Tesis

Prevalensi, durasi, faktor risiko dan komplikasi hipotermia pada resusitasi bayi baru lahir usia gestasi kurang sama dengan 32 minggu menggunakan plastik polietilen lembaran dibandingkan plastik Neohelp = Prevalence, Duration, Risk Factors and Complications of Hypothermia During Neonatal Resuscitation Using Polyethylene Plastic Sheet Compared to Neohelp on Preterm 32 Week Age of Gestational and Less.

Latar belakang: Hipotermia merupakan penyebab utama morbiditas dan mortalitas pada bayi, terutama pada bayi prematur dan atau dengan berat lahir kurang. Membungkus bayi menggunakan plastik terbukti mengurangi hipotermia. Saat ini terdapat Neohelp suatu plastik dengan desain baru yang diharapkan lebih efektif mencegah hipotermia. Tujuan: Mengetahui angka kejadian hipotermia bayi baru lahir dan waktu yang dibutuhkan untuk mencapai normotermia pada resusitasi bayi prematur menggunakan plastik polietilen lembaran dibandingkan dengan plastik Neohelp, serta mengetahui faktor risiko dan komplikasi hipotermia. Metode: Dilakukan randomized controlled trial pada 48 bayi baru lahir usia gestasi ≤ 32 minggu, pada 5 rumah sakit. Faktor lingkungan berupa suhu ruangan, kelembaban, waktu transport dari ruang bersalin ke ruang perawatan serta penggunaan 2 macam plastik untuk mencegah hipotermia, dianalisis secara bivariate menggunakan Uji Chisquare, Fisher exact, t-test dan Man-Whitney test. Hasil: Didapatkan nilai angka hampir sama antara kelompok plastik poietilen lembaran dibanding Neohelp untuk mencapai normotermi di ruang bersalin (4,5 menit vs 5 menit), serta rerata suhu tubuh ketika tiba di ruang perawatan (35,6⁰C vs 35,4⁰C). Suhu dan kelembaban ruangan, waktu tempuh dari ruang bersalin ke ruang perawatan, dan 2 jenis plastik tidak terbukti merupakan faktor risiko terjadinya hipotermia. Kesimpulan: Plastik Neohelp tidak terbukti lebih unggul dibanding polietilen lembaran dalam mencegah hipotermia. Peranan petugas kesehatan sangat besar dalam mencegah hipotermia, apapun jenis plastik yang digunakan.
Kata kunci: Prematuritas, hipotermia, faktor risiko


Background: Hypothermia is a major cause of morbidity and mortality in infants. One way to prevent hypothermia in premature babies is to wear plastic to a newborn baby. Objective: To determine the incidence of hypothermia in newborns and the time needed to achieve normothermia in premature resuscitation using polyethylene sheets compared to Neohelp plastics, and to know the risk factors and complications of hypothermia. Methods: A randomized controlled trial was carried out on 48 newborns of gestational age ≤ 32 weeks, at 5 hospitals between February-July 2019. Environmental factors include room temperature, humidity, transport time from the delivery room to the treatment room and the use of 2 kinds of plastic to prevent hypothermia, analyzed bivariately using Chi-square test, Fisher exact test, t-test and Man-Whitney test. Results: There were 48 infants of gestational age ≤ 32 weeks, 22 (46%) of them used sheet polyethylene plastic to prevent hypothermia, the rest used Neohelp plastic. The Neohelp group takes 5 minutes from birth to normotermy, while the sheet polyethylene group takes 4.5 minutes. The mean body temperature when arriving at the treatment room was 35.4 ° C in the Neohelp group and 35.6 ° C in the sheet polyethylene group. Room temperature and humidity, travel time from the delivery room to the treatment room, and 2 types of plastic do not indicate risk factors for hypothermia. Conclusion: Hypothermia when arriving in the treatment room occurred in 95.8% of subjects. There was no difference in the time to reach normotherm in the delivery room and the average temperature when arriving in the treatment room in the two plastic groups. The role of health workers is very large in preventing hypothermia, regardless of the type of plastic used.
Keywords: Prematurity, hypothermia, risk factors