Program & Abstract Book 14th Indoneisan PICU NICU Update 2023

Organized in Collaboration By
-Pediatric Emergency & Intensive Care Working Group (ERIA)/

Indonesian Pediatric Society (IDAI)
-Neonatology Working Group/Indonesian Pediatric Society (IDAI)
Supported by
Indonesian Pediatric Society - Bali Chapter (IDAI Cabang Bali)
PROGRAM & ABSTRACT BOOK
MON, 26
JU
POST-SY NE 2023
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3 JUNE 2023 WORKSH POSIUM
THURS-FRI, 22-2 OP
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PRE-SYMPOSIUM
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Support fo B a si c to en (PI n
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Adva
SAT - SUN, TUE, 27 JUNE 2023

24 - 25 JUNE 2023 POST-SYMPOSIUM
HYBRID WORKSHOP
FRI, 23 JUNE 2023 - Functional
HYBRID 14th PICU NICU Echocardiography Day 2
(NICU)
14th NICU UPDATE UPDATE (ADVANCED) - Non-Invasive Ventilation
in Critically Infants &
(BASIC) & EXHIBITION & EXHIBITION Children (PICU)
SPEAKERS ABSTRACT 1
WELCOME MESSAGE
Dear Colleagues,
Neonatal and Pediatric emergencies can present in the emergency department many life-threatening conditions,
which are not uncommon problems. Nevertheless, in all instances this populations provides a unique and
significant diagnostic and treatment challenge to the clinicians, and a systematic approach is critical to allow
for rapid diagnosis and subsequent therapy in the setting of a potentially sick neonate and infants. Neonatal
and Pediatric emergencies can be associated with high mortality and morbidity.
Bali is undoubtedly one of the most captivating places to visit. The buzzing cultural islands offer a unique blend
of rich culture and its sheer natural beauty. The strategic team of Indonesian PICU NICU Update has prepared
an exciting simultaneous three days schedule on 23 – 25 June 2023 with the theme “Building Knowledge of
Neonatal and Pediatric Emergencies to Advanced Practice” to fully load up on the latest knowledge in acute
care of pediatrics and neonatology with the expertise of leading national and international figures. The fruitful
workshops in prior setting on 22 – 23 June 2023 and post setting on 26 & 27 June 2023, related to the neonatal
and pediatric emergencies, will gear the professional healthcare an advanced clinical practice guideline.
Organized by collaboration of Pediatric Emergency and Intensive Care (ERIA) Working Group and Neonatology
Working Group/Indonesian Pediatric Society, and with the endorsement of Indonesian Pediatric Society – Bali
Chapter, the annual Indonesian PICU NICU Update has been continuously kept Its work force to share Its
leading clinical and management practice innovations in the field of pediatric and neonates critical care to its
growing followers.
The 14th Indonesian PICU NICU Update 2023 is a forum to discuss the most common conditions of the critical
ill neonate and infant in the emergency field. It gives an in-depth account of the diagnosis and management
of pediatric and neonatal emergency problems encountered day-to-day in an emergency room. In a review
of the recognition, evaluation, and treatment of the most common and potentially life-threatening neonatal
emergencies. We hope that all health professional for neonate and children in acute care settings would find
this event useful in their practice, establish the best approach, their pearls, and pitfalls, includes demonstrate
the standard treatment protocol for management of emergencies of newborn and children, differential diagnosis
based, laboratory testing, and a well guided treatment to improve survival and overall patients' outcome.
The 14th Indonesian PICU NICU Update is your opportunity to influence your specialty and promote the art
and science of pediatric and neonatal intensive care, raising awareness amongst doctors and other allied
healthcare professionals in the field. We aim to provide plenty of opportunities to interact and network with
each other.
Warmest welcoming you to the Island of Gods!
Chairman
14th Indonesian PICU NICU Update
Abdul Latief
1
TABLE OF CONTENTS
ORGANIZING COMMITTEE 2
FORMAT OF THE PROGRAM 3
GENERAL INFOMATION 4
SCIENTIFIC PROGRAM 7
INDUSTRY ACKNOWLEDGEMENT 15
SPEAKERS ABSTRACT 18
E-POSTER PRESENTER LIST 34
FREE PAPER ABSTRACT 37
SPEAKERS/MODERATORS RESUME 61
ORGANIZING COMMITTEE
Steering Committee
- Chairman of Pediatric Emergency and Intensive Care (ERIA) Working Group/Indonesian
Pediatric Society: Dr. dr. Ririe F. Malisie, Sp.A(K)
- Chairman of Neonatology Working Group/Indonesian Pediatric Society/Indonesia Pediatric
Society: dr. Roslina Roeslani, Sp.A(K)
- Chairman of Indonesian Pediatric Society – Bali Chapter: dr. I Gusti Ngurah Sanjaya Putra,
SH. Sp.A(K)
Chairman Scientific Team

dr. Abdul Latief, Sp.A(K) Prof. Dr. dr. Rinawati Rohsiswatmo, Sp.A(K)
Prof. Dr. dr. Antonius H. Pudjiadi, Sp.A(K)
Dr. dr. Ririe F. Malisie, Sp.A(K)
dr. Lily Rundjan, Sp.A(K), FRACP
2
FORMAT OF THE PROGRAM
PRE & POST SYMPOSIUM WORKSHOPS

To emphasize the importance of this essential part of its 14th Indonesian PICU-NICU Update will organize
intractable one/two full days workshops, which consist of scientific lectures, case studies and/or hands-on
special design courses, as its pre & post-symposium workshop programs.
The Pre-Symposium Workshop program will be held on Thursday – Friday, 22 – 23 June 2023, while the
Post-Symposium Workshop Program will be held on Monday – Tuesday, 26 – 27 June 2023, both offline. See
detailed schedule & requirement.
HYBRID 14TH INDONESIAN PICU NICU UPDATE

To accommodate the participants, who are unable to travel, the 14th Indonesian PICU NICU Update will be held
on hybrid method (online and offline) for both:
• 14th Indonesian NICU Update – BASIC on Friday, 23 June 2023
• 14th Indonesian PICU NICU Update – ADVANCED on Saturday – Sunday, 24 – 25 June 2023
NICU UPDATE - BASIC

Kicking off earlier on Friday, 23 June 2023, the live sessions of the Neonatal ICU (NICU Sessions - Basic) will
focus on the theme "Recognition and Preparedness for Appropriate Management of Neonatal Emergencies."
This session is designed to provide participants with essential knowledge and a solid foundation in basic
neonatology before delving into advanced topics during the subsequent sessions on 24-25 June 2023 in
the 14th Indonesian PICUNICU Update.
PICU NICU UPDATE - ADVANCED

Continuing to the main conference on 24 - 25 June 2023, the live sessions of Pediatric ICU (PICU Sessions)
and Neonatal ICU (NICU Sessions) will fully load up on the latest advanced knowledge in acute care
of pediatrics and neonatology with the expertise of leading national and international figures. The PICU
Sessions will focus on the latest developments in pediatric critical care, while the NICU Sessions will delve
into advanced topics in neonatal care. Participants can choose to attend either PICU or NICU sessions to
explore the latest advancements and best practices in both neonatal and pediatric emergency and intensive
care.
EXHIBITION
The 14th Indonesian PICU NICU Update will host an offline scientific exhibition from 23 to 25 June 2023
including the latest technology, equipment for clinical management & research and literature.
3
GENERAL INFORMATION
EVENT Hybrid 14th Indonesian PICU NICU Update

THEME “Building Knowledge of Neonatal and Pediatric Emergencies to Advanced Practice”
ORGANIZED IN COLLABORATION
-Pediatric Emergency & Intensive Care Working Group (ERIA)/Indonesian Pediatric Society (IDAI)
Supported by: Indonesian Pediatric Society - Bali Chapter (IDAI Cabang Bali)
AGENDA
PRE-SYMPOSIUM WORKSHOP
Thursday – Friday, 22 – 23 June 2023
Mechanical Ventilatory Support for Infants and Pediatric: From Basic to Advance [PICU]
SYMPOSIUM
Friday, 23 June 2023
Hybrid 14th Indonesian NICU Update Basic & Exhibition
Saturday – Sunday, 24 – 25 June 2023
Hybrid 14th Indonesian PICU NICU Update Advanced & Exhibition
POST-SYMPOSIUM WORKSHOP
Monday, 26 June 2023
Oxygen Therapy & HFNC in Critically Infants & Children [PICU]
Tuesday, 27 June 2023
Non-Invasive Ventilation in Critically Infants & Children [PICU]
Monday – Tuesday, 26 – 27 June 2023
Functional Echocardiography [NICU]
PLACE
Offline : Grand Ballroom, Grand Hyatt Bali. Kawasan Wisata Nusa Dua BTDC - Nusa Dua Bali - Indonesia
Online : https://picunicu.org/annual-conference/
SECRETARIAT ROOM
The Secretariat-Organizer operates the hospitality secretariat during the official hours and would be pleased to
help you with any related queries regarding the event as well as the helpful details about the scientific program.
The secretariat room will be available at Jepun room, Grand Hyatt Bali from Thursday – Tuesday, 22 – 27 June
2023.
DAILY PRAYER
The Praying Room is arranged at Singaraja 1-2, Grand Hyatt Bali for daily prayer and Friday Prayer from 22
– 25 June 2023.
ON DEMAND VIDEO
The live sessions of 14th Indonesian PICU NICU Update will be recorded, and the output of the recordings
(on-demand video) will available after 10 July 2023 at https://picunicu.org/annual-conference/ and can be
accessed by the registrants until 31 August 2023 to enhance the learning purpose of 14th Indonesian PICU
NICU Update.
MEETING LANGUAGE
The official language of the meeting will be Indonesian and English for International Speakers Session. It’s
applied for media and presentations.
DISCLAIMER
The Organizing Committee accepts no liability for any injuries/losses of whatever nature incurred either
by participants and/or accompanying persons, nor for loss or damage to their luggages and/or personal
belongings. Whilst every attempt will be made to ensure all features of the scientific sessions and exhibition
mentioned in this program will take place as scheduled, the Organizing Committee and Secretariat reserves
the right to make last-minute amendment.
4
RE-REGISTRATION INFORMATION
OFFLINE RE-REGISTRATION
All registrants must appear at the registration counter to complete re-registration procedures and acquire the
official participants’ wristband. The re-registration counter will be available during the following opening hours:
• Thursday, 22 June 2023 07.00 – 17.00 Tabanan Foyer
• Friday, 23 June 2023 07.00 – 17.00 Tabanan Foyer & Inside Grand Ballroom 3
• Saturday, 24 June 2023 07.00 – 17.00 Inside Grand Ballroom 3
• Sunday, 25 June 2023 07.00 – 17.00 Inside Grand Ballroom 3
• Monday, 26 June 2023 07.00 – 16.00 Tabanan Foyer & Badung Foyer
ON SITE REGISTRATION FACILITY

On-Site Registration for offline participants will be managed within the same time frame as the Re-Registration
during the above opening hours.
To facilitate on site registration, unsettled registration & accommodation payments -other than
cash-, participants can make the payment by Credit Card during 22 – 27 June 2023.
HOW TO ACCESS ONLINE SESSIONS:

1. LOGIN to https://picunicu.org/ using your registered Email and Password.
2. Go to the 14th PICUNICU 2023 page.
3. Fill in the Passcode given to online participants. The platform can only be accessed by paid Registrants.
4. Click on the Zoom® logo on the scientific timetable.
5. The live sessions will use Zoom® application to live stream the presentation of the conference. Please
download and install Zoom® application on your notebook / computer.
OFFLINE PARTICIPANTS WRISTBANDS

The 14th Indonesian PICU NICU Update Participants’ Wristband will be issued as you foreseen at the
Registration Counters. The wearing of participants wristband is a must for the offline participants to enter the
scientific meeting room, coffee/tea breaks and lunch programmed.
REGISTRATION FEE INCLUDES

• Admission to scientific sessions.
• Entrance to the Exhibition (Offline) & opening.
• E-Program & Abstract Book
• E-Certificate with IDI and IDAI Accreditation
• PDF Material (only from the speakers with consent/permission to share)
• Admission to all official coffee/tea breaks and lunch program (Offline)
E-CERTIFICATE OF ATTENDANCE
The 14th Indonesian PICU NICU Update will provide official digital Certificate of Attendance for all registrants,
with Indonesian Medical Association and Indonesian Pediatric Society Accreditation to provide the following
CME activity for medical specialists and/or general practitioners. The E-Certificate will be issued on the last
day of the Event. No printed version of the certificate will be provided.
CME ACTIVITY FOR PEDIATRIANS

Due to P2KB (CPD) of Indonesian Pediatric Society requirement, the minimum 70% attendance is strictly
required for Pediatricians (IPS Members) with the following arrangement:
- Offline participants are requested to scan the QR Code and fill in the E-Absention Form 1X a day. The QR
Code will be available inside Grand Ballroom 3.
- While attendance report for Online participants is recorded automotically from the login/logout data record
of zoom webinar.
REGISTRATION & ROOM RESERVATION NO SHOW POLICY

No show for unattending the symposium or workshops, postponed and/or delayed for the room reservation
will automatically cancel the entire registration and/or reservation on the mentioned day, and the loss of the
deposit made, and it is unrefundable.
5
SPEAKERS/MODERATOR GUIDELINES
SPEAKER SLIDE PREVIEW ROOM
The Speaker Slide Preview room for Speakers is located at Rijasa 2 Room, Grand Hyatt Bali, in conjunction
with Luncheon for Speakers/Chairpersons & Organizing Committee.
SPEAKERS SLIDE PREVIEW

• Presenters are responsible for their powerpoint check up and arrangement preparation, at least 1 hour
before the session.
• Slide Preview Counter is for speaker’s slide personal check up and arrangement only. The slides should
be handed over directly to the Operator of the Audio–Visual Desk inside the mentioned conference
room – at least 30 minutes before the session starts.
• All speakers are not allowed to print their materials in the Slide Preview Room. Printer is not provided in
Slide Preview Room.
• All speakers should collect their presentation materials from the Audio-Visual Desk immediately after
their session ends. Presentation materials are privately proprietary and cannot be distributed without the
speaker’s permission.
SPEAKERS AND CHAIRPERSON’S TIPS

1. All speakers and moderators must be familiar with the date, time, and place of their sessions. They are
expected to get inside the meeting room at least 30 minutes before the sessions commence and report
his attendance to the Audio-Visual Desk person-in-charged, which located in the mentioned function room
-next to Podium.
2. Speakers are required to complete their presentation within the time frame allocated. Moderators and
speakers are required to adhere to the time limits.
3. Moderators are in-charged for presenting each speaker in their sessions and responsibled to start and
ending each session on time.
4. Moderators may read the brief resume of the speaker before the presentation starts. Speakers CV/Resume
will be displayed on the main screen.
5. Moderators are in-charged to lead the discussion on the related session.
6
Supported by
SCIENTIFIC PROGRAM
Grand Hyatt Bali - Indonesia

PRE-SYMPOSIUM WORKSHOP Thursday - Friday, 22 - 23 June 2023
HYBRID 14th NICU (BASIC) & EXHIBITION - Friday, 23 June 2023
HYBRID 14th PICU NICU (ADVANCED) & EXHIBITION
Saturday - Sunday, 24 - 25 June 2023
POST-SYMPOSIUM WORKSHOP - Monday - Tuesday, 26 - 27 June 2023
7
SCIENTIFIC PROGRAM
PRE-SYMPOSIUM WORKSHOP – PICU SERIES

