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All Journal Paediatrica Indonesiana Jurnal Prima Medika Sains
Heru Noviat Herdata, Heru Noviat
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Neutrophil lymphocyte ratio and severity of acute kidney injury in septic children Kowita, Nurul Huda; Sovira, Nora; Safri, Mulya; Ismy, Jufitriani; Haris, Syafruddin; Herdata, Heru Noviat; Bakhtiar, Bakhtiar
Paediatrica Indonesiana Vol 63 No 6 (2023): November 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.6.2023.492-8

Abstract

Background Acute kidney injury (AKI) in sepsis is associated with an inflammatory process in kidney microcirculation and may increase morbidity and mortality in children. The neutrophil lymphocyte ratio (NLR) is an inflammatory biomarker of the inflammatory process in sepsis. Objective To determine the role of NLR in predicting the severity of AKI and to describe the demographic and laboratory characteristics, as they relate to outcomes of pediatric patients with AKI and sepsis. Methods This cross-sectional study was conducted in the PICU at Dr. Zainoel Abidin General Hospital (RSUDZA), Banda Aceh, Aceh. Medical record data were obtained from critically ill children with sepsis and AKI. Chi-square test was used to compare the proportions of each variable. We also calculated odds ratios to evaluate the AKI severity, PELOD-2 score, and patient outcomes. Spearman's analysis was used to look for a possible correlation between NLR and AKI severity in septic children. Results Seventy-one subjects with sepsis and AKI were included. Subject characteristics were as follows: 63.4% males, 63.4% < 1 year of age, 56.3% with respiratory problems as a primary disease, 38% with AKI injury stage, and 54.9% subjects with PELOD-2 score ?10. There was no significant correlation between AKI severity and mortality (OR 3.04; 95%CI 0.990 to 9.378; P=0.052). Subjects with a PELOD-2 score ?10 had a 47.6 times higher chance of mortality in septic children with AKI compared to those with PELOD-2 scores <10. There was no correlation between NLR and AKI severity (r=0.019; P=0.878). Conclusion There is no correlation between NLR and AKI severity. Sepsis accompanied by AKI may increase the risk of mortality in children. Septic children with more severe AKI tends to be less survive.
Manifestasi klinis, pemeriksaan penunjang, diagnosis dan tatalaksana abses paru pada anak Bakhtiar, Bakhtiar; Herdata, Heru Noviat; Liansyah, Tita Menawati; Zakaria, Iskandar; Sufriani, Sufriani; Safana, Garsia
Jurnal Prima Medika Sains Vol. 5 No. 1 (2023): Juni
Publisher : Program Studi Magister Kesehatan Masyarakat Universitas Prima Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34012/jpms.v5i1.3909

Abstract

Abses paru merupakan rongga berdinding tebal yang mengandung bahan purulen akibat supurasi dan nekrosis pada parenkim paru yang terlibat. Berdasarkan faktor predsposisi, maka abses paru pada anak dapat dibagi menjadi abses paru primer dan sekunder. Penyebab utama terjadinya abses paru primer adalah Streptococcus pneumoniae atau Staphylococcus aureus. Abses sekunder diperberat oleh penyakit paru, misalnya bronkhiektasis, fibrosis kistik, infark paru. Diagnsosis abses paru pada anak ditegakkan berdasarkan gambaran klinis dan pemeriksaan penunjang. Dicurigai abses paru apabila terdapat keluhan demam dan batuk, dan adanya tanda-tanda konsolidasi paru. Pemeriksaan penunjang diperlukan untuk memperkuat diagnosis abses paru meliputi rontgen dada, ultrasonografi, dan computed tomography (CT Scan). Tatalaksana abses paru meliputi tatalaksana umum dan khusus. Tatalaksana umum meliputi pemberian makanan dan cairan yang cukup dan oksigen. Pemberian oksigen dilakukan jika ada gejala sesak nafas. Selanjutnya, tatalaksana khusus meliputi pemberikan antibiotika, drainase dan tindakan operatif (lobektomi). Antibiotik secara inta vena yang tepat direkomendasikan sebagai terapi awal untuk abses paru. Jika tidak ada perbaikan klinis dan radiologis yang bermakna, maka dipertimbangkan dilakukan drainase. Seterusnya, jika dengan drainase juga tidak ada perbaikan, maka langkah terakhir adalak dilakukan lobektomi.
Co-Authors Bakhtiar Bakhtiar Ismy, Jufitriani Kowita, Nurul Huda Mulya Safri, Mulya Nora Sovira, Nora Safana, Garsia sufriani, sufriani Syafruddin Haris, Syafruddin Tita Menawati Liansyah, Tita Menawati Zakaria, Iskandar