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Harry Akza Putrawan
Gambaran fungsi jantung pada pasien penyakit paru obstruktif kronik berdasarkan echocardiography di RSUP Persahabatan = Cardiac function of chronic obstructive pulmonary disease based on echocardiography in Persahabatan Hospital
"Latar belakang dan tujuan: Penyakit kardiovaskular merupakan komorbid yang sering terjadi dan menjadi penyebab kematian pada pasien penyakit paru obstruktif kronik (PPOK). Penyakit kardiovaskular menjadi salah satu faktor prediksi tahan hidup pasien PPOK. Pemeriksaan echocardiography merupakan pemeriksaan yang akurat dan menyediakan informasi untuk evaluasi fungsi jantung.Tujuan penelitian ini adalah untuk mengetahui fungsi jantung pasien PPOK berdasarkan temuan echocardiography di RSUP Persahabatan Jakarta.
Metode: Penelitian ini merupakan penelitian potong lintang terhadap pasien PPOK stabil yang berkunjung ke poli asma-PPOK di RSUP Persahabatan.Penelitian dilakukan dari Januari-Juni 2017. Subjek yang memenuhi kriteria akan dilakukan anamnesis, spirometri dan echocardiography.
Hasil: Sebanyak 70 pasien ikut serta dalam penelitian ini dan dilakukan echocardiography. Usia rerata subjek adalah 65,68 ± 7,65. Subjek terbanyak adalah laki-laki (95,7%). Pada penelitian ini ditemukan 5,7% subjek memiliki gagal jantung kiri, 11,4% memiliki gagal jantung kanan, 30% hipertensi pulmoner, 8,6% mengalami dilatasi ventrikel kanan dan 11,4% mengalami pembesaran ventrikel kiri. Analisis statistik menemukan hubungan bermakna antara tricuspid annular plane excursion(TAPSE) dengan eksaserbasi pada PPOK(p<0,05). Terdapat hubungan yang bermakna antara indeks massa tubuh (IMT) dengan kontraksi ventrikel kanan, hipertensi pulmoner dan dilatasi ventrikel kanan. Tidak ditemukan hubungan yang bermakna antara derajat keparahan PPOK dengan dimensi, tekanan dan kontraksi jantung.
Kesimpulan: Prevalens gangguan fungsi jantung tinggi pada pasien PPOK dan memiliki hubungan dengan eksaserbasi pada PPOK. Pasien dengan fungsi paru rendah memiliki kecenderungan untuk memilki gangguan di jantung.
Background/Aim: Cardiovascular disease is a frequent comorbidity and cause of death in chronic obstructive pulmonary disease (COPD). Cardiovascular disease is one of predictive of survival in COPD. Echocardiography provides accurate and rapid information to evaluate cardiac function. The aim of this study is to elucidate the cardiac function based on echocardiography findings in stable COPD patients in the Persahabatan Hospital Jakarta.
Methods: This study is a cross sectionalstudy among stable COPD patients who visit asthma-COPD clinics in Persahabatan Hospitals from January to June 2017. Interview, spirometry dan echocardiography perform to all subject who meet the ctiteria.
Results: A total 70 subject with COPD perform echocardiography with mean ages 65,68 ± 7,65. Most of subject were men (95,7%). In this study found 5,7% subjects with left ventricle failure, 11,4% with right ventricle failure, 30% with pulmonary hypertension, 8,6% with right ventricle dilatation and 11,4% left ventricle hypertrophy. Statistic analysis have found significant association between tricuspid annular plane systolic excursion (TAPSE) and exacerbation in COPD patient (p<0,05). In this study found significant relationship between body mass index (BMI) and right ventricle contraction, pulmonary hypertension and right ventricle dilatation. There were no significant relationship between COPD severity and cardiac dimension, pressure and contraction.
Conclusion: Prevalence of cardiac function abnormality were high in COPD patient and have relationship with exacerbation of COPD. Patient with lower lung function tender to have cardiac problem."
Depok: Fakultas Kedokteran Universitas Indonesia, 2017
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UI - Tugas Akhir  Universitas Indonesia Library
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Riyadi Sutarto
Kapasitas difusi paru terhadap karbon monoksida (DLCO) pada pasien adenokarsinoma paru yang mendapat EGFR-TKI di Rumah Sakit Umum Pusat Persahabatan Jakarta, Indonesia = Lung diffusion capacity of lung adenocarcinoma patients treated with the epidermal growth factor receptor-tyrosine kinase inhibitors in Persahabatan Hospital Jakarta, Indonesia
"Latar belakang : Efek potensial EGFR-TKI terhadap fungsi paru belum diinvestigasi secara mendalam. Penelitian ini bertujuan untuk menilai efek pemberian EGFR TKI terhadap fungsi paru terutama nilai DLCO.
Metode : Penelitian berlangsung secara prospektif dari September 2018 hingga Juni 2019 di Rumah Sakit Persahabatan Jakarta. Terdapat 20 subjek adenokarsinoma paru dengan mutasi tunggal di exon 19/21 yang dapat menyelesaikan pemeriksaan DLCO baik sebelum mendapat EGFR TKI dan setelah tiga bulan terapi.
Hasil : Penelitian ini mendapatkan peningkatan bermakna nilai rerata KVP prediksi dari 60,6% menjadi 68,25% (p=0,03), nilai rerata VEP1 Prediksi dari 59,7% menjadi 67,05% (p=0,036), nilai rerata DLCO dari 11,55 ml/menit/mmHg menjadi 13,72 ml/menit/mmHg (p=0,004) dan DLCO prediksi dari 53,4% menjadi 63,85% (p=0,03). Peningkatan nilai rerata DLCO prediksi paling besar pada kelompok dengan hasil RECIST partial response yaitu sebesar 16,43% (p=0,056).
Kesimpulan : Terapi EGFR TKI selama tiga bulan pada subyek adenokarsinoma paru dengan mutasi tunggal exon19/21 dapat meningkatkan fungsi paru secara bermakna baik nilai KVP prediksi, VEP1 prediksi, DLCO, dan DLCO prediksi.