MECHANICAL VENTILATORY SUPPORT FOR INFANTS AND PEDIATRIC: FROM BASIC TO ADVANCE
Thursday – Friday, 22 - 23 June 2023 I 08.00 – 17.00 I Bangli 1-2 Rooms – Grand Hyatt Bali
PROGRAM
Course Director: Dr. dr. Ririe Fachrina Malisie, Sp.A(K)
Co-Course Director: Prof. Dr. dr. Antonius H. Pudjiadi, Sp.A(K)
DAY 1 THURSDAY, 22 JUNE 2023

BASIC MECHANICAL VENTILATION IN CRITICALLY ILL CHILDREN
Re-Registration
LECTURE
08.00 - 08.15 Introduction
08.15 - 08.45 Pre-Test dr. Niken Wahyu Puspaningtyas, Sp.A(K) (Jakarta)
08.45 - 09.15 The Physiology of Mechanical Ventilation in dr. Abdul Latief, Sp.A(K) (Jakarta)
Children: The Current Approach
09.15 - 10.00 Basic Modes of Mechanical Ventilation Satoshi Nakagawa, MD (Japan)
10.00 - 10.15 Discussion
10.15 - 10.30 Coffee/Tea Break
10.30 - 11.15 Initial Setting, Adjusting and Monitoring Dr. dr. Ririe Fachrina Malisie, Sp.A(K) (Medan)
11.15 - 11.45 The New Strategies for Weaning Prof. Dr. dr. Antonius H. Pudjiadi, Sp.A(K) (Jakarta)
12.00 - 13.00 Lunch
13.00 - 16.00 HANDS - ON
Basic Modes Satoshi Nakagawa, MD /
dr. Ni Made Rini Suari, Sp.A(K), M.Biomed
Initial Setting, Adjusting & Monitoring Dr. dr. Ririe Fachrina Malisie, Sp.A(K)
Weaning Prof. Dr. dr. Antonius H. Pudjiadi, Sp.A(K) /
dr. Niken Wahyu Puspaningtyas, Sp.A(K)
DAY 2 FRIDAY, 23 JUNE 2023

ADVANCED MODES OF MECHANICAL VENTILATION IN CRITICALLY ILL CHILDREN
LECTURE
08.00 - 08.45 Pediatric ARDS: Should We Manage by Satoshi Nakagawa, MD (Japan)
Numbers?
08.45 - 09.30 The Evidence and Indications HFOV in Satoshi Nakagawa, MD (Japan)
Critically ill Infant and Children
10.00 - 10.45 Practical Application of Lung Recruitment Prof. Dr. dr. Antonius H. Pudjiadi, Sp.A(K) (Jakarta)
and the Open Lung Concept
10.45 - 11.30 How Do We Attempt Asynchrony? Dr. dr. Ririe Fachrina Malisie, Sp.A(K) (Medan)
W
11.40 - 13.00 Friday Pray & Lunch

13.00 - 16.00 DRY WORKSHOP
Recruit the Lung with Conventional Ventilator Prof. Dr. dr. Antonius H. Pudjiadi, Sp.A(K) /
High Frequency Osscilatory Ventilation Satoshi Nakagawa, MD /
dr. Ni Made Rini Suari, Sp.A(K), M.Biomed
Asynchrony Dr. dr. Ririe Fachrina Malisie, Sp.A(K)
16.00 - 16.30 Post-Test dr. Niken Wahyu Puspaningtyas, Sp.A(K)
16.30 - 17.00 Course Wrap and Evaluation Dr. dr. Ririe Fachrina Malisie, Sp.A(K)
8 SCIENTIFIC PROGRAM
SCIENTIFIC PROGRAM
14TH INDONESIAN PICU NICU UPDATE
"Recognition and Preparedness for Appropriate Management of Neonatal

Emergencies - Basic"
GRAND BALLROOM 1 – GRAND HYATT, NUSA DUA - BALI
WITA Friday 23 June 2023, GRAND BALLROOM 1

08.00 - 08.15 Opening Remarks
BASIC NICU UPDATE
08.15 - 08.20 Moderator: dr. Rosalina Dewi Roeslani, Sp.A(K) (Jakarta)
08.20 - 08.40 Are We Ready for Neonatal Emergencies?
Dr. dr. Rocky Wilar, Sp.A(K) (Manado)
08.40 - 09.00 Neonatal Resuscitation for Very Low Birth Weight Infants
dr. Indrayady, Sp.A(K) (Palembang)
09.00 - 09.20 Strategies of Respiratory Support in Neonates: From Delivery Room to NICU
dr. Gatot Irawan Sarosa, Sp.A(K) (Semarang)
BREAK SYMPOSIUM
Supported by a grant from GSK
DTaP(3) HEXAVALENT VACCINE: VACCINATION IN INFANTS BORN PRETERM
09.55 - 10.00 Moderator: dr. Setya Wandita, Sp.A(K) (Yogyakarta)
10.00 - 10.20 Dr. dr. Toto Wisnu Hendrarto, Sp.A(K) (Jakarta)
BASIC NICU UPDATE
10.30 - 10.35 Moderator: Dr. dr. Putri Maharani Tristanita Marsubrin, Sp.A(K) (Jakarta)
10.35 - 10.55 Nutritional Emergencies in Preterm Infants: From Stabilization to Catch-up Growth
dr. Eny Yantri, Sp.A(K) (Padang)
10.55 - 11.15 Management of Neonatal Hypoglycemia and Hyperglycemia
dr. Rizalya Dewi, Sp.A(K) (Pekanbaru)
11.15 - 11.35 Hemodynamic Instability in Critically ill Neonate
dr. Alifah Anggraini, M.Sc, Sp.A(K) (Yogyakarta)
11.45 - 13.30 Lunch & Friday Prayer
LUNCH SYMPOSIUM
Supported by a grant from IDS Medical System Indonesia
EXPERIENCE HIGH VELOCITY THERAPY DELIVERY ROOM TO NICU IN EXTREME
PREMATURE INFANTS
13.35 - 13.55 Dr. Kevin Ives & Anda Bowring (United Kingdom)
BASIC NICU UPDATE
14.05 - 14.10 Moderator: Prof. Dr. dr Rinawati Rohsiswatmo, Sp.A(K) (Jakarta)
14.10 - 14.30 Application of Cerebral Function Monitoring in NICU
Supported by a grant from IDS Medical System Indonesia
dr. Lily Rundjan, Sp.A(K)., FRACP (Australia)
14.30 - 14.50 Investigation and Management of Late Onset Sepsis
Dr. dr. I Made Kardana, Sp.A(K) (Denpasar)
14.50 - 15.10 Management of Hypoxic Ischemic Encephalopathy Infants
dr. Aris Primadi, Sp.A(K) (Bandung)
Closing Remarks
SCIENTIFIC PROGRAM 9
SCIENTIFIC PROGRAM
“Building Knowledge of Neonatal and Pediatric Emergencies to Advanced Practice”
Grand Ballroom 1-2 – Grand Hyatt Nusa Dua, Bali
SATURDAY, 24 JUNE 2023

WITA GRAND BALLROOM 1 - 2
08.00 - 08.30 Opening Remarks
KEYNOTE LECTURE
08.30 - 08.35 Moderator: dr. Novik Budiwardhana, Sp.A (Jakarta)
08.35 - 09.00 Approach to a Collapsed Neonate
Roxana M. Culcer, M.D., FRACP (Australia)
09.00 - 09.25 Management of Pediatric Shock in the Post-Fluid Expansion as Supportive Therapy Trial Era
Satoshi Nakagawa, MD (Japan)
09.25 - 09.50 Clinical Management Guidelines of Pediatric Shock
A/Prof. Andreas Schibler (Australia)
WITA GRAND BALLROOM 2 WITA GRAND BALLROOM 1
"Recognition and Preparedness for Appropriate Management of Neonatal Emergencies - Advanced" "Optimizing Technologies and Research to Potentiate a More Humanistic Approach to Pediatric Critical Care"
ADVANCES IN NEONATAL CARE 1 SEPSIS AND ORGAN FAILURE
10.30 - 10.35 Moderator: Dr. dr. Tetty Yuniati, Sp.A(K), M.Kes (Bandung) 10.30 - 10.35 Moderator: dr. M. Supriyatna, Sp.A(K) (Semarang)
10.35 - 11.00 Resuscitation in High-Risk Infants: What We Can Do Better? 10.35 - 11.00 The Ethylene Glycol Poisoning in Indonesia: A Long and Winding Road Investigation
Prof. Dr. dr Rinawati Rohsiswatmo, Sp.A(K) (Jakarta) dr. Niken Wahyu Puspaningtyas, Sp.A(K) (Jakarta)
11.00 - 11.25 Endocrine Emergencies in NICU 11.00 - 11.25 Anemia in Septic Children: The Interplay of Oxidative Stress and ROS Scavenging
dr. Frida Soesanti, Sp.A(K), M.Sc (Jakarta) dr. Arina Setyaningtyas, Sp.A(K) (Surabaya)
11.25 - 11.50 Feeding Strategies in Micro Preemies to Avoid Complications 11.25 - 11.50 Prolonged Mechanical Ventilation in Children
Dr. Pranav Jani [FRACP, MD (Paeds), CCPU (Neonatal), M Clin.Epid., MBBS] (Australia)* dr. Indra Saputra, Sp.A K), M.Kes. (Palembang)
11.50 - 12.05 Discussion 11.50 - 12.05 Discussion
BREAK SYMPOSIUM BREAK SYMPOSIUM
Supported by a grant from Nestle Indonesia Supported by a grant from Takeda Indonesia
NUTRITIONAL EMERGENCY: THE IMPORTANCE OF FORTIFIED MILK IN VLBW INFANTS THE THREAT OF SEVERE DENGUE IN CHILDREN: HOW CAN WE PREVENT?
12.05 - 12.10 Moderator: dr. Rosalina Dewi Roeslani, Sp.A(K) (Jakarta) 12.05 - 12.10 Moderator: Dr. dr. Toto Wisnu Hendrarto, Sp.A(K) (Jakarta)
12.10 - 12.30 Prof. Dr. dr Rinawati Rohsiswatmo, Sp.A(K) (Jakarta) 12.10 - 12.30 Prof. DR. Dr. Ismoedijanto, DTMH, Sp.A(K) (Surabaya)
12.40 - 13.30 Lunch 12.40 - 13.30 Lunch
LUNCH SYMPOSIUM LUNCH SYMPOSIUM
Supported by a grant from Demka Sakti Supported by a grant from Indomedik Niaga Perkasa
ASSESSEMENT OF OPTIMAL LUNG RECRUITMENT TO AVOID LUNG INJURY APPROACHES TO REFRACTORY HYPOXEMIA IN CHILDREN
13.30 - 13.35 Moderator: Dr. dr. Risa Etika, Sp.A(K) (Surabaya) 13.30 - 13.35 Moderator: dr. Abdul Latief, Sp.A(K) (Jakarta)
13.35 - 14.15 Dr. dr. R. Adhi Teguh Perma Iskandar, Sp.A(K) (Jakarta)* 13.35 - 13.55 Satoshi Nakagawa, MD (Japan)
dr. Lily Rundjan, Sp.A(K)., FRACP (Australia) 13.55 - 14.15 Dr. dr. Ririe Fachrina Malisie, Sp.A(K) (Medan)
ADVANCES IN NEONATAL CARE 2 RESPIRATORY
14.25 - 14.30 Moderator: Dr. dr. Bugis Mardina Lubis,M.Ked(Ped), Sp.A(K) (Bandung) 14.25 - 14.30 Moderator: dr. Jose M. Mandei, Sp.A(K) (Manado)
14.30 - 14.55 Neonatal Gastrointestinal Emergencies 14.30 - 14.55 Management of Ventilator Asynchronies in Children
dr. Fatima Safira Alatas, Ph.D, Sp.A(K) (Jakarta) dr. Sri Martuti, Sp.A(K) (Solo)
14.55 - 15.20 Neonatal Refeeding Syndrome 14.55 - 15.20 Update of Ventilatory Strategy in Children with Critical Bronchiolitis
Dr. dr. Putri Maharani Tristanita Marsubrin, Sp.A(K) (Jakarta) A/Prof. Andreas Schibler (Australia)
Supported by a grant from Fresenius Kabi Indonesia
15.20 - 15.45 Viral Infections in Neonates: Not to Miss 15.20 - 15.45 What's New in Pediatric Ventilation Liberation
dr. Nina Dwi Putri, Sp.A(K), M.Sc(TropPaed) (Jakarta) dr. Indra Ihsan, Sp.A(K), M.Biomed (Padang)
Supported by a grant from UBC Medical Indonesia
15.45 -16.00 Discussion 15.45 -16.00 Discussion
Coffee/Tea Break Coffee/Tea Break
CLINICAL PRACTICE
DISSEMINATED CMV CLINICAL PRACTICE
COLLAPSED NEONATES PRESSURE RECORDING ANALYTICAL METHOD: FROM PHYSIOLOGY TO BEDSIDE
16.00 - 17.00 Moderator: dr. Rosalina Dewi Roeslani, Sp.A(K) (Jakarta) 16.00 - 17.00 Moderator: dr. Yogi Prawira, Sp.A(K) (Jakarta)
Prof. Dr. dr Rinawati Rohsiswatmo, Sp.A(K) (Jakarta) Case Presenter: dr. Neurinda P. Kusumastuti, Sp.A(K) (Surabaya)
dr. Lily Rundjan, Sp.A(K)., FRACP (Australia) Panelists:
Prof. Dr. dr. Antonius H. Pudjiadi, Sp.A(K) (Jakarta)
Satoshi Nakagawa, MD (Japan)
10
SCIENTIFIC PROGRAM
“Building Knowledge of Neonatal and Pediatric Emergencies to Advanced Practice”

Grand Ballroom 1-2 – Grand Hyatt Nusa Dua, Bali
SUNDAY, 25 JUNE 2023

WITA GRAND BALLROOM 2 WITA GRAND BALLROOM 1
"Recognition and Preparedness for Appropriate Management of Neonatal Emergencies - "Optimizing Technologies and Research to Potentiate a More Humanistic Approach to Pediatric

