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All Journal Paediatrica Indonesiana
Indrayady Indrayady
Department Of Child Health, Universitas Sriwijaya Medical School/Dr. Moh. Hoesin General Hospital, Palembang, South Sumatra, Indonesia
Health Professions Medicine & Pharmacology

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Achievement of full enteral feeding using volume advancement in infants with birth weight 1,000 to Teti Hendrayanti; Afifa Ramadanti; Indrayady Indrayady; Raden Muhammad Indra
Paediatrica Indonesiana Vol 60 No 4 (2020): July 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi60.4.2020.173-7

Abstract

Background Early enteral feeding is one of the efforts to improve gastrointestinal adaptability in preterm infants. Volume advancement (VA) enteral feeding has been associated with less time to reach full feeding, which can improve outcomes. Objective To evaluate the duration of VA needed to achieve full enteral feeding (FEF) in low birth weight (LBW) and very low birth weight (VLBW) infants and related factors. Methods This prospective study was done in infants with birth weight 1,000 to <2,000 grams in the Neonatal Ward and NICU of Dr. Moh. Hoesin General Hospital, Palembang, South Sumatera. All infants underwent VA feeding. The time needed to achieve FEF (150 ml/kg/day) was recorded. Several clinical factors were analyzed for possible associations with the success rate of achieving FEF within 10 days of feeding. Results Thirty-five infants were included in this study with a mean gestational age of 31.83 (SD 2.67) weeks. Their median body weight at the start of protocol was 1,400 (range 1,000 – 1,950) grams and 80% had hyaline membrane disease. Median time to achieve FEF was 11 (range 8–21) days, with 48.6% subjects achieving FEF in <=10 days. Gestational age <32 weeks (OR 5.404, 95%CI 0.963 to 30.341), birth weight <1,500 grams (OR 5.248, 95%CI 0.983 to 28.003), and male (OR 4.751, 95%CI 0.854 to 26.437) gender were associated with the failure of achieving FEF within 10 days of feeding, however, no factors remained statistically significant after multivariate analysis. Conclusion Full enteral feedings in infants with birth weight 1,000 to <2,000 grams with VA feeding are achieved within a median of 11 days. Gestational age, birth weight, and gender are not associated with time needed to achieve FEF.
Diagnostic value of platelet indices for neonatal bacterial sepsis Ading Rohadi; Afifa Ramadanti; Indrayady Indrayady; Achirul Bakri
Paediatrica Indonesiana Vol 60 No 5 (2020): September 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi60.5.2020.253-8

Abstract

Background Neonatal bacterial sepsis is a major cause of neonatal morbidity and mortality worldwide. Blood culture as a gold standard, as well as C reactive protein (CRP), micro erythrocyte sedimentation rate (micro ESR), white blood count (WBC), and immature-to-total (I/T) ratio as a sepsis screens are currently used methods, but their utility may be limited due to delayed reporting. Platelet indices are one of the parameters which can be helpful in the diagnosis of neonatal bacterial sepsis. Objective To evaluate the use of platelet indices, either alone or in combination, with other laboratory screening parameters to diagnose neonatal bacterial sepsis. Methods Neonates admitted to the Neonatal Unit of RSUP Dr. Muhammad Hoesin Hospital, Palembang, South Sumatera, and showing symptoms of sepsis were included in this study. Subjects underwent testing for blood culture, sepsis screen (CRP, micro ESR, WBC, I/T ratio), and platelet indices [platelet count, mean platelet volume (MPV), and platelet distribution width (PDW)]. Results The 107 neonates who fulfilled the inclusion criteria consisted of 42 neonates with proven bacterial sepsis (positive blood culture), 10 neonates with probable bacterial sepsis (positive sepsis screen and negative blood culture), and 55 with clinical bacterial sepsis (negative in both blood culture and sepsis screen). There were no significant differences in platelet count among the proven bacterial sepsis, probable bacterial sepsis, and clinical bacterial sepsis groups. Platelet count < 150,000/ml, PDW ³ 16.8 fL, MPV ³ 10.8 fL and combinations of the three, were highly specific markers for proven sepsis, with specificities of 92.3%, 97%, 75.4%, and 80%, respectively. However, all of these parameters were poor predictive markers for positive cultures in neonatal clinical bacterial sepsis, with sensitivities of 19%, 7.1%, 35.7%, and 23.8%, respectively. Conclusion Platelet indices have high specificity but low sensitivity for the prediction of proven neonatal bacterial sepsis.
Music for pain in healthy neonates Nessie Amelia Ramli; Afifa Ramadanti; Indrayady Indrayady; Yuli Doris Memy
Paediatrica Indonesiana Vol 61 No 2 (2021): March 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.2.2021.69-73