Background : The epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are drugs of choice in non-small cell lung cancer possessing EGFR mutation. Its effect on the lung function is not well understood. This study aims to assess lung function using the lung diffusion capacity (DLCO) test in lung cancer patients treated with EGFR-TKIs. ming
Method :
This prospective study included lung cancer patients treated with EGFR-TKIs at Persahabatan Hospital Jakarta, Indonesia, between September 2018 andGrowt June 2019. The study recruited 20 lung adenocarcinoma patients presented with a single mutation at exon 19 or 21 as subjects in the process. Their DLCO was examined before and three months after receiving EGFR-TKI. Subjects were grouped according to the Response Evaluation Criteria in Solid Tumors (RECIST) assessment.
Results: There was an increase in predicted FVC from 60.60% to 68.25% (p=0.03), predicted FEV1 from 59.7% to 67.05% (p=0.036%), DLCO from 11.5 mL/minute/mmHg to 13.72 mL/minute/mmHg (p=0.004), and predicted DLCO from 53.4% to 63.85% (p=0.03) during the therapy. The largest increase of predicted DLCO was shown in RECIST group of partial response (16.43%, p=0.056) Conclusion: This study found an improvement in lung function (predicted FVC, predicted FEV1, DLCO, and predicted DLCO) among lung adenocarcinoma subjects exhibiting single mutation at exon 19 or 21 after three months of EGFR-TKIs treatment."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2019
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UI - Tugas Akhir  Universitas Indonesia Library
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Harry Agustio Zulhadji
Hubungan Luas Lesi Foto Toraks Dengan Uji Latih Jantung Paru dan Spirometri Pasien Bekas Tuberkulosis Paru Sensitif Obat di RSUP Persahabatan = The Correlation Between Chest X-Ray Lesion Area with Cardiopulmonary Exercise Testing And Spirometry In Post Drug Susceptible Pulmonary Tuberculosis Patients at Persahabatan Hospital
"Latar belakang : Berbagai penelitian menunjukkan bahwa setelah pengobatan tuberkulosis (TB) selesai dan dinyatakan sembuh, sebagian besar penyintas TB masih mengalami gejala sisa. Saat ini program penanggulangan TB sudah berjalan dengan baik, tetapi tindakan rehabilitasi pada pasien yang masih mengalami keterbatasan kapasitas fungsional dan faal paru pasca tuberkulosis masih belum menjadi prioritas program nasional. Penelitian ini bertujuan untuk mencari apakah terdapat hubungan antara luas lesi pada foto toraks yang sudah menjadi standar pemeriksaan pada pasien dengan pengobatan TB dengan kapasitas fungsional lewat pemeriksaan uji latih jantung paru (ULJP) dan faal paru lewat pemeriksaan spirometri, sehingga bisa menjadi alat skrining pasien yang memerlukan pemeriksaan lebih lanjut. Metode : Desain penelitian ini adalah deskriptif observasional dengan metode potong lintang untuk mengetahui luas lesi foto toraks, uji latih jantung paru dan spirometri pada pasien bekas TB paru sensitif obat di RSUP Persahabatan. Hasil : Didapatkan 45 subjek penelitian yang memenuhi kriteria dan bersedia ikut penelitian. Terdapat korelasi negatif bermakna antara luas lesi foto toraks dengan parameter ULJP yaitu VO2 Max (r = −0,389) dan Minute Ventilation (r = −0,435), dengan nilai p masing-masing 0,008 dan 0,003. Terdapat korelasi negatif bermakna antara luas lesi foto toraks dengan parameter spirometri yaitu VEP1 (r = −0,489) dan KVP (r = −0,578), dengan nilai p masing-masing 0,001 dan <0,001, Variabel perancu yang berpengaruh adalah diabetes mellitus dengan koefisien regresi -9,756 terhadap peak minute ventilation dengan nilai p = 0,023. Kesimpulan : Terdapat hubungan antara luas lesi foto toraks dengan ULJP dan spirometri.
Background : Multiple studies show that following the completion of tuberculosis (TB) treatment and successful recovery, the majority of TB survivors still experience residual symptoms. While the TB control program is currently well established, the rehabilitation of individuals with diminished functional capacities post-tuberculosis remains a secondary concern within the national program. This study aims to determine whether there were correlation between chest x-ray lesion area which has become a standard examination in patients undergoing TB treatment, with functional capacity as measured by cardiopulmonary exercise testing (CPET) and lung function assessed through spirometry, so it can be a screening tool for patients who require further examination. Methods : The design of this study was descriptive observational with a cross-sectional method to determine chest x-ray lesion area, cardiopulmonary exercise testing and spirometry in post drug susceptible pulmonary TB patients at Persahabatan Hospital. Results : There were 45 subjects who met the criteria and were agree to take part in the research. There was a significant negative correlation between chest x-ray lesion area and CPET parameters VO2 Max (r = −0.389) and Minute Ventilation (r = −0.435), with p values of 0.008 and 0.003, respectively. There was a significant negative correlation between chest x-ray lesion area and spirometry parameters, FEV1 (r = −0.489) and FVC (r = −0.578), with p values of 0.001 and <0.001, respectively. The significant confounding variable is diabetes mellitus with a regression coefficient -9.756 to peak minute ventilation with p value = 0.023. Conclusions : There were negative correlation of chest x-ray lesion area with CPET and spirometry in post drug susceptible pulmonary TB patients."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2024
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UI - Tugas Akhir  Universitas Indonesia Library
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Ririn Astuty Ningsih
Kapasitas difusi paru pada penerbang pesawat tempur X di Madiun = Lung diffusion capacity of X fighter pilot in Madiun
"Latar Belakang dan Tujuan: Penerbang bekerja di lingkungan ketinggian yang terpajan gaya G dan seiring peningkatan gaya Gz akan berbanding lurus dengan penurunan curah jantung dan oksigenasi otak hal ini akibat perubahan pertukaran gas di paru dalam kondisi hipergravitasi. Penelitian ini bertujuan untuk mengetahui kapasitas difusi paru pada penerbang pesawat tempur serta faktor-faktor yang mempengaruhinya.