Advanced" Critical Care"
ADVANCED NEONATAL PRACTICE 1 MEDICAL ETHIC
08.30 - 08.35 Moderator: Dr. dr. Johanes Edy Siswanto, Sp.A(K) (Jakarta) 08.30 - 08.35 Moderator: Prof. dr. Chairul Yoel, Sp.A(K) (Medan)
08.35 - 09.00 Neonatal Care of Extreme Preterm Infants: Experiences in Japan 08.35 - 08.55 Improving The Quality of End-of-Life Care in The Pediatric Intensive Care Unit
Dr. Arata Oda (Japan) Dr. dr. Nurnaningsih, Sp.A(K) (Yogyakarta)
09.00 - 09.25 Detection of Inborn Error of Metabolism in Neonates ADVANCED CRITICAL CARE PRACTICE
Prof. Dr. dr. Damayanti Rusli Sjarif, Sp.A(K) (Jakarta) 08.55 - 09.00 Moderator: Dr. dr. Ririe Fachrina Malisie, Sp.A(K) (Medan)
09.25 - 09.50 When We Suspect Critical Congenital Heart Disease? 09.00 - 09.25 Update of Pain and Sedation in Critically Infants and Children
Alex Gooi, FRACP, FCSANZ, MBBS, BSc (Med) (Australia) Dr. dr. Bastian Lubis, M.Ked(An), Sp.An-KIC (Medan)
09.25 - 09.50 ECMO Simulation Training during a Worldwide Pandemic: The Role of ECMO Telesimulation
Dr. dr. Eva Miranda Marwali, Sp.A(K) (Jakarta)
10.05 - 10.20 Coffee/Tea Break 10.05 - 10.20 Coffee/Tea Break
10.20 - 10.55 BREAK SYMPOSIUM 10.20 - 11.50 YOUNG INVESTIGATOR
Supported by a grant from AMPM Moderator: dr. Silvia Triratna, Sp.A(K) (Palembang)
DIAGNOSIS OF HYPOXIC ISCHEMIC ENCEPHALOPATHY INFANTS: NOT TO MISS
10.25 - 10.45 dr. Lily Rundjan, Sp.A(K)., FRACP (Australia) 10.20 - 10.45 Using Pediatric Quality of Life Inventory TM (PedsQLTM) Scoring System in Children with Hypoxia
after Hospitalized in The Emergency Room
dr. Julianti, Sp.A, M.Kes (Aceh)
10.45 - 10.55 Discussion 10.45 - 11.10 Vitamin D and Syndecan-1 Angiopoietin 2 as Indicators of Glycocalyx Degradation in Pediatric
Sepsis
dr. Stanza Uga Peryoga, Sp.A(K), M.Kes (Bandung)
10.55 - 11.30 LUNCH SYMPOSIUM 11.10 - 11.35 The Comparison of Renal Angina Index and Urine Microscopic Score to KDIGO Criteria as Acute
Supported by a grant from Pfizer Indonesia Kidney Injury Predictor in Critically Ill Children
PNEUMOCOCCAL VACCINE IS RECOMMENDED FOR PRETERM INFANTS dr. Nathanne Septhiandi, Sp.A(K) (Jakarta)
10.55 - 11.00 Moderator: Dr. dr. I Made Kardana, Sp.A(K) (Denpasar) 11.35 - 11.50 Effectiveness of Implementation of Plan-Do-Study-Act (PDSA) Method Bundle of CLABSI in Pediatric
Patients with Central Venous Catheter Installation
11.00 - 11.20 dr. Made Sukmawati, Sp.A(K) (Denpasar) dr. Dwi Putri Lestari, Sp.A(K) (Surabaya)
11.30 - 13.00 Lunch 12.00 - 13.00 Lunch
ADVANCED NEONATAL PRACTICE 2 HEMODYNAMIC
13.00 - 13.05 Moderator: dr. Setya Dewi Lusyati, Sp.A(K), Ph.D (Jakarta) 13.00 - 13.05 Moderator: Prof. Dr. dr. Munar Lubis, Sp.A(K) (Medan)
13.05 - 13.30 Application of Neurally Adjusted Ventilatory Assist (NAVA) in Neonates 13.05 - 13.30 Hemodynamic Profile of Dengue Shock Syndrome in Sanglah Hospital
Dr. Arata Oda (Japan) dr. Ida Bagus Gede Suparyatha, Sp.A(K) (Denpasar)
Supported by a grant from Indosopha Sakti
13.30 - 13.55 Management of Chronic Lung Disease 13.30 - 13.55 Understanding Lactate in Sepsis
dr. Lily Rundjan, Sp.A(K)., FRACP (Australia) Dr. dr. Irene Yuniar, Sp.A(K) (Jakarta)
13.55 - 14.20 Congenital Anomaly of Kidney & Urinary Tract in Newborn Infants 13.55 - 14.20 Microcirculation and The Vulnerable Pediatric Patient
dr. Henny Adriani Puspitasari, Sp.A(K) (Jakarta) dr. Neurinda Permata Kusumastuti, Sp.A(K) (Surabaya)
14.35 - 15.35 PANEL DISCUSSION 14.35 - 15.35 PANEL DISCUSSION
MANAGEMENT OF CHRONIC LUNG DISEASE THE DEFINITIONS OF SEPSIS & SEPTIC SHOCK FOR CHILDREN
Moderator: Prof. Dr. dr. Rinawati Rohsiswatmo, Sp.A(K) (Jakarta) Moderator: Prof. Dr. dr. Antonius H. Pudjiadi, Sp.A(K) (Jakarta)
dr. Lily Rundjan, Sp.A(K)., FRACP (Australia) Satoshi Nakagawa, MD (Japan)
Dr. Arata Oda (Japan) A/Prof. Andreas Schibler (Australia)
Dr. dr. Ririe Fachrina Malisie, Sp.A(K) (Medan)
dr. Mulya Rahma Karyanti, M.Sc., Sp.A(K) (Jakarta)
15.35 - 15.45 Closing Remark 15.35 - 15.45 Closing Remark
11
SCIENTIFIC PROGRAM
POST-SYMPOSIUM WORKSHOP – NICU SERIES

FUNCTIONAL ECHOCARDIOGRAPHY WORKSHOP
Monday - Tuesday, 26 -27 June 2023 I 08.30 – 12.00 I Karangasem 1 Room, Grand Hyatt Bali
PROGRAM
DAY 1 MONDAY, 26 JUNE 2023
08.30 - 09.00 Re-Registration
LECTURE
09.00 - 09.10 Introduction dr. Lily Rundjan, Sp.A(K)., FRACP (Australia)
09.10 - 09.30 Point of Care Ultrasound in Neonates Dr. Nicholas Evans, MRCP(UK), DM, CCPU
(Australia)
09.30 - 09.50 Knobology and Optimisation of Views Roxana M. Culcer, M.D., FRACP (Australia)
09.50 - 10.20 Standard ECHO Views Roxana M. Culcer, M.D., FRACP (Australia)
10.30 - 11.00 PDA Assessment Using Dr. Nicholas Evans, MRCP(UK), DM, CCPU
Echocardiography (Australia)
11.00 - 11.30 Approach CHD by Echocardiography Alex Gooi, FRACP, FCSANZ, MBBS, BSc (Med)
(Australia)
11.30 - 12.00 Lunch
DAY 2 TUESDAY, 27 JUNE 2023

LECTURE
09.00 - 09.30 Assessment of PPHN and Chronic Lung Dr. Nicholas Evans, MRCP(UK), DM, CCPU
Disease with Echocardiography (Australia)
09.30 - 10.00 ECHO Assessment of Common CHD Alex Gooi, FRACP, FCSANZ, MBBS, BSc (Med)
(Australia)
10.15 - 10.45 Hypotensive Infant and Functional Dr. Nicholas Evans, MRCP(UK), DM, CCPU
Assessment (Australia)
10.45 - 11.15 ECHO Assessment of Complex CHD Alex Gooi, FRACP, FCSANZ, MBBS, BSc (Med)
(Australia)
11.15 - 12.00 Case Studies Roxana M. Culcer, M.D., FRACP (Australia)
Dr. Nicholas Evans, MRCP(UK), DM, CCPU
(Australia)
Alex Gooi, FRACP, FCSANZ, MBBS, BSc (Med)
(Australia)
12.00 - 12.30 Lunch
Facilitators Team:
Roxana M. Culcer, M.D., FRACP (Australia)
Dr. Nicholas Evans, MRCP(UK), DM, CCPU (Australia)
Alex Gooi, FRACP, FCSANZ, MBBS, BSc (Med) (Australia)
dr. Lily Rundjan, Sp.A(K)., FRACP (Australia)
dr. Ahmad Kautsar, Sp.A (Jakarta)
12
SCIENTIFIC PROGRAM
POST-SYMPOSIUM WORKSHOP – PICU SERIES

OXYGEN THERAPY & HIGH FLOW NASAL CANNULA IN CRITICALLY INFANTS & CHILDREN
Monday, 26 June 2023 I 08.00 – 16.40 I Bangli 1-2 Rooms – Grand Hyatt Bali
PROGRAM
Course Director: Dr. dr. Irene Yuniar, Sp.A(K)
Co-Course Director: dr. Abdul Latief, Sp.A(K)
ONE DAY MONDAY, 26 JUNE 2023

08.00 - 08.10 Introduction
08.10 - 08.30 Pre-Test
LECTURE
08.30 - 08.50 1. Oxygenation and Ventilation in Pediatric A/Prof. Andreas Schibler (Australia)
Patients
08.50 - 09.10 2. Basic Principles of Oxygen Therapy dr. Abdul Latief, Sp.A(K) (Jakarta)
09.10 - 09.30 3. Oxygen Therapy: Device Dr. dr. Irene Yuniar, Sp.A(K) (Jakarta)
LECTURE
10.30 - 10.50 1. HFNC in Respiratory Failure A/Prof. Andreas Schibler (Australia)
10.50 - 11.20 2. Initial Setting on HFNC Dr. dr. Ririe Fachrina Malisie, Sp.A(K) (Medan)
11.20 - 11.40 3. Monitoring HFNC Dr. dr. Irene Yuniar, Sp.A(K) (Jakarta)
12.10 - 13.00 Lunch
SKILL STATION
13.00 - 14.00 1. Case Discussion: Oxygen Fraction, SF A/Prof. Andreas Schibler / Dr. dr. Ririe Fachrina
Ratio and ROX Index Malisie, Sp.A(K)
Coffee/Tea Break
14.00 - 15.00 2. Initial Setting on HFNC and Monitoring Dr. dr. Irene Yuniar, Sp.A(K)
15.00 - 16.00 3. Device Introduction and Setting (Hands- dr. Abdul Latief, Sp.A(K) / dr. Sri Martuti, Sp.A(K)
On)
16.00 - 16.20 Post Test
16.20 - 16.40 Evaluation & Closing dr. Abdul Latief, Sp.A(K) & Dr. dr. Irene Yuniar,
Sp.A(K)
13
SCIENTIFIC PROGRAM
POST-SYMPOSIUM WORKSHOP – PICU SERIES

NON-INVASIVE VENTILATION IN CRITICALLY INFANTS & CHILDREN
Tuesday, 27 June 2023 I 08.00 – 16.30 I Bangli 1-2 Rooms – Grand Hyatt Bali
PROGRAM
Course Director: Dr. dr. Ririe Fachrina Malisie, Sp.A(K)
ONE DAY TUESDAY, 27 JUNE 2023

08.00 - 08.10 Introduction Dr. dr. Ririe Fachrina Malisie, Sp.A(K) (Medan)
08.10 - 08.30 Pre-Test dr. Sri Martuti, Sp.A(K) (Solo)
LECTURE
08.30 - 08.50 1. Overview NIV in Children Dr. dr. Ririe Fachrina Malisie, Sp.A(K) (Medan)
08.50 - 09.10 2. Basic Principle of NIV in Children Dr. dr. Irene Yuniar, Sp.A(K) (Jakarta)
09.10 - 09.30 3. NIV: Indication and Contra-Indication dr. Sri Martuti, Sp.A(K) (Solo)
LECTURE
10.30 - 10.50 1. NIV: Equipment in Children Dr. dr. Irene Yuniar, Sp.A(K) (Jakarta)
10.50 - 11.20 2. NIV: Method Support dr. Sri Martuti, Sp.A(K) (Solo)
11.20 - 11.40 3. Monitoring and Analysis of Failure Dr. dr. Ririe Fachrina Malisie, Sp.A(K) (Medan)
12.00 - 13.00 Lunch
SKILL STATION
13.00 - 14.00 Group A
Hands-On CPAP and BiPAP Dr. dr. Ririe Fachrina Malisie, Sp.A(K) (Medan)
Coffee/Tea Break
14.00 - 15.00 Group B
Hands-On Interface and Breathing Circuit dr. Sri Martuti, Sp.A(K) (Solo)
15.00 - 16.00 Group C
Hands-On ICEMAN and Weaning Dr. dr. Irene Yuniar, Sp.A(K) (Jakarta)
16.00 - 16.30 Evaluation & Closing dr. Abdul Latief, Sp.A(K) & Dr. dr. Ririe
Fachrina Malisie, Sp.A(K)
14
INDUSTRY ACKNOWLEDGEMENT
Pediatric Emergency & Intensive Care Working Group (ERIA)/Indonesian Pediatric Society (IDAI) and
Neonatology Working Group/Indonesian Pediatric Society (IDAI) would like to wholeheartedly thank the
following patrons, who are entitled to be recognized as sponsors and exhibitors:
15
EDUCATION SESSION
FRIDAY, 23 JUNE 2023
GLAXO WELLCOME INDONESIA "GSK"
SESSION: BREAK SYMPOSIUM
[09.55 - 10.30] DTaP (3) HEXAVALENT VACCINE: VACCINATION IN INFANTS BORN PRETERM
Toto Wisnu Hendrarto (Jakarta/Indonesia)
IDS MEDICAL SYSTEM INDONESIA

SESSION: LUNCH SYMPOSIUM
[13.35 - 14.05] EXPERIENCE HIGH VELOCITY THERAPY DELIVERY ROOM TO NICU IN EXTREME
PREMATURE INFANTS
Kevin Ives & Anda Bowring (United Kingdom)
SESSION: BASIC NICU UPDATE

[14.10 - 14.30] APPLICATION OF CEREBRAL FUNCTION MONITORING IN NICU
Lily Rundjan (Australia)
SATURDAY, 24 JUNE 2023

NICU SESSION
NESTLE INDONESIA
[12.05 - 12.40] NUTRITIONAL EMERGENCY: THE IMPORTANCE OF FORTIFIED MILK IN VLBW
INFANTS
Rinawati Rohsiswatmo (Jakarta/Indonesia)
DEMKA SAKTI
[13.30 - 14.25] ASSESSEMENT OF OPTIMAL LUNG RECRUITMENT TO AVOID LUNG INJURY
Adhi Teguh Perma Iskandar (Jakarta/Indonesia) & Lily Rundjan (Australia)
FRESENIUS KABI INDONESIA

SESSION: ADVANCES IN NEONATAL CARE 2
[14.55 - 15.20] NEONATAL REFEEDING SYNDROME
Putri Maharani Tristanita Marsubrin (Jakarta/Indonesia)
UBC MEDICAL INDONESIA

SESSION: ADVANCES IN NEONATAL CARE 2
[15.20 - 15.45] VIRAL INFECTIONS IN NEONATES: NOT TO MISS
Nina Dwi Putri (Jakarta/Indonesia)
PICU SESSION
TAKEDA INDONESIA
[12.05 - 12.40] THE THREAT OF SEVERE DENGUE IN CHILDREN: HOW CAN WE PREVENT?
Ismoedijanto (Surabaya/Indonesia)
INDOMEDIK NIAGA PERKASA

