Pengaruh Posisi Bayi Terhadap Kadar Bilirubin Pada Fototerapi Konvensional
ABSTRAK
Latar belakang: Hiperbilirubinemia merupakan suatu masalah yang paling sering
dijumpai pada bayi baru lahir. Fototerapi konvensional adalah metode yang digunakan
untuk menurunkan kadar serum bilirubin pada bayi hiperbilirubinemia. Mengubah posisi
bayi hiperbilirubinemia setiap 3 jam selama fototerapi diyakini mampu meningkatkan
efektifitas fototerapi dalam menurunkan kadar serum bilirubin lebih cepat.
Tujuan: Untuk mengetahui perbedaan penurunan kadar serum bilirubin setelah
fototerapi konvensional antara posisi yang dirubah-ubah setiap 3 jam dengan posisi
telentang.
Metode: Studi randomized controlled trial dilakukan pada bulan Juli 2012 sampai
Oktober 2012 di unit Perinatologi RS.H. Adam Malik Medan dan RS. Dr. Pirngadi Medan.
Sampel dipilih secara randomisasi sederhana dengan menggunakan amplop tertutup
yaitu neonatus hiperbilirubinemia fisiologis, usia kehamilan ≥ 32 minggu ≤ 42 minggu
yang memenuhi kriteria inklusi dan ekslusi diikut sertakan dalam penelitian. Kadar serum
bilirubin diukur pada awal fototerapi dan setelah 24 jam fototerapi. Analisis yang
digunakan adalah uji t-dependent dan uji t-independent.
Hasil: Sebanyak 76 neonatus hiperbilirubinemia fisiologis yang mengikuti penelitian
rentan usia kehamilan ≥ 32 minggu ≤ 42 minggu. Pada masing-masing kelompok
penelitian 38 neonatus hiperbilirubinemia fisiologis, dijumpai penurunan total serum
bilirubin setelah 24 jam fototerapi pada kelompok mengubah posisi setiap 3 jam (2.42%)
dengan (P=0.751) sedangkan kelompok posisi telentang (1.23%) dengan (P= 0.751)
Kesimpulan: Terjadi penurunan kadar serum bilirubin signifikan pada masing-masing
kelompok posisi telentang dengan mengubah posisi setiap 3 jam setelah 24 jam
fototerapi. Tetapi tidak terdapat perbedaan yang bermakna dalam jumlah penurunan
kadar serum bilirubin antara posisi telentang dengan mengubah posisi setiap 3 jam
selama fototerapi konvensional.
Kata kunci: hiperbilirubinemia, neonatus, fototerapi, posisi
Universitas Sumatera Utara
ABSTRACT
Background. Hyperbilirubinemia is one of the most common problems in newborn that
occur during the first day of life. Phototherapy is a conventional method of decreasing
serum bilirubin in newborn hyperbilirubinemia. Changing the position of baby with
hyperbilirubinemia every 3 hours during phototherapy can reduce serum bilirubin levels
more rapidly.
Objectives. To compare the decrease in total serum bilirubin concentration during
conventional phototherapy in infants treated in supine position exclusively versus infant
alternated between exposure in supine and prone position every three hours.
Methods. A randomized controlled trial study conducted in July 2012 to October 2012
in Perinatology unit in H. Adam Malik Hospital Medan and Dr. Pirngadi General Hospital
Medan. Sample is selected by simple randomization using the closed envelope which is
physiological neonatal hyperbilirubinemia, with gestational age between ≥ 32 weeks ≤
42 weeks who fulfill the inclusion and exclusion criteria were included in the study. Total
bilirubin serum was measured at the beginning of phototherapy before and after 24
hours. The analysis use a paired t test and independent t test.
Results. A total of 76 neonatal physiological hyperbilirubinemia with gestational age is
in range ≥ 32 weeks and ≤ 42 weeks. In each group, 38 neonatal physiological
hyperbilirubinemia of TBS level was decreased after 24 hours of phototherapy in group
position changes every 3 hours (2.42%) with (P = 0751) while the supine position
(1.23%) with (P = 0751).
Conclusion. There were no significant differences in total bilirubin reduction between
supine position with changes baby position every 3 hours while conventional
phototherapy performed.