Metode: Penelitian potong lintang yang dilaksanakan bulan Februari 2019 di Madiun dilakukan pada subjek laki-laki di instansi X Madiun. Jumlah sampel sebanyak 44 orang dipilih secara total sampling. Wawancara dilakukan untuk mengisi kuesioner data dasar, jam terbang dan lama berolahraga. Dilakukan pengukuran spirometri dan DLCO dengan menggunakan alat penggukur spirometri dan DLCO portable (Easyone TM Pro Lab).
Hasil: Penelitian ini mendapatkan hasil sebagian besar peserta (93,2%) memiliki nilai spirometri yang normal hanya 3 peserta (6,8%) mengalami kelainan obstruksi dan tidak didapatkan kelainan restriksi sama sekali dengan nilai rerata VEP1 prediksi 103,3±10,60 % dan nilai median VEP1/KVP 84,5% dengan nilai minimum 63,5% dan nilai maksimum 92,5%. Pada nilai uji DLCO diperoleh hasil sebagian besar peserta (93,2%) memiliki nilai yang normal dan terdapat nilai DLCO mengalami penurunan ringan pada 3 peserta (6,8%) pada kelompok perokok.
Kesimpulan: Nilai kapasitas difusi paru dan pemeriksaan spirometri pada penerbang secara umum normal terdapat sebagian kecil yang mengalami penurunan ringan namun tidak mempunyai hubungan yang bermakna antara parameter DLCO dengan usia, IMT, jam terbang tempur, total jam terbang, menit olahraga dalam sepekan serta indeks Brinkman dan nilai parameter spirometri.
Background: Pilot works in the high environment that exposed by G force. Increasing G force led to linear decreases in cardiac output and blood oxygenation of the brain. Thus, likely due to decreased lung gas exchange capacity in hypergravity. This study aims to investigate the pulmonary diffusing capacity test among Fighter pilots in Madiun.
Methods: This study used cross sectional method conducted on February 2019 in Madiun. The total subjects consist of 44 Fighter pilots based on total sampling. Interview was done to fill out question about sociodemografic and smoking habit, flight hour data and physical fitness. Lung function measurement was done using portable spirometry and DLCO equipment (Easyone TM Pro Lab).
Result: Spirometri result was found in the standard normal range in 41 subjects (93,2%) only 3 subject (6,8%) get obstruction abnormalities and none of them get restriction result. Average VEP1 prediction was 103,3±10,60 % and median range for VEP1/KVP was 84,5(63,5-92,5) %. Lung diffusion capacity measurement was found to be normal in 41 subject (93,2%) and to be deficient in 3 subject (6,8%) in smoker.
Conclusion: This study demosntrated that diffusion capacity and spirometry test in Fighter pilots generally in normal range. Lung diffusion capacity has no association with age, BMI, flight hour, physical fitness, Brinkman index and spirometry parameters."
Depok: Fakultas Kedokteran Universitas Indonesia, 2019
T57655
UI - Tesis Membership  Universitas Indonesia Library
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Liberty Tua Panahatan
Efektivitas preoperatif incentive spirometry terhadap atelktasis pneumonia dan hipoksemia pasca operasi mayor abdomen = Efficacy of incentive spiromtry in reducing atelectasis pneumonia and hypoxemia after major abdominal surgery
"[ABSTRAK
Tujuan dari penelitian ini adalah untuk menilai dampak dari preopratif incentive spirometry terhadap komplikasi paru dan uji fungsi paru di antara pasien dengan operasi abdomen mayor Pasien yang menjalani operasi mayor abdomen tanpa riwayat penyakit paru secara acak dibagi menjadi dua kelompok: kelompok latihan dan kelompok kontrol. Kelompok Latihan diberi 15 menit latihan empat kali sehari selama 2 hari sebelum operasi. Kelompok kontrol tidak menerima latihan. Pengukuran fungsi paru baseline dan pasca operasi diambil pada kedua kelompok. Fungsi paru pasca operasi diukur dari hari pertama sampai hari ketujuh. Semua pasien dinilai untuk komplikasi paru pasca operasi oleh ahli pulmonologi.
Kami merekrut 23 pasien dalam setiap kelompok. Insiden komplikasi paru adalah 56,5% pada kelompok kontrol dan tidak ada komplikasi yang ditemukan di antara pasien pada kelompok latihan. Ada penurunan yang signifikan dari komplikasi paru pada kelompok exrcise (p <0,001). Ada penurunan signifikan dari atelektasis (p <0,01), pneumonia (p 0,025), Hipokemia (p 0,005). Incentive spirometry memiliki efek perlindungan dengan resiko relative (RR) 0,11 (CI 95% 0,02-0,74). Odds Ratio (OR) untuk komplikasi pada kelompok kontrol adalah 3,3 (OR 3,30 CI 95% 1,97-5,54) pada komplikasi paru. Dalam hal fungsi paru, kami menemukan peningkatan yang signifikan pada Vital Capacity (dari 2336,96 + 722,56 mL ke 2541,30 + 718,78 mL dengan p <0,01) dan Force Vital Capacity (dari 2287,39 + 706 , 11 untuk 2469,57 + 676,10 dengan p <0,01) setelah latihan. Sebagai kesimpulan, preoperatif incentive spirometry dapat menurunkan insiden komplikasi paru.ABSTRACT The aim of this study is to assess the impact of preoperative incentive spirometry on pulmonary complication and pulmonary fuction test among patients with major abdominal surgery. Petient underwent major abdominal surgery without any history pulmonary disease were randomized into two group: the exercise group and the control group. Exercise group were given 15 minute exercise four times daily for 2 days prior to surgery. The control group receive no exercise. Baselie and post-surgery pulmonary function measurement were taken in both groups. Post surgery pulmonary function measure in first until seventh day after surgery. All patients were assessed for post operative pulmonary complication by attending
pulmonologist.