[13.30 - 14.25] APPROACHES TO REFRACTORY HYPOXEMIA IN CHILDREN
Satoshi Nakagawa (Japan) & Ririe F. Malisie (Medan/Indonesia)
16
SUNDAY, 25 JUNE 2023
NICU SERIES
AMPM Healthcare Indonesia
[10.20 – 10.55] DIAGNOSIS OF HYPOXIC ISCHEMIC ENCEPHALOPATHY INFANTS: NOT TO MISS
Lily Rundjan (Australia)
PFIZER INDONESIA
[10.55 – 11.30] PNEUMOCOCCAL VACCINE IS RECOMMENDED FOR PRETERM INFANTS
Made Sukmawati (Denpasar/Indonesia)
INDOSOPHA SAKTI
SESSION: ADVANCED NEONATAL PRACTICE 2
[13.05 – 13.30] APPLICATION OF NEURALLY ADJUSTED VENTILATORY ASSIST (NAVA) IN NEONATES
Arata Oda (Japan)
17
Supported by
SPEAKERS ABSTRACT

18
ARE WE READY FOR NEONATAL EMERGENCIES?
Rocky Wilar
RSUP Prof. Dr. R.D. Kandou, Manado
Background
Neonatal mortality remains a public health problem in Southeast Asia, especially in Indonesia. Preparedness of
health care providers and effective emergency management of neonatal emergencies is very important to prevent
and reduce high mortality rates.
Discussion
Emergency preparedness in health facilities depends on five factors, namely 1) being able to carry out risk
assessments and the need for emergency conditions 2) establishing written policies 3) selecting appropriate
equipment and supplies 4) adequate staff education 5) maintaining a state of health facility preparedness to handle
emergency state. The knowledge and practice of the healthcare experts, in combination with preparedness of
health facilities for emergency neonatal resuscitation, are still not optimal, especially in developing countries. All
departments related to neonatal emergencies must be prepared in the management of critically ill neonates, which
includes the alertness of the neonatal emergency team, appropriate resuscitation equipment, and drugs in the
emergency trolley. Provision of a professional emergency team with special knowledge and expertise related
to neonatal emergencies is urgently needed. Simulation-based neonatal emergency team training in neonatal
resuscitation has been conducted and shown to improve team performance and technical performance in an
evaluation conducted 3 to 6 months later. The recording on emergency trolley including essential emergency
medicines checklists is important to do regularly. Essential neonatal emergency kits should also be available and
of the appropriate size for the neonate.
Conclusion
Routine training simulations in neonatal emergencies among the neonatal resuscitation team, provision of adequate
health professionals, appropriate resuscitation equipment, and medications available on emergency trolleys will
enhance the preparedness of healthcare providers for neonatal emergencies.
Keywords: Neonatal Emergency, Neonatal Emergency Preparedness, Neonatal Emergency Team, Emergency
Medicine and Equipment
References
1. Kebede AA, Taye BT, Wondie KY, Tiguh AE, Eriku GA, Mihret MS. Preparedness for neonatal emergencies
at birth and associated factors among healthcare providers working at hospitals in northwest Ethiopia: A
multi-center cross-sectional study. Heliyon. 2021 Dec 20;7(12):e08641.
2. Walker D, Cohen S, Fritz J, Olvera M, Lamadrid-Figueroa H, Cowan JG, Hernandez DG, Dettinger JC,
Fahey JO. Team training in obstetric and neonatal emergencies using highly realistic simulation in Mexico:
impact on process indicators. BMC Pregnancy Childbirth. 2014 Nov 20;14:367.
3. Perez AM, Martinez MS, Corrales AY. A Practical Approach to Emergencies in the Neonatal Period. J
Neonatal Period Biol.2016;5:1.
4. Sommer L, Dangl MH, Schrehof KK, Berger AB, Schwindt E. A Novel Approach for More Effective Emergency
Equipment Storage: The Task-Based Package-Organized Neonatal Emergency Backpack. Front. Pediatr.
2021;9:771396.
5. Lindhard MS, Thim S, Laursen HS, Schram AW, Paltved C, Henriksen TB. Simulation-Based Neonatal
Resuscitation Team Training: A Systematic Review. Pediatrics. 2021 Apr;147(4):e2020042010.
6. Calzada R, Corrales AY, Martinez MS. Management of Common Newborn Emergencies. Glob J of Ped &
Neonatol Car. 2020; 2(3).
7. Barfield WD, Krug SE; COMMITTEE ON FETUS AND NEWBORN; DISASTER PREPAREDNESS ADVISORY
COUNCIL. Disaster Preparedness in Neonatal Intensive Care Units. Pediatrics. 2017 May;139(5):e20170507.
8. Usman F, Tsiga-Ahmed FI, Abdulsalam M, Farouk ZL, Jibir BW, Aliyu MH. Facility and care provider emergency
preparedness for neonatal resuscitation in Kano, Nigeria. PLoS One. 2022 Jan 7;17(1):e0262446.
9. Kabbani N, Kabbani MS, Al Taweel H. Cardiac emergencies in neonates and young infants. Avicenna J Med.
2017 Jan-Mar;7(1):1-6.
10. Cavicchiolo ME, Trevisanuto D, Lolli E, Mardegan V, Saieva AM, Franchin E, Plebani M, Donato D, Baraldi
E. Universal screening of high-risk neonates, parents, and staff at a neonatal intensive care unit during the
SARS-CoV-2 pandemic. Eur J Pediatr. 2020 Dec;179(12):1949-1955.
NEONATAL RESUSCITATION FOR VERY LOW BIRTH WEIGHT INFANTS
Indrayady
Department of Child Health, Faculty of Medicine Sriwijaya University-Mohammad Hoesin Hospital, Palembang
Abstract
Most newborn make the transition from intrauterine to extrauterine life without difficulty. About 10% need some
assistance, and fewer than 1% require cardiac compression or medication in the delivery room. However, among
very low birth weight (VLBW) infants, approximately 90% need some kind of resuscitation and 4–10% require
cardiac compression or medication.
Despite the improvement in survival and outcomes of VLBW infants (birth weight less than 1,500 g), survivors
are at high risk of neonatal mortality, short-term and long-term morbidities that result in life-long health problems.
The survival of VLBW infants is dependent on professional perinatal management that begins at delivery. For
successful delivery room management, various aspects of the postnatal adaption process need to be considered
such as the support of the thermal adaptation, airway management, breathing, circulation and metabolism for this
vulnerable population.
Resuscitation guidelines are based on the International Liaison Committee on Resuscitation (ILCOR) 2020
Consensus on Science and Treatment Recommendations (CoSTR) for Neonatal Life Support. This guideline
provides special considerations resuscitation of premature infants more specifically in VLBW infants. These special
considerations include the initial steps (provide warmth and dry), oxygen management and assisted ventilation.
According to updated guidelines, changes in resuscitation significantly associated with reducing mortality and
morbidities. The improvement of delivery room care may affect neonatal outcome, especially in very-low-birth-
weight infants.
__________________________________________________________________________________________
STRATEGIES OF RESPIRATORY SUPPORT IN NEONATES:

FROM DELIVERY ROOM TO NICU
Gatot Irawan Sarosa
RSUP Dr. Kariadi, Semarang
Respiratory distress is commonly brings infants to the intensive care nursery. The etiology of premature lung
dysfunction includes pulmonary parenchymal problems such as respiratory distress syndrome, pneumonia,
aspiration syndromes, and lung hypoplasia, among others. These problems generally result in diminished lung
compliance (stiff lungs) and a loss of functional residual capacity (FRC) equating to low lung volume and atelectasis.
Respiratory distress is a common problem seen in neonates, both preterm and full term. Appropriate use
of respiratory support can be life-saving in these neonates. While invasive ventilation is unavoidable in some
situations, noninvasive ventilation may be sufficient in several neonates.
In this article, the authors have summarized the best practices to deliver effective respiratory support, especially
noninvasive ventilation support in neonates.
Noninvasive respiratory is the standard respiratory support for preterm and term infants. Type of NIV used is based
on the severity of respiratory distress, risk of treatment failure, gestational age, and timing of application. HFNC,
CPAP, NIPPV (synchronized or nonsynchronized) are the most
commonly used NIV in the newborn. BiPAP, Nasal HFOV and NAVA are infrequently used and need further
evaluation before routine application. Early initiation, adequate and aggressive use of surfactant/caffeine, optimum
warmidification, appropriate nasal interface, and nursing care are crucial in the success of NIV. Optimise baseline
oxygen saturation utilising appropriate invasive or noninvasive respiratory support is important. Despite multiple
studies, the ideal oxygen saturation target range for preterm infants, both at birth and in the NICU, which would
allow maximal survival and minimise the risk of neurosensory impairment continues to be elusive. However, efforts
should be made to decrease exposure at the extremes of oxygenation in this vulnerable population.
20 SPEAKERS ABSTRACT
NUTRITIONAL EMERGENCIES IN PRETERM INFANTS:
FROM STABILIZATION TO CATCH-UP GROWTH
Eny Yantri
Neonatology Division of Dr. M Djamil Hospital Padang

Faculty of Medicine, Andalas University
The aim of providing nutrition to premature infants is to meet the growth rate of a healthy fetus at the same
gestational age and to produce a body composition similar to that of a healthy fetus in terms of organ growth, tissue
components, and cell number and structure. The quantity and quality of nutrients are very important for the normal
growth and development of preterm infants. Failure to provide the required amounts of all essential nutrients has
resulted in not only growth failure, but also increased susceptibility to infectious diseases arising from suboptimal
immune defenses, increased respiratory distress from lung injury due to muscle weakness, impaired tissue repair,
and general retardation all other organs.
Providing nutrition to premature babies is a challenge because their nutritional needs are higher than
those of full-term babies. When a baby is born prematurely, the nutritional needs previously obtained from the
mother must be met from the outside, either parenterally or enterally.
Nutrition in the premature infant consists of an acute phase, to prevent catabolism, and to avoid extra
uterine growth retardation by starting parenteral nutrition soon after birth. Then start enteral nutrition as soon as
possible if hemodynamically stable within 24 hours, but maternal colostrum should be given within the first hour
or two after birth, with a buccal swab to help establish the oral and gastrointestinal microflora in the infant. In the
catch-up growth phase, it is achieving growth that is in accordance with the fetus at the same gestational age.
Breast milk or mother-expressed breast milk (MEBM) remains the gold standard and the first choice of milk for all
babies, including premature babies. Fortification of breast milk with breast milk boosters is recommended in this
phase. The post- discharge phase is able to go through catch-up growth well and is stable at its potential.
__________________________________________________________________________________________
MANAGEMENT OF NEONATAL HYPOGLYCEMIA AND HYPERGLYCEMIA
Rizalya Dewi
Neonatal working group – Budhi Mulia Women and Children Hospital
Neonatal hypoglycemia and hyperglycemia are common metabolic disturbances in the early postnatal period
that require prompt and appropriate management to prevent adverse outcomes. This abstract provides a concise
overview of the current approaches and strategies for managing neonatal hypoglycemia and hyperglycemia.
Neonatal hypoglycemia, defined as a blood glucose level below the normal range for age, is a significant concern
due to its potential for neurologic injury. The primary goal in managing neonatal hypoglycemia is to maintain
euglycemia to ensure optimal brain development and function. Management strategies typically involve early
identification through targeted screening in high-risk infants, such as those born preterm, large-for-gestational-age,
or with perinatal stressors. The first-line intervention is prompt feeding, either through breastfeeding or formula,
with subsequent blood glucose monitoring to evaluate treatment efficacy. If the blood glucose level remains below
the target range, intravenous glucose infusion is initiated to rapidly correct hypoglycemia. Close monitoring and
regular follow-up are crucial to prevent recurrence.
Neonatal hyperglycemia, characterized by elevated blood glucose levels, can result from various factors such
as stress, prematurity, sepsis, or maternal diabetes. The management of neonatal hyperglycemia focuses on
identifying and addressing the underlying cause while maintaining glucose homeostasis. Non-pharmacological
measures such as optimizing nutrition, reducing stress, and minimizing iatrogenic factors are important initial steps.
If hyperglycemia persists despite these measures, pharmacological interventions such as insulin may be required.
Careful monitoring of blood glucose levels, electrolyte imbalances, and potential complications is essential during
treatment.
In conclusion, the management of neonatal hypoglycemia and hyperglycemia requires a multidisciplinary approach
involving neonatologists, pediatric endocrinologists, and nursing staff. Early identification, prompt intervention, and
close monitoring are vital to prevent adverse outcomes associated with these metabolic disturbances. Ongoing
research and advancements in diagnostic tools and treatment modalities are crucial to further improve the
management strategies for neonates with hypoglycemia and hyperglycemia, ensuring optimal long-term outcomes.
__________________________________________________________________________________________
MANAGEMENT OF HYPOXIC ISCHEMIC ENCEPHALOPATHY INFANTS
Aris Primadi
RSUP Dr. Hasan Sadikin, Bandung
There is significant heterogeneity in hypoxic ischemic encephalopathy (HIE) management. Optimal care may
require tailoring treatments according to gender, genetic risk, injury severity and inflammatory status. Following
initial resuscitation and stabilization, therapeutic hypothermia (TH) is a recommended regimen for newborn
infants who are at or near term with evolving moderate-to-severe HIE. There are recommendations regarding
TH including: (1) selection criteria for TH; (2) choices of method and equipment for TH; (3) TH prior to and during
transport; (4) methods for temperature maintenance, monitoring, and rewarming; (5) systemic care of patients
during TH, including the care of respiratory and cardiovascular systems, management of fluids, electrolytes, and
nutrition, as well as sedation and drug metabolism; (6) monitoring and management of seizures; (7) neuroimaging,
prognostic factors, and outcomes; and (8) adjuvant therapy for TH. Supportive management is also critical to
prevent additional injury from seizure activity, poor perfusion, electrolyte imbalance, and abnormal glycemic control.
Efforts are focusing on finding adjuvant therapies for HIE and understanding the pathophysiology of HIE is the first,
indispensable, step to better clarify the mechanism underlying it. Pathophysiology of HIE involves several different
events, strictly linked one to the others. Mitochondrial dysfunction, excitotoxicity, calcium surge, reactive oxygen
species accumulation, and inflammation are the five main events caused by severe anoxic brain injury. Starting
from them, a variety of complex pathways begins. Some gaps in our knowledge concerning the pathophysiology
and the timing of important endogenous neuroprotective and neurodegenerative mechanisms still exist. Although
there have been significant steps in the basic sciences to create novel neuroprotective and intervention strategies
to combat HIE, there is still much more research needed to be conducted to translate potential life-saving and brain
damage-limiting therapies.
__________________________________________________________________________________________
INVESTIGATION AND MANAGEMENT OF LATE ONSET SEPSIS IN NEONATE
I Made Kardana
Department of Child Health, Medical Faculty of Udayana University /Prof. Ngoerah Hospital Denpasar
Neonatal sepsis contributes substantially to neonatal morbidity and mortality, and is an ongoing major global public
health challenge. According to the onset of age, neonatal sepsis is divided into early-onset sepsis (EOS) and
late-onset sepsis (LOS). The onset of LOS is most frequently defined at 72 hour after birth. Late-onset sepsis is
associated with the postnatal nosocomial or community environment. The incidence of LOS is inversely associated
with birth weight or gestational age. Apart from immaturity, other well-recorded risk factors for LOS included the
long-term use of invasive interventions, such as mechanical ventilation and intravascular catheterization, the failure
of early enteral feeding with breast milk, a prolonged duration of parenteral nutrition, hospitalization, surgery and
underlying respiratory and cardiovascular diseases. Besides the classic risk factors for LOS, neonates requiring
intensive care in developing countries are at risk due to structural factors such as overcrowding, shortages of
nursing and medical staff, lack or improper use of basic supplies and equipment, excessive use of antibiotics,
insufficient knowledge and difficulties in the implementation of infection control practices.
Clinical signs of neonatal LOS are generally regarded as nonspecific and inconspicuous. The spectrum of
symptoms in LOS ranges from a mild increase in apnea to fulminant sepsis. Lethargy, an increase in the number
or severity of apneic spells, feeding intolerance, temperature instability, and/or an increase in ventilator support all
may be early sign of LOS. Blood culture remains as the definitive diagnostic tool for neonatal sepsis. However, this
“ gold standard” testing method is time-consuming and may produce false positive results as well as false negative
results. The combination of multiple biomarkers, such as hematologic indices (peripheral white blood cell count and
differential count, platelet count, the total number of neutrophils, immature to total neutrophil ratio), Acute phase
reactants (C-reactive protein (CRP), procalcitonin (PCT),serum amyloid A), cytokines (TNF-α, IL-1, IL-6). Other
markers such as CD64, CD11b. Recently, molecular-based methods for diagnostic neonatal sepsis is PCR.
Management of LOS does not always protect infants from the risk of long term neurodevelopmental impairment,
the best strategy is to prevent rather than to treat LOS. Infection control protocols remains to be the cornerstone
of LOS prevention. Other strategy to prevention are probiotics, early enteral trophic feeding with breast milk,
lactoferrin, and skin care with antiseptics. Empirical antibiotic treatment is initiated on suspicion of LOS. The flora
of the NICU must be considered. For LOS admitted from the community considered ampicillin and gentamicin.
Keywords: Late onset sepsis, neonate, investigation, management