Abstract

Background The neonatal pain threshold is 30-50% lower than in adults and older children because of immature pain inhibition function in nervous centers. Acute pain in neonates results in behavioral, physiological, and cerebral blood flow changes that may lead to intraventricular bleeding and periventricular leukomalacia. Music is believed to reduce pain perception as it distracts, influencing the parasympathetic and sympathetic nervous system by decreasing pulse rate, blood pressure, and breathing, hence, promoting a relaxed state. Objective To evaluate effects of music intervention on physiological parameters and pain perception in healthy newborns undergoing a painful medical procedure (immunization injection). Methods This was a double-blind, randomized control trial study. A recorded instrumental lullaby “Nina Bobo” was given for 5 minutes to the music group and no music for control, prior injection of Hepatitis B 0. The evaluation of heart rate and SpO2 were performed at baseline, 30 seconds, and 5 minutes after injection. Pain perception were measured by Neonatal Infant Pain Scale (NIPS) at 30 seconds and 5 minutes after injection. Results Total of 51 subjects were enrolled. There were no difference of SpO2 and NIPS between both music and control groups. Music improved heart rate after 30 seconds and 5 minutes after injection, median 126 (range 55-149) bpm from median 136 (range 78-154) bpm, and even lower than baseline [mean 128.9 (SD 12.5) bpm; P=0.019]. The control showed no improvement of heart rate mean 124,34 (SD 18,45) from 124,73 (SD 18,39); P=0.875There were no significant differences between the 2 groups. Conclusion Music is not effective in improving oxygen saturation, heart rate, and is not effective in reducing the degree of pain.
Ceftazidime as an empiric therapy for neonatal sepsis Indrayady Indrayady; Afifa Ramadanti; Yulia Iriani; Herka Pratama Putra
Paediatrica Indonesiana Vol 61 No 4 (2021): July 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.4.2021.198-204

Abstract

Background Sepsis is still the leading cause of death in neonates in developing countries. Proper administration of antibiotics is important for managing neonatal sepsis. The microorganisms that cause neonatal sepsis, as well as their sensitivity patterns, change over time and differ from one place to another. Since 2001, ceftazidime has been used as an empirical antibiotic for managing neonatal sepsis at Dr. Mohammad Hoesin Hospital, Palembang, South Sumatera, but its effectiveness is questionable. Objective To evaluate the effectiveness of ceftazidime as an empiric therapy for neonatal sepsis. Methods This study was pre-experimental, for one group, pre- and post-test, was conducted in 49 neonates with neonatal sepsis in the Neonatal Ward at Dr. Mohammad Hoesin Hospital, Palembang, South Sumatera, from April to September 2019. The effectiveness of ceftazidime was determined based on clinical and laboratory improvements 72 hours after ceftazidime administration. Results Of 49 neonates, 28 experienced clinical and laboratory improvement, while 21 experienced improvement in only one parameter, either clinical or laboratory. Gram positive bacteria were found in 22/49 subjects. Conclusion There is a significant difference on white blood cell count and CRP level between before and after ceftazidime administration but overall ceftazidime is no longer effective as empiric antibiotic therapy in neonatal sepsis.
Co-Authors Achirul Bakri Ading Rohadi Afifa Ramadanti Herka Pratama Putra Nessie Amelia Ramli Raden Muhammad Indra Teti Hendrayanti Yuli Doris Memy Yulia Iriani, Yulia