We recruited 23 patients in each group. The incidence of pulmonary complication was 56,5% in the control group and no complication were found among patient in the exercise group. There was a significant decrease of pulmonary complication in exrcise group (p <0,001). There were signigicant decrease of atelectasis (p <0,01), pneumonia (p 0,025), Hipoxemia (p 0,005). Incentive spirometry has protective effect with relative risk (RR) 0,11 (CI 95% 0,02-0,74). Odds Ratio (OR) for complication in control group was 3,3 (OR 3,30 CI 95% 1,97-5,54) on pulmonary complication. In terms of pulmonary function, we found significant increase on Vital Capacity (from 2336,96 + 722,56 mL to 2541,30 + 718,78 mL with p<0,01) and Force Vital Capacity (from 2287,39 + 706,11 to 2469,57 + 676,10 with p<0,01) after exercise.
As conclusion, preoperative incentive spirometry may decrease incidence of pulmonary complication. , The aim of this study is to assess the impact of preoperative incentive spirometry on pulmonary complication and pulmonary fuction test among patients with major abdominal surgery. Petient underwent major abdominal surgery without any history pulmonary disease were randomized into two group: the exercise group and the control group. Exercise group were given 15 minute exercise four times daily for 2 days prior to surgery. The control group receive no exercise. Baselie and post-surgery pulmonary function measurement were taken in both groups. Post surgery pulmonary function measure in first until seventh day after surgery. All patients were assessed for post operative pulmonary complication by attending
pulmonologist.
We recruited 23 patients in each group. The incidence of pulmonary complication was 56,5% in the control group and no complication were found among patient in the exercise group. There was a significant decrease of pulmonary complication in exrcise group (p <0,001). There were signigicant decrease of atelectasis (p <0,01), pneumonia (p 0,025), Hipoxemia (p 0,005). Incentive spirometry has protective effect with relative risk (RR) 0,11 (CI 95% 0,02-0,74). Odds Ratio (OR) for complication in control group was 3,3 (OR 3,30 CI 95% 1,97-5,54) on pulmonary complication. In terms of pulmonary function, we found significant increase on Vital Capacity (from 2336,96 + 722,56 mL to 2541,30 + 718,78 mL with p<0,01) and Force Vital Capacity (from 2287,39 + 706,11 to 2469,57 + 676,10 with p<0,01) after exercise.
As conclusion, preoperative incentive spirometry may decrease incidence of pulmonary complication. ]"
Fakultas Kedokteran Universitas Indonesia, 2015
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UI - Tugas Akhir  Universitas Indonesia Library
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Muhammad Hafiz
Prevalens dan faktor risiko penyakit refluks gastroesofagus (prge) pada pasien penyakit paru obstruktif kronik (ppok) stabil di rsup persahabatan = Prevalence and risk factors of reflux esophagitis among stable copd patients treated at persahabatan hospital Jakarta, Indonesia
"Latar belakang dan tujuan: Penyakit refluks gastroesofagus (PRGE) merupakan salah satu penyebab terbanyak batuk kronik dan menjadi faktor risiko terjadinya eksaserbasi pada penyakit paru obstruktif kronik (PPOK), menurunkan kualitas hidup dan memperparah gejala respirasi dan pencernaan. Total 40 pasien diikutkan pada penelitian ini. Pasien diambil secara konsekutif dari poliklinik asma PPOK di RSUP Persahabatan dimulai dari bulan Mei 2017. Diagnosis PPOK berdasarkan GOLD 2017 yaitu nilai spirometri VEP1/KVP pasca bronkodilator < 0.7. Diagnosis PRGE menggunakan endoskopi saluran cerna bagian atas apabila ditemukan kerusakan mukosa esofagus. Kriteria eksklusi yaitu eksaserbasi dan kelainan esofagus yang sudah diderita sebelumnya.
Metode: Penelitian ini adalah potong lintang pada pasien PPOK stabil yang berkunjung ke poli asma-PPOK di RSUP Persahabatan mulai bulan Juli sampai Nopember 2017. Sebanyak 40 pasien dipilih secara konsekutif sejak bulan Mei 2017. Pemeriksaan berupa wawancara, spirometri dan endoskopi dilakukan pada semua subjek yang memenuhi kriteria inklusi.
Hasil: Subjek yang mengikuti penelitian sebanyak 40. Prevalens PRGE pada PPOK adalah 40% (16/40). Tidak ada perbedaan bermakna diantara kedua grup berdasarkan usia, jenis kelamin, Indeks Brinkman (IB) dan Indeks Massa Tubuh (IMT). Keterbatasan aliran udara yang lebih berat dan nilai spirometri pascabronkodilator yang lebih rendah memiliki kecenderungan terjadinya PRGE lebih besar walaupun secara statistik tidak bermakna. Rerata pasien berusia lanjut dan mempunyai riwayat merokok. Eksaserbasi dan skor CAT berhubungan secara bermakna (p < 0.05) dengan kejadian PRGE. Penggunaan obat-obatan PPOK seperti LABA, LAMA dan SABA tidak berubungan bermakna dengan PRGE. Gejala dada terbakar (heartburn) bermakna secara statistik (p < 0.05) sebagai tanda PRGE.
Kesimpulan: Prevalens PRGE cukup tinggi pada pasien PPOK dan bahkan lebih tinggi dibandingkan pasien bukan PPOK dengan gejala dispepsia di Jakarta. Dokter harus mempertimbangkan kemungkinan PRGE sebagai salah satu komorbid yang penting pada PPOK. Penelitian kohort dan strategi pencegahan disarankan untuk dilakukan selanjutnya.
Background/Aim: Gastroesophageal reflux disease (GERD) is one of the most common causes of chronic cough and is a potential risk factor for exacerbation of chronic obstructive pulmonary disease (COPD), decreasing quality of life in COPD patients, aggravating symptoms both respiratory and gastro-intestinal. Total 40 patients were recruited consecutively from the outpatient of Asthma and COPD clinic at Persahabatan hospital Jakarta started from May 2017. The diagnosis of gastroesophageal reflux disease (GERD) was based on the mucosal break on the esophageal lining through endoscopic examination. Exclusion criteria were COPD exacerbation and known esophageal disease.
Methods: This is a cross sectional study among stable COPD patients who visited asthma-COPD clinics at Persahabatan Hospital from July to November 2017. 40 patients were recruited consecutively started from May 2017. Interview, spirometry and endoscopy performed to all subjects who meet the inclusion criteria.