__________________________________________________________________________________________
HEMODYNAMIC INSTABILITY IN CRITICALLY ILL NEONATE
Alifah Anggraini
Faculty of Medicine University of Gadjah Mada

RSUP Dr. Sardjito
The neonatal circulation is different from pediatric and adult circulation. Newborn population has a wide range
of gestational and postnatal ages with different maturation levels in cardiovascular system. Furthermore, they
undergo dynamic changes during the transition from fetal to neonatal life. It is still difficult to identify hemodynamic
instability and decide whether to start treatment.1 In sick newborns, hemodynamic instability is frequent, very
heterogeneous in its underlying pathophysiology. The outcome and survival of neurodevelopmental processes are
thought to be negatively impacted by dysregulated systemic and cerebral blood flow.2
In the past, methods for defining hemodynamic instability were mostly dependent on imprecise assessments of the
effectiveness of the pulmonary or systemic circulation (such as blood pressure).1,2 Since the ability of the circulatory
system to provide tissues with enough oxygen to meet metabolic needs defines a healthy cardiovascular system,
treatment decisions must take end-organ function into consideration.2 Comprehensive and serial hemodynamic
assessment is now growing. There is now evidence for the use of noninvasive impedance-based cardiometry,
functional echocardiography, and near-infrared spectroscopy to supplement standard bedside hemodynamic
measurements like blood pressure and heart rate.3 Comprehensive hemodynamic monitoring is essential for a
customized pathophysiology-based hemodynamic management.
Hemodynamic instability in the preterm infant could be found in the patent ductus arteriosus (PDA), after ligation of
a hemodynamically significant PDA, sepsis, and necrotizing enterocolitis (NEC). Whereas hemodynamic instability
in the term infant could be found in perinatal hypoxic-ischemic injury, persistent pulmonary hypertension, and
infants of diabetic mothers.2
Daftar Pustaka
1. Vrancken SL, van Heijst AF, de Boode WP. Neonatal Hemodynamics: From developmental physiology to
comprehensive monitoring. Front Pediatr. 2018;6(April):1–15.
2. Giesinger RE, McNamara PJ. Hemodynamic instability in the critically ill neonate: An approach to
cardiovascular support based on disease pathophysiology. Semin Perinatol [Internet]. 2016;40(3):174–88.
Available from: http://dx.doi.org/10.1053/j.semperi.2015.12.005
3. Wu TW, Noori S. Recognition and management of neonatal hemodynamic compromise. Pediatr Neonatol
[Internet]. 2021;62:S22–9. Available from: https://doi.org/10.1016/j.pedneo.2020.12.007
NEONATAL ENDOCRINE EMERGENCIES IN NICU SETTING
Frida Soesanti
Endocrinology Division - Child Health Department

Faculty of Medicine - University of Indonesia
RSUPN Cipto Mangunkusumo, Jakarta
Endocrine emergencies in neonates, especially in NICU setting is not rare, sometimes this area can be
challenging in presentation and management for both neonatologists and pediatric endocrinologists. The
neonatal period is unique, because of the transition period from intrauterine life to the extra uterine life, where
some neonates failed to adjust smoothly. Hypoglycemia, imbalance electrolyte, adrenal crisis due to congenital
adrenal hyperplasia, ambiguous genitalia, and congenital hypothyroidism are among those common endocrine
problems during neonatal period that will be covered in this abstract.
Hypoglycemia is one of the most frequent problems in the first 48 hours of life. The definition of
hypoglycemia varies between the AAP and the Pediatric Endocrine Society (PES). The AAP define hypoglycemia
as blood glucose < 47 mg/dL, while PES define hypoglycemia as a blood glucose value of < 50 mg/dL.
Unfortunately, the optimal strategy for managing this problem remains obscure and is a matter of differing
interpretations of the available literature. Occasionally, hypoglycemia can persist after 48 hours of life and one
of the etiology is perinatal stress-induced hyperinsulinism. The risk factors include birth asphyxia, maternal
preeclampsia, prematurity, intrauterine growth retardation, and other peripartum stress. The mechanism
responsible for the dysregulated insulin secretion is not known. Other cause of persistent hyperinsulinism is
congenital hyperinsulinism due to monogenic disorders or associated with certain syndrome. These disorders
will need more advanced diagnosis and management guided by the genetic study.
The second most common endocrine emergency in neonates after hypoglycemia is hypothyroidism,
which is another disorder that requires prompt diagnosis and treatment to improve prognosis and reduce
the chances of developmental delay and mental retardation. The interpretation of thyroid function test in sick
or critically ill neonates is more complicated. The understanding of normal neonatal physiology is the key.
Other endocrine emergencies is neonatal hypocalcemia that can be classified into early onset if hypocalcemia
occurred in the first 72 hours of life and late onset if occurred after 72 hours of life. The risk factors to
develop early onset neonatal hypocalcemia include prematurity, infant of diabetic mother, asphyxia, IUGR,
and maternal hyperparathyroidism. The risk factors for late onset hypocalcemia include hypomagnesemia,
vitamin D deficiency, hypoparathyroidism, increased load of phosphate, and PTH resistance and syndromes.
Management of early onset hypocalcemia includes the administration of elemental calcium I and continuous
infusion is more preferred than boluses. The treatment of LNH is specific based on the etiology and can be
life-long in certain disorders.
Hyponatremia (serum sodium <130 mEq/L) is one of the common cause of seizures to electrolyte
imbalance in neonates. Symptomatic hyponatremia should always be aggressively treated. Hyponatremia
in neonates with genitalia ambiguous (in female) and hyponatremia in normally male neonates with
hyperpigmentation should raise awareness on the possibility of adrenal crisis due to congenital adrenal
hyperplasia. Neonates with classic CAH usually presented within 2 weeks after birth with vomiting, poor
feeding, dehydration, and reduced level of consciousness. In the critically ill neonates, a basic metabolic panel
to check for the typical electrolyte abnormalities of hyponatremia and hyperkalemia is warranted to detect early
adrenal crisis to prevent mortality. Once diagnosis is made, treatment with hydrocortisone and fludrocortisone
are commenced.
NEONATAL GASTROINTESTINAL EMERGENCIES
Fatima Safira Alatas
Child Health Department

Faculty of Medicine, University of Indonesia
RSUPN Cipto Mangunkusumo - Jakarta
Background: Neonatal gastrointestinal emergencies are often associated with high morbidity and mortality.
These can be caused by various congenital anomalies that affect the upper or lower gastrointestinal tract.
Furthermore, gastrointestinal emergencies can also lead to severe dehydration, malnutrition, electrolyte
abnormalities, sepsis and irreversible intestinal ischemia in neonates. The aim of this presentation is to describe
various neonatal gastrointestinal emergencies and provide a step-by-step approach for a precise and timely
diagnosis.
Discussion: Neonatal gastrointestinal emergencies are classified into two groups which are upper
gastrointestinal emergencies and lower gastrointestinal emergencies. Both groups have an entirely different
underlying etiology. Possible etiologies for upper gastrointestinal emergencies in neonates include esophageal
atresia, pyloric atresia/stenosis, duodenal obstruction, malrotation and midgut volvulus. Meanwhile, etiologies
for lower gastrointestinal emergencies in neonates are necrotizing enterocolitis, meconium related disorders
and Hirschsprung's disease. In general, the most common etiology of neonatal gastrointestinal emergencies
is necrotizing enterocolitis. Patients with necrotizing enterocolitis may present with nonspecific signs and
symptoms such as bradycardia, lethargy and mottling. Radiography and ultrasound are the main modalities
used to diagnose necrotizing enterocolitis. Radiographic findings in necrotizing enterocolitis include an
abnormal bowel gas pattern, pneumatosis, portal venous gas and pneumoperitoneum.
Conclusion: Neonatal gastrointestinal emergencies often present with nonspecific and overlapping signs and
symptoms. Therefore, imaging plays a major role in determining the underlying etiologies. Combination of
history taking, physical examination and imaging may guide clinicians in establishing an accurate diagnosis.
Prompt diagnosis and management are crucial to provide an optimal patient care and preventing future
complications.
______________________________________________________________________________________
NEONATAL REFEEDING SYNDROME
Putri Maharani Tristanita Marsubrin, Kanya Lalitya Jayanimitta Sugiyarto
Neonatology Division of Cipto Mangunkusumo Hospital Jakarta
Refeeding syndrome (RS) is characterized by a decrease of one or a combination of phosphorus, potassium,

and/or magnesium, or it can be a manifestation of thiamin deficiency, which develops hours to days after
initiation of calorie provision to an individual who has been exposed to a substantial period of undernourishment.
In premature infants, it has been proposed that the electrolyte disturbances are triggered by high intravenous
(IV) amino acid and glucose provision, such as with placental insufficiency or inadequate IV energy and
protein intake for several days after birth. The incidence rate of RS in premature infants varies specifically
hypophosphatemia around 20–90%, hypokalemia around 8.8–66.7%, and hypomagnesemia around 1–8.3%.
Other studies found a higher incidence of electrolyte disturbances in patients with intrauterine growth restriction
(IUGR) and very low birth weight (VLBW). The effect of neonatal RS is metabolic acidosis, hypernatremia,
hypovolemia, respiratory alkalosis, ischemia, delayed full enteral feeding, sepsis, and chronic lung disease.
The mortality rate in infants with RS was 3 times higher compared to infants without RS (32.4% vs 10.7%, P
= .001). Optimal nutrition (IV phosphate and calcium) provision can reduce the incidence of RS and problems
in infants with RS.
THE ETHYLENE GLYCOL POISONING IN INDONESIA: A LONG AND WINDING ROAD
INVESTIGATION
Niken Wahyu Puspaningtyas
Pediatric Emergency and Intensive Care Division

Department of Child Health Cipto Mangunkusumo Hospital
University of Indonesia
Since January 2022, Indonesia has been dealing with an increasing number of cases of acute kidney injury with
unknown causes. Initally, there were two cases, but the numbers gradually rose in the following months. Most
of the patients who came to Cipto Mangunkusumo Hospital (CMH) presented with gastrointestinal or respiratory
symptoms. They had received medication from healthcare providers but subsequently developed oliguria (reduced
urine output) or anuria (complete absence of urine output). Many Indonesian experts have linked these cases to
sepsis and multiple inflammatory syndromes associated with Covid-19 (known as MISC), considering that Covid-19
was still a pandemic during that time. Various tests, including metagenomic analysis, have been conducted to
identify the cause of sepsis, but the results are very scaNered.
Over the past nine months, paediatricians at CMH have treated the patients with medications for sepsis and MISC;
however, the outcomes have not been favourable. The mortality rate during this period was over 75%.
In September, Gambia reported the deaths of 28 children due to acute kidney problems. In October, the World
Health Organization (WHO) declared that these deaths might be linked to contaminated cold and cough medications
containing ethylene glycol (EG) and diethylene glycol (DEG). Consequently, in October 2023, pediatricians from
CMH conducted an online meeting with experts from Gambia. They discovered that the signs and symptoms
observed in the children from Gambia were strikingly similar to those seen in Indonesia. The next steps involved
coordinating with the CMH director, government officials, and the Ministry of Health. Subsequent examinations of
the remaining patients focus on identifying the substances involved, and the effort were made to find an antidote for
their treatment. A_erward, the patients who were highly likely to have shown intoxication with EG and DEG based
on history and examinations were given the antidote (Fomepizole).
Ethylene glycol (EG) is a toxic alcohol that can be found in various household and industrial agent. The liquid
substance is colorless, have a sweet testing and most commonly found in antifreeze and industrial solvent. The
sweet taste of the substance occasionally responsible to accidental toxic exposures which can be extremely
dangerous and have significant morbidity and mortality if left untreated.
Diethylene glycol (DEG) is widely used in manufacturing because of several properties, including its ability to
dissolve chemicals that are insoluble in water. It is a viscous liquid even at subzero temperatures making it suitable
as an antifreeze. Similar to EG, DEG is colorless and odorless (although it has a slightly sweet taste) and most
importantly, it is inexpensive to produce. DEG is rapidly absorbed and distributed throughout the body, with the
kidneys, brain, liver, spleen, and adipose tissue receiving the highest concentration.
The primary cause of EG and DEG toxicity is typically ingestion. Dermal absorption is another possible source
of intoxication, although it is rare compared to ingestion, unlike other alcohols such as methanol. Most cases
of intentional exposure to the substance are related to suicide attempts. In the case of children, unintentionally
ingestion can occur as they explore their environment and consume the substance due to its sweet taste.
Daftar Pustaka
1. Mcallister E. Gambia probes link between dozens of child deaths and parasetamol syrup (internet). Available
from: https://www.reuters.com/world/africa/gambia-says-it-isinves>ga>ng-link-between-dozens-child-deaths-
paracetamol-2022-09-08/
2. Sean. Dangers Diethylene Glykol: The poison that Keeps on Killing (internet). Available from: https://_loscience.
com/dangers-of-diethylene-glycol-poison/
3. Iqbal A, Glagola JJ, Nappe TM. Ethylene Glycol Toxicity. [update 2022 Sep 26]. In: StatPearls (internet).
Treasure Island (FL): Statpearls Publishing; 2023 Jan-. Available from: hNps://www.ncbi.nlm.nih.gov/books/
NBK537009/
4. Schep LJ, Slaughter RJ, Temple WA, Beasley MG. Diethylene Glycol Poisoning. Clin Toxicol(Phila). 2009;47(6):525-35.
ANEMIA IN SEPTIC CHILDREN:
THE INTERPLAY OF OXIDATIVE STRESS AND ROS SCAVENGING
Arina Setyaningtyas, Antonius Hocky Pudjiadi
Faculty of Medicine, University of Airlangga

