Latar belakang. Amino terminal pro-brain natriuretic peptide (NT-proBNP) merupakan neurohormon jantung yang dikeluarkansebagai respon terhadap beban tekanan dan volume yang berlebihan pada gagal jantung. Secara teori, faktor yang memengaruhikadar NT-proBNP di antaranya anemia, frekuensi ISPA sering, dan diameter defek besar.Tujuan. Membuktikan bahwa anemia, frekuensi ISPA sering, dan diameter defek besar sebagai faktor yang dapat memengaruhikadar NT-proBNP pada anak dengan PJB pirau kiri ke kanan yang mengalami gagal jantung.Metode. Penelitian kasus kontrol, subjek 50 anak PJB pirau kiri ke kanan yang mengalami gagal jantung di RSUP dr. Kariadi, terdiri atas 25anak dengan kadar NT-proBNP di atas cut off point sebagai kasus dan 25 anak di bawah cut off point sebagai kontrol. Kadar NT-proBNPdianalisis dengan metode ELISA, sedangkan uji Mann-Whitney untuk perbedaan kadar NT-proBNP masing-masing kelompok.Hasil. Kelompok kasus didapatkan rentang usia 2-91 bulan (median 25 bulan), 16 (53,3%) perempuan, 21 (84%) diameter defekbesar, dan 19 (76%) malnutrisi. Pada kelompok kontrol didapatkan rentang usia 2-121 bulan (median 35 bulan), 17 (65,4%)perempuan, 13(52%) diameter defek besar, dan 14(56%) malnutrisi. Frekuensi ISPA sering dan diameter defek merupakan faktorrisiko peningkatan kadar NT-proBNP (OR=3,43; p=0,041; IK95%: 1,26-11,47) dan (OR=4,846; p=0,015; IK95%: 1,287-18,25).Anemia bukan merupakan faktor risiko (OR=1,0; p=1,00; IK95%:0,25-3,99).Kesimpulan. Frekuensi ISPA sering dan diameter defek besar merupakan faktor risiko peningkatan kadar NT-proBNP pada anakdengan PJB pirau kiri ke kanan yang mengalami gagal jantung, sedangkan anemia bukan merupakan suatu faktor risiko.

Latar belakang. Anak dengan penyakit jantung bawaan (PJB) pirau kiri ke kanan lebih mudah menderita pneumonia. Seng merupakan trace element yang berperan dalam sistem imunitas tubuh. Tujuan. Membuktikan pengaruh suplementasi seng dalam mencegah kejadian pneumonia pada anak PJB pirau kiri ke kanan. Metode. Dilakukan double blind randomized controlled trial pada anak PJB pirau kiri ke kanan usia 12-60 bulan di Poliklinik Kardiologi Anak RS dr Kariadi. Subjek penelitian dibagi 2 kelompok yang mendapat suplementasi seng 20 mg/hari dan plasebo, pemberian selama 2 minggu, selanjutnya dipantau selama 3 bulan. Data kejadian pneumonia dikumpulkan melalui wawancara saat kontrol atau melalui telepon setiap 2 minggu selama 3 bulan. Pemeriksaan antropometri dan laboratorium dilakukan sebelum dan sesudah suplementasi. Analisis statistik dilakukan dengan uji chi-square dan Mann-Whitney. Hasil. Subjek 40 anak dengan PJB pirau kiri ke kanan didapatkan kejadian pneumonia pada kelompok seng (5%) lebih rendah dibanding plasebo (30%), perbedaan ini tidak berbeda bermakna. Episode pneumonia lebih rendah pada kelompok seng 1 kali dibandingkan plasebo 1-2 kali selama 3 bulan pengamatan, tidak berbeda bermakna. Terdapat peningkatan kadar seng secara bermakna pada kelompok perlakuan dari median 57,55 menjadi 72,42 mcg/dL dibandingkan plasebo 42,40 menjadi 52,85 mcg/dL (p=0,002). Terdapat perbedaan bermakna selisih peningkatan kadar seng pada kelompok seng 20 mcg/dL dibanding plasebo 7,25 mcg/dL (p=0,004). Didapatkan manfaat suplementasi seng terhadap pencegahan pneumonia dengan relative risk reduction (RRR) 83%. Kesimpulan. Suplementasi seng menurunkan kejadian pneumonia pada anak PJB pirau kiri ke kanan. Sari Pediatri 2014;16(4):221-8.Kata kunci: penyakit jantung bawaan (PJB) pirau kiri ke kanan, suplementasi seng, kejadian pneumonia

Background Duct-dependant circulation in a baby presents as a life threatening emergency. Maintain the duct patency is crucial for patient survival before they have an cardiac surgery. We describe a case of a baby with pulmonary atresia who underwent succesful procedure of patent ductus arteriosus (PDA) stenting. Case Summary a female baby was born in peripheral hospital with birth weight of 3 kg by normal delivery, noticed to have cyanosis sixteen hours after birth. At our centre, the baby look cyanosed. Saturation by pulse oximetry was 84%. In physical examination appears, a continuous murmur was heard below clavicle at linea parasternal. Echocardiography confirmed the diagnosis of pulmonary atresia. Faint flow of PDA observed with duct size less than 1 mm. Prostaglandin E1 Infusion was start immediately at the rate of 1 µg/Kg/min. Within 6 hours of infusion the baby had an episode of apnoea. The baby then taken up for ductal stenting to keep the duct patent for few months before staged cardiac surgery. Discussion Pulmonary atresia is an critical case of congenital heart disease. The systemic or pulmonary circulation are mantained through flow in patent ductus arteriosus. Before cardiac surgical repair these patient can survive only if duct patency is reliably maintained. PDA stenting has been shown to be as an acceptable and less invasive approach to maintain ductal patency.

Background Duct-dependant circulation in a baby presents as a life threatening emergency. Maintain the duct patency is crucial for patient survival before they have an cardiac surgery. We describe a case of a baby with pulmonary atresia who underwent succesful procedure of patent ductus arteriosus (PDA) stenting. Case Summary a female baby was born in peripheral hospital with birth weight of 3 kg by normal delivery, noticed to have cyanosis sixteen hours after birth. At our centre, the baby look cyanosed. Saturation by pulse oximetry was 84%. In physical examination appears, a continuous murmur was heard below clavicle at linea parasternal. Echocardiography confirmed the diagnosis of pulmonary atresia. Faint flow of PDA observed with duct size less than 1 mm. Prostaglandin E1 Infusion was start immediately at the rate of 1 µg/Kg/min. Within 6 hours of infusion the baby had an episode of apnoea. The baby then taken up for ductal stenting to keep the duct patent for few months before staged cardiac surgery. Discussion Pulmonary atresia is an critical case of congenital heart disease. The systemic or pulmonary circulation are mantained through flow in patent ductus arteriosus. Before cardiac surgical repair these patient can survive only if duct patency is reliably maintained. PDA stenting has been shown to be as an acceptable and less invasive approach to maintain ductal patency.