Results: A total 40 subjects were enrolled in our study. Prevalence of GERD in COPD was 40%. There was no significant difference between the two groups regarding age, sex, Index Brinkman (IB) and Body Mass Index (BMI), although in the RE group has a slightly higher BMI. More severe airflow obstruction tends to increase in GERD group although no significant statistical difference Most patients were elderly and smoker/ex. Exacerbation and CAT score were significantly associated with GERD (p<0.05). Post BD spirometry showed greater airway and severe COPD tends to also had GERD similar to results of other studies. Respiratory medication such as ICS + LABA, LAMA and SABA statistically insignificant with GERD. Heartburn as a symptom showed statistically significant to predict GERD (p < 0.05).
Conclusion: Prevalence of GERD was high in COPD patient and even higher than previously reported in general patient with dyspepsia syndrome in Jakarta. Physician should consider GERD as one of the most important comorbidities in COPD. Cohort study and preventive strategy are warranted in the future."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
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UI - Tugas Akhir  Universitas Indonesia Library
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Yusuf Musafir Kolewora
Prevalens penyakit paru obstruktif kronik (Ppok) berbasis spirometri di Rumah Sakit Rujukan Respirasi Nasional Persahabatan = Prevalence of chronic obstructive pulmonary disease based on the spirometry in Persahabatan Hospital Jakarta, Indonesia
"ABSTRAK
Latar belakang: Penyakit Paru Obstruksi Kronik (PPOK) merupakan penyebab utama angka kesakitan dan kematian di seluruh dunia termasuk di Indonesia. Hasil Riset Kesehatan Dasar (RISKESDAS) tahun 2013 menunjukkan bahwa prevalens PPOK di Indonesia sebanyak 3,7% dan menduduki peringkat ke-6 dari 10 penyebab kematian di Indonesia. Penelitian ini merupakan studi awal untuk mengetahui prevalens PPOK di RSUP Persahabatan.
Metode: Penelitian ini menggunakan desain studi potong lintang dengan metode consecutive sampling pada pasien PPOK yang berkunjung di RSUP Persahabatan Jakarta pada bulan April-September 2018. Diagnosis PPOK dilakukan dengan menggunakan COPD Diagnostic Questionnaire (CDQ) dan pemeriksaan spirometri.
Hasil: Subjek penelitian sebanyak 875 subjek. Sampel akan dilakukan penapisan awal menggunakan CDQ dengan skor nilai ≥19,5 sebanyak 332 subjek. Hasil pemeriksaan spirometri pada 332 subjek sebelum pemberian bronkodilator inhalasi menunjukkan bahwa sebanyak 83 subjek (25%) memiliki hasil VEP1/KVP <70% dan 249 subjek (75%) memiliki hasil VEP1/KVP ≥70%. Hasil pemeriksaan spirometri setelah pemberian bronkodilator inhalasi menunjukkan bahwa sebanyak 78 subjek (94%) memiliki hasil VEP1/KVP <70% yang berarti menderita PPOK dan 5 subjek (6%) memiliki hasil VEP1/KVP ≥70% yang berarti tidak menderita PPOK sehingga prevalens PPOK adalah 8,9% dari keseluruhan sampel. Gejala klinis pada pasien PPOK antara lain batuk (43,6%), terdapat dahak (50%), dan sesak (39,7%). Hasil uji statistik menunjukkan bahwa faktor yang berhubungan dengan PPOK dalam penelitian ini adalah umur (nilai-p = 0,040), lama merokok (nilai-p = 0,012), jumlah rokok yang dihisap per hari (nilai-p = 0,000) dan derajat berat merokok (nilai-p = 0,000) sedangkan faktor yang tidak berhubungan adalah jenis kelamin (nilai-p = 0,585) dan indeks massa tubuh (nilai- p = 0,953).
Kesimpulan: Prevalens PPOK di rumah sakit Persahabatan Jakarta adalah 8,9%. Gejala klinis pada pasien PPOK antara lain batuk, terdapat dahak dan sesak. Hasil uji statistik menunjukkan bahwa faktor yang berhubungan dengan PPOK dalam penelitian ini adalah umur, lama merokok, jumlah rokok yang dihisap per hari dan derajat berat merokok sedangkan faktor yang tidak berhubungan adalah jenis kelamin dan indeks massa tubuh.
ABSTRACT
Background: Chronic Obstructive Pulmonary Disease (COPD) is the main cause of morbidity and mortality rates in the world including in Indonesia. The result of Riset Kesehatan Dasar (RISKESDAS) in 2013 showed the prevalence of COPD in Indonesia was 3.7% and was ranked 6th from 10 causes of death in Indonesia. This study is the preliminary study to determine of prevalence of COPD in Persahabatan Hospital.
Method: This is a cross sectional study design with consecutive sampling method in COPD patient who visited to the Persahabatan Hospital Jakarta in April- September 2018. COPD diagnosed by using COPD Diagnostic Questionnare (CDQ) and spirometry examination.
Result: Study subject were 875 subject. The sample will be screened preliminary by using CDQ whom get score ≥ 19.5 only 332 subject. The results of spirometry tests on 332 subject before inhaled bronchodilators showed that 83 subject (25%) had results VEP1/KVP <70% which meant diagnose COPD and 249 subject (75%) had results VEP1/KVP ≥70% which means not diagnose COPD. The results of spirometry after inhaled bronchodilators showed that as many as 78 subject (94%) had results VEP1/KVP <70% which meant diagnose COPD and 5 subject (6%) had results VEP1/KVP ≥70%, which means not diagnose COPD so that the prevalence of COPD is 8.9% from all the sample. There were some of symptoms of COPD patients reported such as daily coughing (43,6%), coughing with phlegm (50%), and wheezing (39,7%). Statistical test results indicate that factors associated with COPD in this study are age, duration of smoking, number of cigarettes smoked per day and the degree of smoking-free while the unrelated factors are gender and Body Mass Index."