RSUP Dr Soetomo Surabaya
Sepsis is one of the main causes of morbidity and mortality in critically ill children worldwide. Mortality
of critically ill pediatric patients with sepsis ranges from 4–50%, depending on disease severity, risk factors,
and geographic location. Premorbid factors that affect the outcome of children with sepsis are their specific
age, nutritional status, and anemia. Anemia often develops in the clinical course of sepsis and becomes
a complication in the management of sepsis, which has unclear consequences and is associated with
dependency on the use of life support equipment. Optimal management of anemia in critically ill conditions is
still being debated. Severe sepsis has traditionally been understood as an uncontrolled inflammatory process
triggered by an infectious process. The presence of cytokine stimulation, immune cells, and endothelial
cell injury will stimulate an increase in reactive oxygen species (ROS). High ROS levels will affect blood
circulation and endothelial cells, causing damage at a cellular level. Oxidative stress in septic conditions has
more serious consequences in pediatric patients than in adults due to lower functional reserve capacity and
the need for tissue growth. In addition to increased oxidative stress, there was also an increase in plasma
antioxidant capacity, glutathione peroxidase (GPx) activity, and F2-isoPs in pediatric patients with sepsis and
severe sepsis. Similarly, in an anemic state, there is also an increase in oxidative stress which is proved by
an increase in the activity of the GPx enzyme and lipid peroxidation in pediatric patients with iron deficiency
anemia. The accumulation of metabolic toxins causes pathological conditions that lead to organ dysfunction.
In controlling metabolic toxins, the body produces antioxidants to clean these toxins.
______________________________________________________________________________________
PROLONGED MECHANICAL VENTILATION IN CHILDREN
Indra Saputra
Division of Paediatric Emergency and Intensive Care, Department of Paediatrics, Faculty of Medicine,
Universitas Sriwijaya/Mohammad Hoesin General Hospital, Palembang, Indonesia
Background: Mechanical ventilation is a common treatment in intensive care, whether for neonates,
children, or adults. Independent of the underlying disease, this supportive treatment is associated with many
complications that may prolong its duration. Recently, the number of patients requiring prolonged mechanical
ventilation (PMV) has been increasing worldwide, burdening healthcare systems. Increased duration of
invasive mechanical ventilation is associated with increased morbidity and mortality. A consensus on the
definition of prolonged mechanical ventilation (PMV) for children is absent. There is still a lack of published
work presenting the epidemiology, risk factors, and outcomes for PMV patients.
Objective: To describe the incidence, baseline characteristics, risk factors, and outcomes of PMV in pediatric
patients
Methods: This review searched all known literature regarding relevant studies.
Results: Incidences of PMV in children range from 3 - 35% based on the cut point of time. Children on
PMV suffer mainly from neuromuscular problems, upper airways, central nervous system diseases, acute
lung disease, acute circulatory system disease, postoperative monitoring, and others. Risk factors of PMV in
children are younger age < 12 months old, prematurely born, the severity of illness, malnutrition, the severity
of lung disease, use of NIV before intubation, continuous intravenous sedation, and vasoactive administration.
Children with PMV have a higher rate of extubation failure, extended PICU stay, prolonged hospital stay, high
hospitalization costs, and high mortality after one month of discharge.
Conclusion: The incidence and mortality of PMV in pediatric patients are surprisingly high. Some risk factors
associated with PMV in children. Patients with PMV exhibit a more significant burden concerning medical costs
than those on non-PMV. It is essential to establish a specific definition of PMV in children and specialized weaning
units for mechanically ventilated patients to shorten the time for using mechanical ventilation.
Keywords: children, prolonged mechanical ventilation, risk factors, outcome

__________________________________________________________________________________________
MANAGEMENT OF VENTILATOR ASYNCHRONIES IN CHILDREN
Sri Martuti
Faculty of Medicine, Universitas Sebelas Maret

RSUD Dr. Moewardi, Surakarta

Mechanical ventilation is a treatment procedure commonly applied in critically ill patients. Asynchrony is a common
problem when we give support MV and associated with poor outcome including increased of sedation needed,
duration of MV, PICU length of stay and mortality. During invasive ventilation, it can widely range from 10% to 50%
and is often unrecognized, underestimated, and inappropriately treated. Asynchronies is a mismatch between the
patient’s respiratory efforts and mechanical ventilator delivery. It can occur at any phase throughout the respiratory
cycle. The type of asynchrony are triggered asynchrony, flowed asynchrony and cycling. Triggered asynchrony
include: trigger delay, reserve-triggering, ineffective efforts, auto-triggering, and double triggering; flow asynchrony:
it happens during the inspiratory phase; and cycling asynchrony includes: premature cycling and delayed cycling.
We can detect asynchrony by clinical findings and bedside graphics monitor airway pressure–time and flow–
time waveforms displayed on the ventilator. Management Asynchronies are different depending on the causes
of asynchronies. The most common interventions for asynchrony are giving deep sedation and analgesia. But
deeper sedation is associated with increasing length of stay and mortality in critical care patients. Before optimizing
the ventilator mode and setting, one should first correct any external disturbances because these can corrupt
waveform (leaks or clear of obstruction or secretion). By increasing or lowering triggering, increasing or decreasing
inspiratory time and breathing frequency can correct the trigger asynchronies. And also decreasing pressure
support or Auto PEEP. Increased inspiratory flow or shortened rise time can be used to correct flow asynchrony.
In cycling asynchronies, we can increase inspiratory time or decrease the cycle threshold to correct this type of
asynchrony depending on mode of MV. The new mode for reduces asynchronies are PAV (proportional assist
ventilation) and NAVA (Neurally-adjusted Ventilatory Assist).
__________________________________________________________________________________________
WHAT’S NEW IN PEDIATRIC VENTILATION LIBERATION
Indra Ihsan
Pediatric Emergency and Intensive Care Division

Medical Faculty of Andalas University / M Djamil Hospital Padang
Invasive mechanical ventilation (IMV) is one of the most common respiratory procedures in critically ill children.
Although IMV can be lifesaving, prolonged IMV is associated with severe risks such as exposure to sedative
medications, ventilator-associated events, and ventilator-induced lung injury. On the other hand, premature
ventilator liberation can be associated with extubation failure and adverse outcomes.
The weaning phase starts when the patient is recovering from the underlying disease which caused the
intubation. The weaning process implies a transition from full ventilatory support to spontaneous breathing work
by gradually decreasing ventilatory support. The patient ready for extubation when weaning is completed; the
patient is sufficiently awake with intact airway reflexes, hemodynamically stable, and has manageable secretions.
A clinical approach and several indicator scores (RSBI, CROP Index, Volumetric Capnography) can be used to
decide the best timing of weaning and extubation.
In General, there are four steps in the conceptual framework of ventilation liberation; (1) assess and
prepare; consisting of assessment ventilation, screening for extubation readiness tes(ERT), extubation readiness
testing bundle, and sedation weaning. (2) Prepare; use of corticosteroids prior to extubation for reduced rates of
post-extubation upper airway obstruction (UAO) (3) Performing extubation, (4) support; non-invasive respiratory
support choice following extubation, CPAP may be a more suitable first-line option for children post-extubation,
especially in infants under one year.
__________________________________________________________________________________________
PRESSURE RECORDING ANALYTICAL METHOD (PRAM): FROM PHYSIOLOGY TO BEDSIDE
Neurinda Permata Kusumastuti
Faculty of Medicine, Universitas Airlangga

RSUP. Dr. Soetomo, Surabaya
The pressure recording analytical technique (PRAM) is a method for continuously monitoring cardiac output by
detecting the pressure in the arteries. This method does not require prior calibration or pre-calculated parameter
based on prior research. The primary idea is to calculate the volume change in the radial artery based on the
pressure change by studying the morphology of the pressure waveform, which includes both the pulsatile and
continuous components of the arterial pressure waveform. Another feature that forms the foundation of PRAM is
the use of a frequency of 1000 Hz, which allows for a high level of precision, which is critical for arterial impedance
calculations and the precise measurement of systolic, diastolic, mean arterial pressure (MAP), and dicrotic.
We can measure systemic blood pressures, stroke volume, cardiac output, and vascular resistances with this
PRAM, as well as continuously monitor dynamic parameters to determine fluid responsiveness, such as stroke
volume variation (SVV), pulse pressure variation (PPV), and systolic pressure variation (SPV). As a result, this
hemodynamic monitoring tool is commonly used in pediatric patients in the pediatric intensive care unit (PICU)
who are critically ill. The study by Calamanddrei et al. using the PRAM revealed a small bias and error rate of only
25% when compared to echocardiography. This PRAM approach can thus be used to assess postresuscitation
myocardial dysfunction (PRMD).
__________________________________________________________________________________________
CONGENITAL ANOMALY OF KIDNEY AND URINARY TRACT (CAKUT) IN NEWBORN INFANTS
Henny Adriani Puspitasari, Intan Dyah Puspitasari
Division of Nephrology, Department of Child Health, Faculty of Medicine Universitas Indonesia, dr. Cipto
Mangunkusumo General Hospital, Jakarta, Indonesia
Congenital anomalies of kidney and urinary tract (CAKUT) is defined as defects in the kidney and urinary tracts
that are caused by anomalies during embryonic development. The prevalence of CAKUT is 4000-6000 newborns
among 4 million live births in 2018. Genetics and teratogenic agent exposure during pregnancy contribute to the
development of CAKUT. Also, one study reported that the prevalence of CAKUT is associated with early gestational
age. Newborns with CAKUT may develop acute kidney injury and eventually progress to end-stage kidney disease
as a long-term outcome. Differential diagnosis of CAKUT consists of renal dysplasia/hypoplasia, renal agenesis,
rapid kidney growth, abnormal position or number of kidneys, polycystic kidney disease, or obstruction of outflow
tracts. CAKUT cases are generally asymptomatic and are usually identified incidentally through ultrasound,
antenatally, and/or postnatally. However, some of the cases may present with symptoms such as micturition
difficulties, abdominal pain, fever, or even sepsis. Early detection of CAKUT through antenatal ultrasound plays
an important role in diagnosing CAKUT. It diagnoses about 60-85% of CAKUT in infants. Postnatal ultrasound is
recommended to be conducted on high-risk infants suspected of CAKUT, including preterm infants. It is important
to thoroughly evaluate children with CAKUT for extrarenal manifestations, as this condition is often not isolated.
The study of genetics in CAKUT has been advancing, but the variety of its results has made it challenging to apply
in practical settings. The treatment for CAKUT will depend on the type and severity of anomalies present, as the
condition has a broad range of potential symptoms. In general, newborns with CAKUT should be monitored for
urinary tract infection, blood pressure, periodic urinalysis, and kidney function. Early diagnosis and follow-up are
fundamental parts of treating CAKUT patients.
Keywords: newborn, congenital anomalies of kidney and urinary tract, CAKUT, diagnosis
IMPROVING THE QUALITY OF END-OF-LIFE CARE IN THE PEDIATRIC INTENSIVE CARE UNIT
Nurnaningsih
Faculty of Medicine – Gadjah Mada University

RSUP Dr. Sardjito - Yogyakarta
The primary goals of intensive care medicine are to help patients survive acute threats to their lives
while preserving and restoring the quality of those lives. End-of-life care is emerging as a comprehensive area
of expertise in the Pediatric Intensive Care Unit (PICU) and demands the same high level of knowledge and
competence as all other areas of PICU practice.
End of Life (EOL) care has progressively improved, especially with the development of palliative care
that provides support at home or in the general ward. Increased confidence among pediatric intensivists when
providing end-of-life care, and the availability of a Palliative Care Unit may contribute to improvements in the
quality of end-of-life care. Palliative care aims to prevent and relieve suffering and improve the quality of life for
patients approaching the end of their life, and to support the family.
The management of children at the end of life can be divided into three steps. The first concerns
the decision- making process, the second concerns the actions taken once a decision has been made to
forgo life-sustaining treatments, and the third regards the evaluation of the decision and its implementation.
There are six relevant domains to improve the quality of end-of-life care: strong interdisciplinary collaboration
and communication within the critical care team and with the palliative care specialists; good communication
skills of the team members; excellence in symptom assessment and management including pain, dyspnea,
delirium and anxiety; patient and family centered care focusing on the patient’s and family’s values and
treatment preferences, as well as regular communication, psychological, spiritual and social support; regular
interdisciplinary family meetings focused on shared decision making, as well as support for family members.
______________________________________________________________________________________
ECMO SIMULATION TRAINING DURING A WORLDWIDE PANDEMIC: THE ROLE OF ECMO

TELESIMULATION
Eva M. Marwali
Pediatric Cardiac ICU

National Cardiovascular Center Harapan Kita
Jakarta, Indonesia
Extracorporeal membrane oxygenation (ECMO) is a supportive therapy used in the most severe forms of acute
respiratory distress syndrome. Due to its intrinsic complexity and relatively low annual volume, simulation
is essential for efficient and appropriate ECMO management. COVID-19 has limited the opportunities for
high-fidelity in-person simulation training when many hospitals are looking to expand their ECMO services
to battle the ongoing pandemic. To meet this demand, the National Cardiovascular Center Harapan Kita,
Jakarta, Indonesia, conducted a novel model of education during COVID-19 outbreak, a 3-day ECMO course
entailing online didactic lectures (adult and paediatric stream), water drills and telesimulation. Participants
were given an ECMO knowledge pre-course and post-course test and a telesimulation evaluation survey at
the conclusion and these data were collected. The course was attended by 104 physicians, critical care nurses
and perfusionists. Pre-course and postcourse assessments showed a significant improvement in ECMO
knowledge (60.0% vs 73.3%, respectively). Overall, the participants rated the telesimulation positively, and
most found it acceptable to in-person simulation training considering the pandemic restrictions. Despite the
complexities of ECMO, our first recent experience demonstrates ECMO education and simulation delivered
online is feasible, welcomed and supportive of a change in ECMO training course format. As we incorporate
more innovative digital technologies, telesimulation may further enhance the quality of future ECMO training.
QUALITY OF LIFE OF HYPOXIC CHILDREN AFTER HOSPITALIZED IN THE EMERGENCY
DEPARTMENT AND PEDIATRIC INTENSIVE CARE UNIT USING PEDIATRIC QUALITY OF LIFE
INVENTORYTM (PEDSQLTM) IN DR. CIPTO MANGUNKUSUMO NATIONAL CENTRAL PUBLIC HOSPITAL
AND THE INFLUENCING FACTORS
Irene Yuniar1, Julianti1, Hartono Gunardi1, Rismala Dewi1,

