75.7%) to discriminate sepsis. The median Cit-H3 levels at 0-hour were lower in survivor compared to non-survivor group (p=0.016). Cit-H3 level was able to predict mortality with optimal cut-off point ≥1,200 ng/mL, sensitivity 72.2% and specificity 57.1% (AUC of 69.2%; p=0.017). Using survival analysis, Cit-H3 was significantly associated with the mortality rate (p=0.023; hazard ratio of 3.45).CONCLUSION: Cit-H3 level could be potential to predict pediatric sepsis events and its outcome.KEYWORDS: citrullinated histone H3, neutrophil extracellular traps, pediatric sepsis, PELOD-2 score, pSOFA score, survival

Plasmaferesis Sebagai Terapi Sindrom Guillain-Barre Berat pada Anak Vimaladewi Lukito; Irawan Mangunatmadja; Antonius H. Pudjiadi; Tatang M. Puspandjono
Sari Pediatri Vol 11, No 6 (2010)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp11.6.2010.448-55

Plasmaferesis atau plasma exchange merupakan salah satu pilihan terapi bagi sindrom Guillain-Barreberat. Beberapa penelitian menunjukkan bahwa plasmaferesis dan imunoglobulin intravena (IVIg) sebagaiterapi sindrom Guillain-Barre memiliki efektivitas yang sama, namun penggunaan plasmaferesis padapasien anak lebih jarang dilakukan karena membutuhkan peralatan dan persiapan yang lebih kompleks.Tujuan dari laporan kasus untuk melaporkan terapi sindrom Guillain-Barre berat dengan menggunakanplasmaferesis pada pasien anak. Seorang anak perempuan usia 10 tahun dirawat di RSUPN. Dr. CiptoMangunkusumo dengan diagnosis sindrom Guillain-Barre. Pada hari kedua perawatan pasien mengalamiparalisis otot pernafasan sehingga pernafasan harus dibantu dengan ventilasi mekanik. Faktor ekonomi danketersediaan alat menyebabkan plasmaferesis dipilih sebagai terapi, dibandingkan dengan pengobatan IVIg.Plasmaferesis dilakukan empat kali dalam waktu satu minggu dengan menggunakan fraksi protein. Efeksamping plasmaferesis berupa hipotensi dan sepsis yang ditangani dengan pemberian cairan dan antibiotik.Fungsi motorik pasien berangsur membaik dalam waktu satu minggu. Ventilasi mekanik dilepas setelahduapuluh enam hari dan pasien dipulangkan setelah dua bulan perawatan. Plasmaferesis dan IVIg memilikiefektifitas yang sama sebagai terapi sindrom Guillain-Barre berat. Keputusan untuk memilih salah satu terapitersebut berdasarkan pada keadaan klinis pasien, sistem penunjang, dan kemampuan ekonomi orang tuapasien.

REPRESENTATION OF ERYTHROCYTES IN PIGLET (Sus scrofa) POST HYPOVOLEMIC SHOCK WITH NORMO AND HYPERVOLEMIA RESUSCITATION OF CRYSTALLOID FLUID Gunanti Gunanti; Ahmad Arif Amin; Antonius H. Pudjiadi; Najma Hayati
Jurnal Kedokteran Hewan Vol 14, No 1 (2020): March
Publisher : Universitas Syiah Kuala

The aim of this study is to evaluate the representation of erythrocytes, which is the count of erythrocytes; hemoglobin concentration, hematocrit value, and platelet count in piglet (Sus scrofa) after hypovolemic shock with normal and hypervolemia resuscitation of crystalloid fluid. This study uses nine male castrated piglets 6-8 weeks of age. The piglets are given treatments such catheter installation, shock induction, normovolemia resuscitation, and hypervolemia resuscitation. The fluid for resuscitation is crystalloid fluid, NaCl 0.9%. Blood sample is taken in baseline, normovolemia condition, and hypervolemia condition. The sample is analyzed using hematology blood analyzer and is tested using T-Paired. Total erythrocytes count after normovolemia resuscitation is 3.07x106/µL, while after hypervolemia resuscitation the erythrocytes count decrease until 2.86x106/µL. Hemoglobin concentration after normovolemia resuscitation is 9.4 g/dL, while after hypervolemia resuscitation hemoglobin concentration decreases to 8.64 g/dL. Hematocrit count from piglets after normovolemia resuscitation is 28 %, while it decreases after hypervolemia resuscitation to 25.89%. Platelet count after normovolemia resuscitation is 297.22x103/mm3 and decreases to 263.89x103/mm3 after hypervolemia resuscitation. Evaluation of the erythrocytes index shows that the piglets suffer anemia. Hypovolemic shock and normal, and hypervolemia resuscitation cause the significant decreases in all erythrocytes indexes except the platelet count.

REPRESENTATION OF ERYTHROCYTES IN PIGLET (Sus scrofa) POST HYPOVOLEMIC SHOCK WITH NORMO AND HYPERVOLEMIA RESUSCITATION OF CRYSTALLOID FLUID Gunanti Gunanti; Ahmad Arif Amin; Antonius H. Pudjiadi; Najma Hayati
Jurnal Kedokteran Hewan Vol 14, No 1 (2020): March
Publisher : Universitas Syiah Kuala

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21157/j.ked.hewan.v14i1.15763

The aim of this study is to evaluate the representation of erythrocytes, which is the count of erythrocytes; hemoglobin concentration, hematocrit value, and platelet count in piglet (Sus scrofa) after hypovolemic shock with normal and hypervolemia resuscitation of crystalloid fluid. This study uses nine male castrated piglets 6-8 weeks of age. The piglets are given treatments such catheter installation, shock induction, normovolemia resuscitation, and hypervolemia resuscitation. The fluid for resuscitation is crystalloid fluid, NaCl 0.9%. Blood sample is taken in baseline, normovolemia condition, and hypervolemia condition. The sample is analyzed using hematology blood analyzer and is tested using T-Paired. Total erythrocytes count after normovolemia resuscitation is 3.07x106/µL, while after hypervolemia resuscitation the erythrocytes count decrease until 2.86x106/µL. Hemoglobin concentration after normovolemia resuscitation is 9.4 g/dL, while after hypervolemia resuscitation hemoglobin concentration decreases to 8.64 g/dL. Hematocrit count from piglets after normovolemia resuscitation is 28 %, while it decreases after hypervolemia resuscitation to 25.89%. Platelet count after normovolemia resuscitation is 297.22x103/mm3 and decreases to 263.89x103/mm3 after hypervolemia resuscitation. Evaluation of the erythrocytes index shows that the piglets suffer anemia. Hypovolemic shock and normal, and hypervolemia resuscitation cause the significant decreases in all erythrocytes indexes except the platelet count.

Title

Found 7 Documents
Search

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Title Search

Found 7 Documents Search

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Title

Found 7 Documents
Search