Depok: Fakultas Kedokteran Universitas Indonesia, 2019
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Efriadi
Hubungan antara hasil pemeriksaan kapasitas difusi paru terhadap karbonmonoksida (DLCO) metode napas tunggal dengan derajat pasien PPOK di RSUP Persahabatan Jakarta = The correlations between measurement of lung diffusing capacity with single breath methods (DLCO-SB) with the group of COPD patients in Persahabatan Hospital Jakarta
"ABSTRAK
Latar belakang : Penelitian ini merupakan studi awal untuk mengukur kapasitas
difusi paru DLCO-SB ipada pasien PPOK di RSUP Persahabatan Jakarta untuk
mengetahui prevalens penurunan nilai DLCO pada pasien PPOK.
Metode : Penelitian ini menggunakan desain studi potong lintang (cross sectional
study) pada pasien PPOK yang berkunjung di Poliklinik Asma-PPOK RSUP
Persahabatan Jakarta. Dilakukan uji spirometri dan DLCO pada pasien PPOK
yang diambil secara konsekutif antara bulan Mei-Juli 2015. Komorbiditas juga
dicatat.
Hasil : Uji Spirometri and DLCO dilakukan pada 65 subjek didapatkan 7 subjek
(10,8%) termasuk kedalam PPOK Grup A, 19 subjek (29,2%) PPOK Grup B, 21
subjek (32,3%) PPOK grup C dan 18 subjek (27,7%) PPOK grup D. rerata usia
64,15 (45-89) tahun;rerata VEP
1
% 46,05%, rerata nilai DLCO 19,42
ml/menit/mmHg dan rerata DLCO % adalah 72.00%. prevalens penurunan
DLCO pasien PPOK adalah 56,92% (37/65 subjek) sedangkan 28 subjek dengan
nilai DLCO normal. Ditemukan 15 subjek (23,07%) dengan penurunan ringan, 18
subjek (27.69%) penurunan sedang dan 4 subjek (6,15%) dengan penurunan berat.
Ditemukan 47 subjek (72,3%) memiliki komorbid. Terdapat hubungan bermakna
antara grup PPOK, derajat spirometri, VEP
1
, IMT dan komorbiditas dengan nilai
hasil uji DLCO. Tidak terdapat hubungan bermakna antara nilai DLCO dengan
jenis kelamin, umur, riwayat merokok, Indeks Brinkmann, obstruksi-restriksi dan
lama terdiagnosis PPOK.
Kesimpulan : Proporsi penurunan nilai DLCO pada pasien PPOK adalah
56,92%. Terdapat hubungan bermakna antara grup PPOK, derajat spirometri,
VEP
1
, IMT dan riwayat TB dengan nilai hasil uji DLCO. Tidak terdapat
hubungan bermakna antara nilai DLCO dengan jenis kelamin, umur, riwayat
merokok, Indeks Brinkmann, obstruksi-restriksi, komorbid dan lama terdiagnosis
PPOK.ABSTRACT
Background and the aim of study : This is a preliminary study to measure
DLCO-SB in COPD patients in Persahabatan Hospital. The aim of the study is to
know the magnitude of disturbance in diffusing capacity of the lung in COPD
patients.
Methods : This was a cross sectional study in which COPD patients attending
COPD-Asthma clinic in Persahabatan Hospital Jakarta were performed spirometry
and DLCO-SB consecutively between May 2015?July 2015. Comorbidities
conditions were also recorded.
Results : Spirometry and DLCO-SB measurement were conducted on 65 COPD
subjects of which 7 subjects (10.8%) were COPD Group A, 19 subjects (29.2%)
were Group B, 21 subjects (32.3%) were COPD group C and 18 subjects (27.7%)
were COPD group D. The mean age was 64.15 (45-89); mean FEV
1
% was
46.05%, mean DLCO measured was 19.42 ml/min/mmHg and the mean DLCO%
was 72.00%. The prevalence of decreasing in diffusing capacity of the lung in
COPD patients was 56.92% (37 subjects) While 28 subjects were normal. There
were 15 subjects (23.07%) with mild decrease in DLCO, 18 subjects (27.69%)
were moderate decrease and 4 subjects (6.15%) with severe decrease. 47 subjects
(72.3%) had comorbid conditions. There was significant correlation between grup
COPD, GOLD COPD grade, VEP
1
, BMI and comorbidities with magnitude of
decreasing DLCO value. There was no correlation between DLCO value with sex,
smoking history, Brinkmann index, age, obstruction-mix criteria, length of COPD
period.
Conclusion : The proportion of decreasing in DLCO in COPD patients are
56.92%. There is significant correlation among the group of COPD, GOLD
COPD grade, VEP
1
, BMI and previous TB history with magnitude of decreasing
DLCO value. There is no correlation between DLCO value with sex, smoking
history, brinkmann index, age, obstruction-mix criteria, comorbidities and length
of COPD period. ;Background and the aim of study : This is a preliminary study to measure
DLCO-SB in COPD patients in Persahabatan Hospital. The aim of the study is to
know the magnitude of disturbance in diffusing capacity of the lung in COPD
patients.
Methods : This was a cross sectional study in which COPD patients attending
COPD-Asthma clinic in Persahabatan Hospital Jakarta were performed spirometry
and DLCO-SB consecutively between May 2015?July 2015. Comorbidities
conditions were also recorded.
Results : Spirometry and DLCO-SB measurement were conducted on 65 COPD
subjects of which 7 subjects (10.8%) were COPD Group A, 19 subjects (29.2%)
were Group B, 21 subjects (32.3%) were COPD group C and 18 subjects (27.7%)
were COPD group D. The mean age was 64.15 (45-89); mean FEV
1
% was
46.05%, mean DLCO measured was 19.42 ml/min/mmHg and the mean DLCO%
was 72.00%. The prevalence of decreasing in diffusing capacity of the lung in
COPD patients was 56.92% (37 subjects) While 28 subjects were normal. There
were 15 subjects (23.07%) with mild decrease in DLCO, 18 subjects (27.69%)
were moderate decrease and 4 subjects (6.15%) with severe decrease. 47 subjects
(72.3%) had comorbid conditions. There was significant correlation between grup
COPD, GOLD COPD grade, VEP
1
, BMI and comorbidities with magnitude of
decreasing DLCO value. There was no correlation between DLCO value with sex,
smoking history, Brinkmann index, age, obstruction-mix criteria, length of COPD
period.