Tjhin Wiguna2, Risma Kerina Kaban1, Munar Lubis3
1
Department of Child Health, University of Indonesia, Jakarta, Indonesia
2
Department of Psychiatry, University of Indonesia, Jakarta, Indonesia
3
Department of Child Health, Universitas Sumatra Utara, Medan, Indonesia
Introduction. Study on long-term outcomes of hypoxic children after hospitalized is limited, even though
hypoxia is highly known to affect the quality of life (QoL). The aim was to assess the QoL of hypoxic children
after hospitalized in the emergency department (ED) and pediatric intensive care unit (PICU).
Method. A prospective cohort study, targeting children aged 2–7 years with critical disease, was conducted at
Dr. Cipto Mangunkusumo National Central Public Hospital Indonesia, from November 2021 to April 2022. The
PedsQLTM questionnaire prior to and 1 month and 3 months after hypoxia was used to assess QoL. Patients
with palsy cerebral, mental retardation, chromosomal abnormalities, liver transplantation, and length of stay of
≤24 hours were excluded. Man-Withney test and Chi-Squared test was used.
Results. Forty six hypoxic children with a median age of 4 (2–7) years old. They had a decreased QoL at
1 month and 3 months after had hypoxia than before, based on PedsQLTM scores. The physical, emotional,
and social domains decreased (p<0,01). Prior to hypoxia, 78,3% children had experienced an impaired QoL.
Malnutrition contributed to a decreased child’s QoL, even with medication.
Conclusion. Hypoxic children experienced a reduced QoL at one month and three months after had hypoxia
compared with before, based on PedsQLTM scores. When viewed based on its components, the domains that
experienced a decline were physical, emotional, and social.
Keywords: hypoxia; post–treatment; quality of life; PedsQLTM
______________________________________________________________________________________
THE COMPARISON OF RENAL ANGINA INDEX AN URINE MICROSCOPIC SCORE TO KDIGO

CRITERIA AS1 ACUTE KIDNEY 1
INJURY PREDICTOR IN 1
CRITICALLY ILL CHILDREN
1 1
Nathanne Septhiandi , Rismala Dewi , Bambang1
Supriyatno , Eka Laksmi
2
Hidayati , Yogi Prawira ,
Murti Andriastuti , Arina Setyaningtyas
1
Department of Child Health, University of Indonesia / Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
2
Department of Child Health, Airlangga University / Dr. Soetomo Hospital, Surabaya, Indonesia
Background: Acute kidney injury (AKI) can increase mortality and morbidity in critically ill children, hence the
urgency in finding a tool to predict its occurrence. Renal angina index (RAI) and urine microscopic score (UMS)
have been recommended as AKI predictors. This study aims to evaluate the validity of RAI and UMS compared
to KDIGO criteria.
Methods: The is a cohort prospective study, with subjects included are paediatric children aged 1 month to 18
years to be observed for three days since PICU admission. RAI and UMS were measured and compared to
occurrence of KDIGO AKI on day 3.
Results: The study included 83 samples. On day 0, RA(+) was identified in 38% cases and UMS(+) in
5% cases. Stastitical analysis reported RAI (RR 3.949, p=0.004) and KDIGO (RR 4.783, p<0.005) were
comparable predictors of day 3 AKI. RAI is more sensitive compared to KDIGO (76.5% vs 64.7%), whereas
KDIGO is more spesific compared to RAI (81,8% vs 62,1%). UMS was not significant predictor of day 3 AKI
(RR1.950,p=0,093).
Conclusion: RAI is a valid predictor for subsequent day 3 AKI in critical patients compared to UMS and is
more sensitive compared to KDIGO criteria.
Keywords: acute kidney injury; critical illness; renal angina index; urine microscopic score
______________________________________________________________________________________
EFFECTIVENESS OF IMPLEMENTATION OF PLAN-DO-STUDY-ACT (PDSA) METHOD BUNDLE OF

CENTRAL LINE ASSOCIATED BLOOD STREAM INFECTION (CLABSI) IN REDUCING CLABSI RATES
IN PEDIATRIC PATIENTS WITH CENTRAL VENOUS CATHETER (CVC) INSTALLATION AT DR. CIPTO
MANGUNKUSUMO HOSPITAL
Yogi Prawira1, Dwi Putri Lestari1, Nina Dwi Putri1, Pramita Gayatri1, Irene Yuniar1,
Aryono Hendarto1, Idham Jaya Ganda2.
1
Departement of child Health, University of Indonesia / Dr. Cipto Mangunkusumo Hospital, Jakarta,
Indonesia
2
Departemen of Child Health, Hasanuddin University / Dr. Wahidin Sudirohusodo Hospital,
Makassar, Indonesia
Background: Insertion of a CVC can cause serious complications, especially CLABSI. Prevention CLABSI
is very challenging. The PDSA method is expected to increase compliance in implementing the bundle. The
purpose of this study was to determine the effectiveness of implementing bundle CLABSI PDSA method in
reducing CLABSI rates in children at Cipto Mangunkusumo Hospital
Method: The design of this study is quasi-experiential. Pediatric patient aged 1 month to 18 years old who were
installed CVC by the Pediatric Emergency and Intensive Care team in the period between June-November
2022. The sampling technique is carried out by consecutive sampling.
Results: Total subjects were 280. PDSA pre-test were 143 installations, while the PDSA post-test had 137
subjects. CLABSI rate decreased 4.1/1000 days of CVC insertion within 3 months after PDSA. Total CLABSI
pre-test PDSA rate 12.7/1000 days of insertion and decreased to 8.6/1000 days of insertion after PDSA
implementation. The highest peak of CLABSI rate before PDSA in July 2022 was 18.9/1000 days of insertion,
the lowest CLABSI rate achieved in November 2022 of 3.4/1000 days of insertion after PDSA implementation.
Conclusion: The CLABSI rate can decrease by 4.1/1000 days of CVC insertion within 3 months, and reach
the target 3.5/1000 days of insertion in November 2023 with a CLABSI rate of 3.4/ 1000 days of insertion after
Bundle IAD PDSA method implementation.
Keywords: CLABSI, CVC, PDSA, CLABSI Bundle
HEMODYNAMIC PROFILE OF DENGUE SHOCK SYNDROME USING ULTRASONIC CARDIAC OUTPUT
MONITOR (USCOM) IN SANGLAH HOSPITAL
Ida Bagus Gede Suparyatha, Siska Permanasari Sinardja, I Nyoman Budi Hartawan, I Wayan
Gustawan, Dyah Kanya Wati, I Made Gede Dwi Lingga Utama
Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Udayana/ RSUP Sanglah Denpasar,
Bali
Background: Monitoring hemodynamic status clinically in Dengue shock syndrome (DSS) cases in children
is still challenging. Hemodynamic measurement with USCOM could be useful to measure real-time cardiac
performance and hemodynamic status quantitatively. Hence, adequate intervention will be approached to
decrease morbidity.
Objective: To present hemodynamic profile of children with DSS quantitatively.
Methods: A pilot study in 2016, measured hemodynamic status using USCOM. Data were obtained when
diagnosis of DSS was confirmed at Sanglah Hospital Denpasar.
Result: USCOM results of 69 subjects showed low mean cardiac index, systemic vascular index, cardiac
contractility, and perfusion levels as 3.03 (±1.06) L/min/m2, 27.4 (±9.7) ml/m2, 0.92 (±0.27) m/s, and 474
(±188) ml/min respectively, with very high mean afterload level as 2,409 (±950) ds cm-5m2.
Conclusion: Similar USCOM results were found in both compensated and decompensated DSS, with
hypodynamic shock pattern. Awareness of complications that may occur based on these findings could help
clinicians achieve better outcomes.
Keywords: Dengue Shock Syndrome, pediatric, USCOM, and hemodynamic monitoring

______________________________________________________________________________________
MICROCIRCULATION AND THE VULNERABLE PEDIATRIC PATIENT
Neurinda Permata Kusumastuti
Faculty of Medicine, Universitas Airlangga

RSUP. Dr. Soetomo, Surabaya
Microcirculation is a network of small blood arteries (arterioles, capillaries, and venules) smaller than 100
µm in diameter. Microcirculation is crucial in both providing oxygen and other critical substrates to cells
and cleaning up their waste products. Good microcirculation is necessary for normal cellular function and,
by extension, organ function. A developing youngster is more prone to microcirculation disruptions at vital
times. If therapeutic approaches do not result in coherent microcirculatory improvement, optimally functioning
macrocirculation does not guarantee appropriate microcirculatory perfusion. This condition is most common in
states of shock, inflammation, reperfusion, and infection. There are four types of microcirculatory alterations
that contribute to the loss of hemodynamic coherence between macro and microcirculation, resulting in
tissue hypoxia. Type 1 conditions include occluded capillaries close to perfused capillaries, which results in
uneven oxygenation of tissue cells. Type 2 is caused by hemodilution, which results in the loss of red cell-filled
capillaries and an increase in the distance between oxygen-carrying red blood cells and tissue cells. Stasis
of microcirculatory red blood cell flow is caused by type 3 modifications such as increased arterial resistance,
vasopressor treatment, increased venous pressure, or hyperoxia. Type 4 modifications are characterized by
edema induced by capillary leak syndrome, resulting in an increased diffusion distance and a reduced ability of
oxygen to reach tissue cells. As a result, in the pediatric intensive care unit (PICU), the idea of hemodynamic
coherence might serve as a framework for generating microcirculation metrics for use in everyday clinical
practice.
Supported by
E-POSTER PRESENTER LIST

34
CATEGORY: NICU
NO PRESENTER INSTITUTION E-POSTER TITLE
NEO.01 Siti Humairah Universitas Sumatera OXYGEN INDEX ACCURACY OF EXTUBATION SUCCESS IN
Utara NEONATES USING MECHANIC AL VENTILATION
NEO.02 Vetria Sekar RS Akademik UGM OUTCOME OF NEONATAL ANORECTAL MALFORMATIONS IN

Damayanti Yogyakarta GADJAH MADA UNIVERSITY HOSPITAL 2022 : A CASE SERIES
NEO.03 Viany Rehansyah Universitas Sumatera CORRELATION OF FIBRINOGEN WITH SNAPPE-II SCORE
Putri Utara IN NEONATAL SEPSIS AS A PREDICTIVE FACTOR OF
MORTALITY
NEO.04 Tri Yuliani Putri RSUD Cibinong-FK IPB CONGENITAL TUBERCULOUS INFECTION: A CASE REPORT
NEO.05 Celine RSUD Wangaya THE ASSOCIATION OF NEONATAL SEPSIS AND HYPER-
BILIRUBINEMIA AT WANGAYA REGIONAL HOSPITAL
NEO.06 Nadya Gratia RSUD Kabupaten INTERMITTENT PHOTOTHERAPY VERSUS CONTINUOUS

Juliawan Buleleng PHOTOTHERAPY, WHICH ONE IS MORE EFFECTIVE? AN
EVIDENCE-BASED CASE REPORT
NEO.07 Ni Luh Putu Herli Fakultas Kedokteran RECORDING MOTHER’S VOICE TO REDUCE PAIN IN
Mastuti Universitas Airlangga, PRETERM INFANT
RSUD Dr. Soetomo
NEO.08 Fuka Priesley RSIA Bunda Jakarta MULTISYSTEM INFLAMMATORY SYNDROME IN NEONATES
WITH COVID-19 INFECTION MATERNAL HISTORY: A RARE
CASE REPORT
NEO.09 Ajeng Puspitasari Sentra Medika Cibinong MICROBIAL PATTERN AND ANTIBIOTIC SUSCEPTIBILITY
Hospital IN NEONATAL INTENSIVE CARE UNIT, SENTRA MEDIKA
CIBINONG HOSPITAL
NEO.10 Audi Yudhasmara RSIA Bunda Jakarta MANAGEMENT OF CONGENITAL CHOLEDOCHAL CYST IN
NEONATE
NEO.11 Selina Natalia Soe Regional General APLASIA CUTIS CONGENITA ASSOCIATED WITH TRISOMY 13:
Hospital, Timor Tengah A CASE REPORT
Selatan
NEO.12 Zaneth Sugiri Siloam Hospitals Kebon A MALE INFANT WITH UNSUSPECTED CONGENITAL
Jeruk, Jakarta DIAPHRAGMATIC HERNIA AND SIGMOID PERFORATION: A
CASE REPORT
NEO.13 Raden Diah RSUD Cicalengka THE IMPORTANCE OF PULSE OXYMETRY SCREENING FOR
Mutmainah CRITICAL CONGENITAL HEART DISEASE: NEONATE WITH
HYPOPLASTIC LEFT HEART SYNDROME
NEO.14 Nikita Shalifa RSIA Bunda Jakarta MULTISYSTEM INFLAMMATORY SYNDROME IN NEONATES
(MIS-N): INDONESIA EXPERIENCE

CATEGORY: PICU
NO PRESENTER INSTITUTION E-POSTER TITLE
ERIA.01 Visia Vrisca Universitas Sumatera Utara CORRELATION OF URINARY ALBUMIN CREATININE RATIO
WITH KIDNEY INJURY MOLECULE-1 (KIM-1) AS A MARKER OF
KIDNEY INJURY IN CRITICALLY ILL CHILDREN
ERIA.02 Fathy Z Pohan Cipto Mangunkusumo CASE SERIES OF RECRUITMENT MANEUVER USING HIGH
Hospital / FKUI FREQUENCY OSCILLATORY VENTILATION AFTER PEDIATRIC
CARDIAC SURGERY
ERIA.03 Fathy Z Pohan RSJPD Harapan Kita RECRUITMENT MANEUVER USING HIGH FREQUENCY
OSCILLATORY VENTILATION IN POST-CARDIAC SURGERY
PATIENT: A SUCCESS STORY
ERIA.04 Zulfikar Caesar Pasar Rebo General MANAGEMENT OF FLUID OVERLOAD IN OVERWEIGHT
Narendra Regional Hospital AND OBESE PEDIATRIC PATIENTS WITH DENGUE SHOCK
SYNDROME (DSS); A LITERATURE REVIEW
ERIA.05 Asri Yuniastuti Ilmu Kesehatan Anak, FK WITHDRAWAL OF THE MECHANICAL VENTILATOR IN THE
KMK-UGM, Yogyakarta PEDIATRIC INTENSIVE CARE UNIT
ERIA.06 Ivana Lola Sutanto Siloam Hospitals LEPTOSPIROSIS: SOMETHING THAT IS INITIALLY MILD, BUT
Purwakarta CAN BE DEATHLY
ERIA.07 Marsha Kurnia Sentra Medika Cibinong MENINGITIS TUBERCULOSIS WITH COMPLICATION OF
Chyntia Maharani Hospital PNEUMONIA IN A 9-YEARS OLD CHILD: A CASE REPORT
ERIA.08 Asri Yuniastuti Ilmu Kesehatan Anak, FK APPROACH TO CRITICALLY ILL CHILDREN WHO PRESENTED
KMK-UGM WITH SEVERE METABOLIC ACIDOSIS: A CASE SERIES
ERIA.09 Rufaida Mudrika RSUP Dr. Sitanala A CASE REPORT: FOCAL-ONSET WITH IMPAIRED AWARENESS
Tangerang SEIZURE AS AN ADVANCED CLINICAL MANIFESTATIONS OF
ACUTE POST-STREPTOCOCCAL GLOMERULONEPHRITIS
(APGN)
ERIA.10 Petra Leatemia RS Graha Hermine - Batam INTRAVENOUS IMMUNOGLOBULIN (IVIG) IN AN INFANT
WITH SEVERE PNEUMONIA ASSOCIATED VARICELLA: CASE
REPORT
ERIA.11 Janet Tee Universitas Udayana RARE EVENT OF ANAPHYLAXIS REACTION IN A RABIES POST-
EXPOSURE PROPHYLAXIS VACCINE: A CASE REPORT
ERIA.12 Amirah Muhammad RSU PKU Muhammadiyah ACUTE KIDNEY INJURY IN PEDIATRIC WITH NEPHROTIC
Abdullah Mojoagung SYNDROME: A CASE REPORT
ERIA.13 Ivana Lola Sutanto Siloam Hospitals SEVERE DIABETIC KETOACIDOSIS IN TYPE I DIABETES
Purwakarta MELLITUS WITH NON-COMPLIANT SUBCUTANEOUS INSULIN
ADMINISTRATION
ERIA.14 Ajeng Puspitasari Sentra Medika Cibinong A CASE OF SPONTANEOUS INTRACRANIAL HAEMORRHAGE
Hospital WITH UNRECOGNIZED HAEMOPHILIA A
ERIA.15 Rahmi Silviyani FK Universitas Sumatera EFFECTIVENESS OF ISOTONIC RESUSCITATION FLUID
Utara COMPARED WITH HYPOTONIC SOLUTIONS IN CHILDREN
WITH SEPTIC SHOCK AT H. ADAM MALIK HOSPITAL MEDAN
ERIA.16 Ni Luh Putu RSUD Wangaya Denpasar MULTI-SYSTEM INFLAMMATORY SYNDROME (MIS-C) IN
Diaswari Predani CHILDREN: A SYSTEMATIC REVIEW OF CLINICAL FEATURES,
TREATMENT AND POSSIBLE OUTCOMES
ERIA.17 Ronald Chandra Pediatric Intensive Care METABOLIC RESUSCITATION IN PEDIATRIC SEPTIC SHOCK: A
Department, Graha Hermine CASE REPORT
Hospital
ERIA.18 Felicia Imanuella Dr Johannes Leimena DIAGNOSTIC AND THERAPEUTIC DILEMMAS IN
Thorion Central General Hospital TUBERCULOUS MENINGITIS: A CASE REPORT FROM A RURAL
SETTING
ERIA.19 Ririe Fachrina Department of Child RELATIONSHIP BETWEEN PEDIATRIC EARLY WARNING
Malisie Health, Faculty of Medicine, SYSTEM IN EMERGENCY ROOM WITH THE CLINICAL
Universitas Sumatera Utara OUTCOME AND LENGTH OF STAY IN PICU WARD
ERIA.20 Selina Natalia Rumah Sakit Umum Siloam A RARE CASE OF AN 6-MONTH-OLD INFANT WITH DENGUE
Lippo Karawaci MENINGOENCEPHALITIS
36 E-POSTER PRESENTER LIST

