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Bacterial ventriculitis is one of the most common and serious complications of shunt placement. Shunt infection has varied management and is difficult to treat neurosurgically. We report a case of intraventricular empyema due to shunt infection. Standard management was failed for this case and reaccumulation of pus in the both ventricles. Neuroendoscopic surgery with intraventricular lavage and aspiration using cannula nasogastric tube (NGT) through a single burr hole, has successfully decreased the accumulation of intraventricular empyema. After lavage and aspiration, antibiotic can be distributed effectively to the affected area. Follow up imaging and cerebrospinal fluid (CSF) culture shown a good result and shorter length of stay in the hospital. Neuroendoscopy appears effective and safe for the management of bacterial ventriculitis due to shunt infection in infant. The strategy described in this report might be useful to treat intraventricular empyema.

Latar belakang. Terapi sinar adalah terapi utama dalam penanganan hiperbilirubinemia. Meningkatkan intensitas sinar terapi sinar dengan menambahkan kain putih sebagai pemantul dapat meningkatkan efektifitas terapi sinar dan menurunkan kadar bilirubin serum lebih cepat. Tujuan. Membandingkan efektifitas t erapi s inar t unggal d engan d an t anpa k ain p utih p ada b ayi b erat l ahir r endah d engan hiperbilirubinemia. Metode. Uji klinis acak terkontrol terbuka yang dilakukan di Rumah Sakit Cipto Mangunkusumo dari bulan September sampai November 2012. Didapat 40 bayi berat lahir rendah dengan hiperbilirubinemia. Subjek dibagi dua kelompok secara random, yaitu kelompok terapi sinar dengan kain satin putih (kelompok intervensi, n=19) dan tanpa kain satin putih (kelompok kontrol, n=21). Tujuan utama adalah membandingkan perbedaan penurunan kadar bilirubin total dan indirek setelah 6 jam terapi sinar, lama penggunaan terapi sinar, dan efek samping dari terapi sinar. Hasil. Median (rentang) penurunan kadar bilirubin serum total setelah 6 jam terapi sinar 2,51 mg/dL (-0,61;5,18) pada kelompok intervensi dan 0,85 mg/dL (-1,67;5,50) kelompok kontrol, p=0,029. Sementara penurunan kadar bilirubin serum indirek setelah 6 jam terapi sinar 2,57 mg/dL (-0,42;5,63) pada kelompok intervensi dan 0,47 mg/dL (-1,63;6,00) kelompok kontrol, p=0,004. Penilaian secara Cox proportional hazard regression menunjukkan median dari penggunaan terapi sinar kelompok intervensi, yaitu 12 jam dan 28 jam pada kelompok kontrol. (perubahan chi-square 7,542; p=0,006; hazard ratio 0,565; IK95%: 0,197-0,762). Selama penelitian, tidak ditemukan efek samping hipertermia, diare, rashes, dan burns. Kesimpulan. Penggunaan kain satin putih meningkatkan efektifitas terapi sinar pada bayi berat lahir rendah dengan hiperbilirubinemia indirek tanpa efek samping. Sari Pediatri 2016;18(3):233-9Kata kunci: bayi berat lahir rendah, kain satin putih, terapi sinar, hiperbilirubinemia Effectiveness of Single Phototherapy with and without White Satin on Low Birth Weight Infants with HyperbilirubinemiaStanislaus Djokomulyanto, Rinawati Rohsiswatmo, Aryono Hendarto Background. Hyperbilirubinemia is a condition frequently seen in low birth weight (LBW) babies. Phototeraphy is the main treatment for hyperbilirubinemia. Adding a sheet of white satin as a reflector can increase the effectiveness of phototherapy and lower serum bilirubin levels faster. Objective. To compare the effectiveness of single phototherapy with and without white satin on LBW infants with hyperbilirubinemia Methods. Randomized controlled trial was done at Cipto Mangunkusumo Hospital from September to November 2012. There were 40 LBW infants with hyperbilirubinemia during that period. Subjects were randomly divided into two groups, phototherapy with a white satin (intervention group, n = 19) and phototeraphy without white satin (control group, n = 21). The main purposes were to compare the decrease in total and indirect bilirubin levels after 6 hours of phototherapy, duration of phototherapy and side e...

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