Conclusion : The proportion of decreasing in DLCO in COPD patients are
56.92%. There is significant correlation among the group of COPD, GOLD
COPD grade, VEP
1
, BMI and previous TB history with magnitude of decreasing
DLCO value. There is no correlation between DLCO value with sex, smoking
history, brinkmann index, age, obstruction-mix criteria, comorbidities and length
of COPD period. ;Background and the aim of study : This is a preliminary study to measure
DLCO-SB in COPD patients in Persahabatan Hospital. The aim of the study is to
know the magnitude of disturbance in diffusing capacity of the lung in COPD
patients.
Methods : This was a cross sectional study in which COPD patients attending
COPD-Asthma clinic in Persahabatan Hospital Jakarta were performed spirometry
and DLCO-SB consecutively between May 2015?July 2015. Comorbidities
conditions were also recorded.
Results : Spirometry and DLCO-SB measurement were conducted on 65 COPD
subjects of which 7 subjects (10.8%) were COPD Group A, 19 subjects (29.2%)
were Group B, 21 subjects (32.3%) were COPD group C and 18 subjects (27.7%)
were COPD group D. The mean age was 64.15 (45-89); mean FEV
1
% was
46.05%, mean DLCO measured was 19.42 ml/min/mmHg and the mean DLCO%
was 72.00%. The prevalence of decreasing in diffusing capacity of the lung in
COPD patients was 56.92% (37 subjects) While 28 subjects were normal. There
were 15 subjects (23.07%) with mild decrease in DLCO, 18 subjects (27.69%)
were moderate decrease and 4 subjects (6.15%) with severe decrease. 47 subjects
(72.3%) had comorbid conditions. There was significant correlation between grup
COPD, GOLD COPD grade, VEP
1
, BMI and comorbidities with magnitude of
decreasing DLCO value. There was no correlation between DLCO value with sex,
smoking history, Brinkmann index, age, obstruction-mix criteria, length of COPD
period.
Conclusion : The proportion of decreasing in DLCO in COPD patients are
56.92%. There is significant correlation among the group of COPD, GOLD
COPD grade, VEP
1
, BMI and previous TB history with magnitude of decreasing
DLCO value. There is no correlation between DLCO value with sex, smoking
history, brinkmann index, age, obstruction-mix criteria, comorbidities and length
of COPD period. "
Fakultas Kedokteran Universitas Indonesia, 2015
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Risca Rini Aryanti
Hubungan Rasio PAO2/FIO2 dan Kadar D-Dimer terhadap Kadar ST2 Terlarut dan Spirometri pada Pasien dengan Penyakit Kardiovaskular Pasca Covid-19 Varian Omicron = Relationship of PaO2/FiO2 Ratio and D-Dimer Levels to sST2 Levels and Spirometry Profile in Patients with Post COVID-19 Variant Omicron with Cardiovascular Disease
"Latar Belakang: COVID-19 di Indonesia menyebabkan kematian hingga lebih dari 150.000 orang. Salah satu populasi yang mengalami dampak dengan risiko kematian yang tinggi adalah populasi penyakit kardiovaskular. Severitas COVID-19 sering dikaitkan dengan rendahnya rasio PaO2/FiO2 dan tingginya kadar D-dimer. COVID-19 varian Omicron diketahui memiliki angka penyebaran yang lebih tinggi dengan severitas infeksi yang lebih rendah dibandingkan varian sebelumnya. Namun dampak jangka panjang pada pasien COVID-19 varian Omicron, khususnya pada populasi pasien dengan penyakit kardiovaskular masih menjadi pertanyaan. Penelitian ini ingin mengetahui dampak pasca COVID-19 varian Omicron dengan melihat kadar ST2 terlarut dan adanya gangguan paru yang dinilai dengan pemeriksaan spirometri.
Tujuan: Penelitian ini dilakukan untuk mengetahui hubungan Rasio PaO2/FiO2 dan Kadar D-dimer pada saat admisi terhadap kadar ST2 terlarut dan gambaran spirometri pada pasien pasca COVID-19 varian Omicron dengan penyakit kardiovaskular. Metode: Penelitian berupa studi potong lintang terhadap pasien COVID-19 varian Omicron dengan riwayat komorbid penyakit kardiovaskular yang dirawat di Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita. Diagnosis COVID-19 varian Omicron dilakukan dengan menggunakan metode WGS/SGTF. Pasien dengan kriteria inklusi menjalani pemeriksaan spirometri dan pengukuran kadar ST2 terlarut pada 6 bulan pasca perawatan.
Hasil dan Pembahasan: Penelitian ini menunjukkan rasio PaO2/FiO2 dengan median 454 dan kadar D-dimer 790ng/mL. Mayoritas pasien menunjukkan gambaran gangguan resktriktif. Kadar ST2 terlarut pasca perawatan memiliki median 2716,8pg/mL. Tidak ditemukan adanya hubungan yang signifikan antara rasio PaO2/FiO2 dan kadar D-Dimer terhadap kadar ST2 terlarut maupun gambaran spirometri pada 6 bulan pasca COVID-19. Hal ini dapat dikaitkan dengan severitas COVID-19 yang lebih rendah sehingga tidak terdapat hubungan bermakna terhadap parameter admisi serta hubungan pengukuran 6 bulan pasca COVID-19 dengan kemungkinan adanya perbaikan fibrosis.
Kesimpulan: Tidak ada hubungan yang signifikan antara rasio PaO2/FiO2 dan kadar D- Dimer terhadap kadar ST2 terlarut ataupun gambaran spirometri pada 6 bulan pasca COVID-19 varian Omicron.
Introduction: COVID-19 in Indonesia has caused more than 150,000 deaths. One of the affected populations with a high risk of death is the cardiovascular disease population. The severity of COVID-19 is associated with a low of PaO2/FiO2 ratio and the increased levels of D-dimer. Omicron variant is known to have higher transmission with less severe infection than the previous variant. However, research related to long term effect post COVID-19 with Omicron variant in cardiovascular population is not yet known.
Aim: This study was conducted to determine the relationship of PaO2/FiO2 ratio and D- dimer levels at admission to sST2 levels and spirometry profile in post COVID-19 variant Omicron patient with cardiovascular disease.