Keywords: Hyperbilirubinemia, neonatal, phototherapy, position
Universitas Sumatera Utara
Latar belakang: Hiperbilirubinemia merupakan suatu masalah yang paling sering
dijumpai pada bayi baru lahir. Fototerapi konvensional adalah metode yang digunakan
untuk menurunkan kadar serum bilirubin pada bayi hiperbilirubinemia. Mengubah posisi
bayi hiperbilirubinemia setiap 3 jam selama fototerapi diyakini mampu meningkatkan
efektifitas fototerapi dalam menurunkan kadar serum bilirubin lebih cepat.
Tujuan: Untuk mengetahui perbedaan penurunan kadar serum bilirubin setelah
fototerapi konvensional antara posisi yang dirubah-ubah setiap 3 jam dengan posisi
telentang.
Metode: Studi randomized controlled trial dilakukan pada bulan Juli 2012 sampai
Oktober 2012 di unit Perinatologi RS.H. Adam Malik Medan dan RS. Dr. Pirngadi Medan.
Sampel dipilih secara randomisasi sederhana dengan menggunakan amplop tertutup
yaitu neonatus hiperbilirubinemia fisiologis, usia kehamilan ≥ 32 minggu ≤ 42 minggu
yang memenuhi kriteria inklusi dan ekslusi diikut sertakan dalam penelitian. Kadar serum
bilirubin diukur pada awal fototerapi dan setelah 24 jam fototerapi. Analisis yang
digunakan adalah uji t-dependent dan uji t-independent.
Hasil: Sebanyak 76 neonatus hiperbilirubinemia fisiologis yang mengikuti penelitian
rentan usia kehamilan ≥ 32 minggu ≤ 42 minggu. Pada masing-masing kelompok
penelitian 38 neonatus hiperbilirubinemia fisiologis, dijumpai penurunan total serum
bilirubin setelah 24 jam fototerapi pada kelompok mengubah posisi setiap 3 jam (2.42%)
dengan (P=0.751) sedangkan kelompok posisi telentang (1.23%) dengan (P= 0.751)
Kesimpulan: Terjadi penurunan kadar serum bilirubin signifikan pada masing-masing
kelompok posisi telentang dengan mengubah posisi setiap 3 jam setelah 24 jam
fototerapi. Tetapi tidak terdapat perbedaan yang bermakna dalam jumlah penurunan
kadar serum bilirubin antara posisi telentang dengan mengubah posisi setiap 3 jam
selama fototerapi konvensional.
Kata kunci: hiperbilirubinemia, neonatus, fototerapi, posisi
Universitas Sumatera Utara
ABSTRACT
Background. Hyperbilirubinemia is one of the most common problems in newborn that
occur during the first day of life. Phototherapy is a conventional method of decreasing
serum bilirubin in newborn hyperbilirubinemia. Changing the position of baby with
hyperbilirubinemia every 3 hours during phototherapy can reduce serum bilirubin levels
more rapidly.
Objectives. To compare the decrease in total serum bilirubin concentration during
conventional phototherapy in infants treated in supine position exclusively versus infant
alternated between exposure in supine and prone position every three hours.
Methods. A randomized controlled trial study conducted in July 2012 to October 2012
in Perinatology unit in H. Adam Malik Hospital Medan and Dr. Pirngadi General Hospital
Medan. Sample is selected by simple randomization using the closed envelope which is
physiological neonatal hyperbilirubinemia, with gestational age between ≥ 32 weeks ≤
42 weeks who fulfill the inclusion and exclusion criteria were included in the study. Total
bilirubin serum was measured at the beginning of phototherapy before and after 24
hours. The analysis use a paired t test and independent t test.
Results. A total of 76 neonatal physiological hyperbilirubinemia with gestational age is
in range ≥ 32 weeks and ≤ 42 weeks. In each group, 38 neonatal physiological
hyperbilirubinemia of TBS level was decreased after 24 hours of phototherapy in group
position changes every 3 hours (2.42%) with (P = 0751) while the supine position
(1.23%) with (P = 0751).
Conclusion. There were no significant differences in total bilirubin reduction between
supine position with changes baby position every 3 hours while conventional
phototherapy performed.
Keywords: Hyperbilirubinemia, neonatal, phototherapy, position
Universitas Sumatera Utara