Pemberian Lipid Parenteral secara Dini dan Agresif pada Bayi Prematur: Hubungannya dengan Kejadian Sepsis
Sari
Latar belakang. Pemberian lipid parenteral secara dini dan agresif sering tidak optimal karena dikhawatirkan terjadinya sepsis. Hubungan antara pemberian lipid parenteral dengan kejadian sepsis masih kontroversial.
Tujuan. Menilai keamanan dan efikasi pemberian lipid parenteral secara dini dan agresif dalam hal hubungannya dengan kejadian sepsis pada bayi prematur melalui telaah sajian kasus berbasis bukti.
Metode. Menelusuri pustaka secara online dengan menggunakan instrumen pencari Pubmed, Cochrane, dan Highwire. Kata kunci yang digunakan adalah “lipidâ€, “fatâ€, “parenteralâ€, pretermâ€, “prematureâ€, “low birth weightâ€. Batasan yang digunakan adalah studi berupa uji klinis, telaah sistematik, atau meta analisis, berbahasa Inggris, dilakukan pada manusia, publikasi dalam 10 tahun terakhir.
Hasil. Meta-analisis oleh Vlaardingerbroek dkk menunjukkan pemberian lipid parenteral secara dini pada bayi prematur dengan BBLSR tidak meningkatkan insidens sepsis (risk ratio 0,88; IK95% 0,72-1,08; p=0,22). Meta-analisis oleh Simmer dan Rao tidak dapat dilakukan karena definisi sepsis yang tidak seragam, walaupun masing-masing penelitian tidak menunjukkan peningkatan kejadian sepsis pada kelompok yang mendapat lipid parenteral kurang dan sama dengan lima hari setelah lahir. Uji acak terkontrol oleh Ibrahim dkk dan Vlaardingerbroek dkk menunjukkan pemberian lipid parenteral 2-3 gram/kgBB/hari segera setelah lahir tidak meningkatkan kejadian sepsis yang bermakna secara statistik.
Kesimpulan. Pemberian lipid parenteral secara dini dan agresif pada bayi prematur tidak terbukti berhubungan dengan kejadian sepsis neonatorum.
Kata Kunci
Teks Lengkap:
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DOI: http://dx.doi.org/10.14238/sp18.4.2016.332-38
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