Method: Research in the form of a cross-sectional study was conducted on Omicron variant COVID-19 patients with a history of comorbid cardiovascular disease who were treated at the Harapan Kita Heart and Blood Vessel Hospital (RSJPDHK). The diagnosis of COVID-19 is carried out using the WGS/SGTF method. Patients undergo spirometry examination and measurement of sST2 levels at 6 month after hospitalization.
Results and Discussion: This study shows a PaO2/FiO2 ratio with a median of 454 with D-dimer levels 790 ng/mL. The majority of patients have a restrictive patterns. The median sST2 value in Omicron variant COVID-19 patients at 2716.8 pg/mL. There was no significant relationship between the ratio of PaO2/FiO2 and D-Dimer levels to sST2 levels and spirometry profile at 6 months after COVID-19 infection. This can be associated with lower COVID-19 severity so that there is no significant association with inflammatory parameters such as PaO2/FiO2 ratio and D-dimer levels, as well as the relationship between measurements 6 months post COVID-19 and the possibility of fibrosis improvement.
Conclusion: There was no significant relationship between the ratio of PaO2/FiO2 and D-Dimer levels to sST2 levels and spirometry abnormality at 6 months post COVID-19 variant Omicron."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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Muhammad Abduh
Hubungan Kadar ST2 Terlarut dengan Kelainan Spirometri Pada Penderita Penyakit Kardiovaskular Pasca COVID-19: Studi Komparasi Varian Delta dan Omicron = Association of Soluble ST2 levels and Spirometry Abnormalities in Patients with Cardiovascular Disease Post COVID-19: Comparative Study of Delta and Omicron Variants
"Latar Belakang: Pada pasien dengan penyakit jantung, gangguan pada fungsi paru dapat memperburuk kondisi jantung dengan menyebabkan terjadinya dekompensasi. Infeksi virus SARS-CoV-2 berpotensi mengakibatkan terjadinya fibrosis paru dan gangguan fungsi paru lainnya yang dapat dinilai dengan pemeriksaan spirometri dan kadar ST2 terlarut dalam darah. Infeksi COVID-19 varian Omicron mengakibatkan luaran yang relatif lebih baik dibandingkan varian Delta namun jumlah kasusnya lebih banyak dan tetap dapat mengakibatkan komplikasi tersebut. Oleh sebab itu, penelitian ini akan membandingkan kedua parameter tersebut pada pasien pasca infeksi COVID-19 varian Omicron dan Delta.
Tujuan: Mengetahui hubungan kadar ST2 terlarut dan luaran spirometri pada pasien pasca COVID-19 varian Omicron dibandingkan varian Delta pada pasien dengan penyakit kardiovaskular serta perbedaan pada kedua populasi.
Metode: Studi observasional potong lintang pada 76 pasien dengan penyakit jantung yang terinfeksi COVID-19 varian Omicron dan Delta dilakukan pemeriksaan spirometri dan kadar ST terlarut 12 minggu pasca konfirmasi negatif. Analisis statistik dilakukan untuk mengetahui hubungan antara kadar ST2 terlarut pada varian Omicron dibandingkan dengan Delta terhadap gangguan fungsi paru menggunakan spirometri dan perbedaan luaran kedua varian.
Hasil: Dari 76 subjek penelitian, proporsi pasien dengan varian Omicron lebih banyak dibandingkan Delta (53 orang berbanding 23 orang), dengan perbedaan pada proporsi pasien dengan gagal jantung, penyakit jantung koroner, penerima vaksin dan distres pernafasan akut pada admisi. Kadar ST2 terlarut (p=0.026, OR 1.01 (95% CI 1.00-1.01)) dan kondisi gagal jantung (p=0.019, OR 6.07 (95% CI 1.34-27.47)) memiliki hubungan terhadap kejadian luaran gambaran spirometri abnormal khususnya gambaran restriksi terutama pada varian Omicron, namun hubungan ini lemah dan kemaknaan klinis tidak signifikan.
Hasil studi ini mengindikasikan bahwa kadar ST2 terlarut, meskipun lemah, mungkin memiliki asosiasi terhadap kelainan spirometri pada penyintas COVID-19, namun temuan ini terbatasi oleh perbedaan pada masing-masing populasi dari studi ini.
Background: In patients with heart disease, impaired lung function can exacerbate cardiac conditions due to decompensation. Infection by the SARS-CoV-2 virus has the potential to cause pulmonary fibrosis and other lung impairment which could be assessed by spirometry and measurement of soluble ST2 levels. Omicron infection resulted in a relatively better outcome than the Delta variant but higher number of cases and it could still cause these complications. Therefore, this study aims to compare these two parameters in survivors of COVID-19 infected by Omicron and Delta variant.
Objective: To determine the relationship between soluble ST2 levels and spirometry outcomes in patients with cardiovascular disease after COVID-19 infection by Omicron variant as compared to the Delta variant and the differences in the two populations.
Methods: A cross-sectional observational study on 76 patients with heart disease who were infected by Omicron and Delta variant of COVID-19 underwent spirometry and blood sampling for soluble ST levels at the Outpatient clinic in 12 weeks after confirmed negative. Statistical analysis will be performed to find out the association between soluble ST2 levels in the Omicron variant compared to Delta and impairment of lung function using spirometry and the difference in the outcomes of the two variants.

 

Results: From 76 study subjects, the proportion of survivor of Omicron variant was higher than Delta (53 versus 23), with differences in the proportion of patients with heart failure, coronary artery disease, recipients of vaccine and acute respiratory distress syndrome on admission. Soluble ST2 levels (p=0.026, OR 1.01 (95% CI 1.00-1.01)) and heart failure (p=0.019, OR 6.07 (95% CI 1.34-27.47)) have a significant association to abnormal spirometry pattern, especially the restrictive pattern in the Omicron variant, however this relationship may be weak and the clinical implication might be insignificant.

Conclusion: The results of this study indicate that soluble ST2 levels, although weak, may have an association with spirometry abnormalities in COVID-19 survivors, but these findings may be limited by differences in each population and study design."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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