Supported by
FREE PAPER E-POSTER ABSTRACTS

37
NEO-01
OXYGEN INDEX ACCURACY OF EXTUBATION SUCCESS IN NEONATES USING MECHANICAL
VENTILATION
Siti Humairah1, Bugis Mardina Lubis2, Pertin Sianturi3
1
Department of Paediatrics, Faculty of Medicine, Universitas Sumatera Utara- Haji Adam Malik Central
General Hospital, Medan, North Sumatra, Indonesia
Introduction: Acute respiratory insufficiency often occurs in neonates requiring mechanical ventilation in the
NICU as a countermeasure by intubation. Prolonged intubation can lead to complications such as ventilator-
associated pneumonia, airway trauma and bronchopulmonary dysplasia (BPD). These complications often
arise due to difficulties in determining the right time to extubate neonates. Further evaluation is needed on the
accuracy of the oxygen index as a parameter of extubation in neonates.
Method: We conduct observational study with diagnostic test to evaluate the accuration of oxygen index with
extubation success in neonates aged 0-28 days using mechanical ventilation on Haji Adam Malik Central
General Hospital, Medan, North Sumatera, Indonesia during September 2021-2022.
Result: This study was followed by 50 neonates using mechanical ventilation who were treated in the neonatal
intensive care unit (NICU), 30 boys (60%) and 20 girls (40%). Seven neonates (14%) experienced failed
extubation and 43 neonates (86%) were successfully extubated. The results of the oxygen index examination
showed an average of 1.62 (SD = 1.41). ROC curve in predicting the success of extubation were 84% with a
p value = 0.004 and 95% CI 65.1% - 100% with a cut off of 1.1.
Conclusion: There was a significant relationship between the oxygen index and extubation success in
neonates using mechanical ventilation
Keyword: oxygen index, neonates, intubation, mechanical ventilation, extubation
______________________________________________________________________________________
NEO-02
OUTCOME OF NEONATAL ANORECTAL MALFORMATIONS IN GADJAH MADA UNIVERSITY
HOSPITAL 2022: A CASE SERIES
Vetria Sekar Damayanti 1, Eko Purnomo 2,

Husna Yulianingsih 3, Dewi Cahyati 3, Eka Puji Nurlaili 3
1.
Pediatric Department, . Pediatric Surgery Department,3. Neonatal Intensive Care Unit
2
Academic Hospital Gadjah Mada University, Yogyakarta, Indonesia
Background / Objective
Anorectal malformations (ARMs) are common congenital defects in neonates and surgery is the definitive
therapy. Predictors of poor outcome are congenital heart defect and infection.
Cases
We reported five cases of neonatal ARMs in Gadjah Mada University Hospital during 2022. All cases were male
and term babies. Two patients were high level ARMs, one with rectourethral fistule, and one without fistule.
Three patients were low level ARMs, two with perineal fistule and one with rectourethral fistule. All patients
underwent surgery at the age of 1 day old. Two high level ARMs patients and one low level ARMs patient
underwent transverso-colostomy sinistra (TCS). Two low level ARMs patients with perineal fistule underwent
posterior sagittal anorectoplasty (PSARP). Faecal material was passed in 24-48 hours after surgery in both
38 FREE PAPER E-POSTER ABSTRACTS

TCS and PSARP patients. Enteral feeding was started at 2-3 days after surgery. Three patients got antibiotics
for 7 days and two patients only got prophylactic antibiotic before surgery. Mean length of stay were 10 days.
Two patients with TCS underwent PSARP at the age of 6-7 months old and had good outcome. One patient
with high level ARMs and some anomalies (atrial septal defect, polydactyl of left hand, and bifid scrotum)
suffered from surgical wound infection and malnutrition and died at the age of 6 months old. Two patients with
PSARP were in good condition during follow up.
Conclusions
Outcome of ARMs in our hospital was good. Poor outcome was related to other congenital anomalies and
infection
Keywords: Anorectal malformations, surgical management, outcome
______________________________________________________________________________________
NEO-03
CORRELATION OF FIBRINOGEN WITH SNAPPE-II SCORE IN NEONATAL SEPSIS AS A PREDICTIVE
FACTOR OF MORTALITY
Viany Rehansyah Putri*, Bugis Mardina Lubis*, Nelly Rosdiana*, Erna Mutiara**, Gema Nazri Yanni*
*Department of Pediatrics, Faculty of Medicine, Universitas Sumatera Utara, Indonesia
** Faculty of Public Health, Universitas Sumatera Utara, Indonesia
Background: Neonatal sepsis is the leading cause of neonatal mortality in developing countries, accounting for
30–50 % of neonatal deaths. It is often associated with hemostasis disturbance, such as impaired fibrinolysis,
which can lead to organ dysfunction. Recently, many studies have been done to investigate fibrinogen levels
in predicting short-term outcomes. Aside from that, there was also scoring to predict mortality and morbidity in
neonatal sepsis. Score for Neonatal Acute Physiology-Perinatal Extension II (SNAPPE-II) is recent scoring to
predict mortality and morbidity.
Objective: To determine the correlation between fibrinogen level with SNAPPE-II score in neonatal sepsis as
a predictive factor of mortality.
Method: A prospective cohort study was conducted on neonatal with sepsis in Perinatology Unit Haji Adam
Malik General Hospital, Medan. Assessment of SNAPPE-II score, serum fibrinogen level performed within 12
hour after admission. Pearson’s correlations test were used to examine the association between fibrinogen
level and SNAPPE-II score. Differences in the fibrinogen level and mortality were tested with independent
T-test.
Result: 35 subjects were recruited in this study. Fibrinogen level was negatively correlated with SNAPPE-II
score (r=-0.435, p=0.009) and had a significant association with the mortality rate (p<0.021). Fibrinogen level
could be used as a predictive factor of mortality (AUC 71.7%, p=0.028) with a cut-off point of 157.5mg/dL
(66.7% sensitivity, 82.4% specificity, RR 2.6)
Conclusion: Serum fibrinogen levels have negative correlation with SNAPPE-II score as a predictive factor of
mortality in neonatal sepsis.
Keyword: fibrinogen, SNAPPE-II, neonatal sepsis, mortality
FREE PAPER E-POSTER ABSTRACTS 39

NEO-04
CONGENITAL TUBERCULOUS INFECTION: A CASE REPORT
Putri, Tri Yuliani and Kawilarang, Ava Lanny
Departement of Pediatric, Cibinong District Hopital, Bogor, West Java.
Introduction:
Congenital tuberculosis has a high mortality rate. It is still challenging to distinguish congenital from postnatally
acquired tuberculosis. The clinical manifestations and radiographic findings of congenital tuberculosis are
nonspecific.
Case:
A 28 days old girl (weight 2200 g) was born at 36 weeks of gestation,birth weight 1800 g. He was admitted
with respiratory distress. Her mother had history of Tb infection since before pregnancy until first trimester
of pregnancy. She was declared cured after treatment. On clinical examination at admission documented
tachypnea, coarse breathing sound and abdominal distenstion. A white blood cell count was 17,500/µL
and CRP level was 14 mg/dL. Blood culture was negative. A chest X-ray exhibited pneumonia. Intravenous
antibiotics were administered. Despite the administration of antibiotic, the symptoms persisted and developed
greenish gastric fluid. Abdominal USG exhibited nonspecific dilated bowel loops and accumulation of fluid in
loops, suspected NEC grade 2. Antibiotics were switched based on the result of sputum culture and we added
metronidazole. Because no improvement, infection caused by Mycobacterium tuberculosis was considered.
Gastric lavages for culture were examined and the result was negative. Tuberculin Skin test was negative
but IGRA test was indeterminate. Patient was administered anti-TB drugs. After initiating anti-TB drugs,the
patient's symptoms subsided gradually.
Conclusion:
Congenital TB is treatable if diagnosed and treated early. In areas where it is endemic, it should be taken into
consideration. Accurately documenting a maternal history of TB and any clinical symptoms of the disease are
critical for early diagnosis.
______________________________________________________________________________________
NEO-05
THE ASSOCIATION OF NEONATAL SEPSIS AND HYPER-BILIRUBINEMIA AT WANGAYA REGIONAL
HOSPITAL
Celine1, Putu Siska Suryangingsih2,I Wayan Bikin Suryawan2

1
General Practitioner, Wangaya Regional Hospital, Bali
2
Pediatrician, Wangaya Regional Hospital, Bali
2
Pediatrician endocrinologist, Wangaya Regional Hospital, Bali
Background: Hyper-bilirubinemia is a common event encountered in 60% of full-term and 80% of preterm
infants. Identifying the cause of hyper-bilirubinemia is crucial to determine interventional therapy and prevent
severe hyper-bilirubinemia. South Asia and sub-Saharan Africa are recorded as countries with the highest
incidences of hyperbilirubinemia in the world with 1.1 million infants annually. Greco et al (2015) showed that
the rate of kernicterus is undetectable as very few incidences are recorded and even none in Indonesia. Sepsis
as one of the potential causes of hyper-bilirubinemia, should be evaluate in infants with unknown caused of
hyper-bilirubinemia.
40 FREE PAPER E-POSTER ABSTRACTS

Objective: This study aims to determine the association of neonatal sepsis and hyper-bilirubinemia in neonates
at Wangaya Regional Hospital, Denpasar.
Methodology: This study design was observational analytic cross sectional using medical record data from
January to December 2022. The study involved 34 neonates who were diagnosed as sepsis in the NICU and
perinatology ward at Wangaya Regional Hospital. The sample was taken by consecutive and random sampling
from the total population. Data analyzed with Chi square test on SPSS version 23.
Result: In this study, 11 of 18 infants (61.1%) diagnosed as sepsis experienced hyper-bilirubinemia during
treatment, compared to non-sepsis infants who experienced hyperbilirubinemia (62.5%). The analysis result
proved the association between neonatal sepsis and hyper-bilirubinemia was significant with p value = 0.007
(p < 0.05) and prevalence ratio 0.98.
Conclusion: Neonatal sepsis was associated with the incidence of hyper-bilirubinemia in neonates at Wangaya
Regional Hospital.
Keywords: hyperbilirubinemia, neonatal sepsis
______________________________________________________________________________________
NEO-06
INTERMITTENT PHOTOTHERAPY VERSUS CONTINUOUS PHOTOTHERAPY,
WHICH ONE IS MORE EFFECTIVE? AN EVIDENCE-BASED CASE REPORT
Nadya Gratia Juliawan1, Ida Ayu Putu Purnamawati1
Department of Pediatric, Buleleng General Hospital, Singaraja-Bali, Indonesia
Background: Neonatal hyperbilirubinemia is one of the most common problems found in newborns.
Phototherapy is a treatment for hyperbilirubinemia that has been used for a long time and has proven to
be effective. Phototherapy acts by photoisomerization, which transforms indirect bilirubin molecules into
more hydrosoluble isomers. This procedure, which takes place in the skin, occurs within nanoseconds.
However, bilirubin migration and elimination from the skin take longer, and during this time, phototherapy
has a very limited impact. According to this theory, intermittent phototherapy could be used to treat neonatal
hyperbilirubinemia. The aim of this Evidence-Based Case Report (EBCR) is to determine the effectiveness of
intermittent phototherapy compared to continuous phototherapy in treating neonatal hyperbilirubinemia.
Methodology: Electronic literature searches using Cochrane, Pubmed, Proquest, and ScienceDirect
using keywords ("neonatal jaundice" OR "icterus neonatorum" OR “hyperbilirubinemia”) AND ("intermittent
phototherapy") AND ("continuous phototherapy")
Results: Through literature searches, 4 studies were selected for critical appraisal (3 randomized control
trials, 1 systematic review and meta-analysis). All studies found no significant difference in total serum
bilirubin levels between groups receiving intermittent phototherapy and continuous phototherapy. Intermittent
phototherapy is proven to increase mother-infant bonding because babies have the opportunity to breastfeed
directly and receive kangaroo mother care. However, there is no standard regarding the duration of intermittent
phototherapy.
Conclusion: Intermittent phototherapy has the same effectiveness in reducing total serum bilirubin levels as
continuous phototherapy. In hospitals with limited resources, intermittent phototherapy can be considered.
Intermittent phototherapy is also more pleasant to the parents because it increases mother-infant bonding.
FREE PAPER E-POSTER ABSTRACTS 41

NEO-07
RECORDING MOTHER’S VOICE TO REDUCE PAIN IN PRETERM INFANT
Ni Luh Putu Herli Mastuti, Risa Etika, Nur Rochmah, Martono Tri Utomo, Dina Angelika, Kartika Darma
Handayani, WurryAyuningtyas, Nurani Widianti
Department of Child Health

Faculty of Medicine
Airlangga University/Dr.Soetomo Academic General Hospital
Surabaya
Background:
Preterm infants have a high risk to suffer pain which leads to short-term and long-term effects. Therefore, this
paper aims to analyze the effect of listening to a recording of the mother’s voice in reducing pain in preterm
infants.
Methods:
This was an experimental study of the preterm infants hospitalized between March and April 2023, fulfilled the
criteria of preterm infants include, post menstrual age of 33 weeks, has taken venous blood sampling. Pain
assessment uses Neonatal Infant Pain Scale (NIPS) five minutes before and at the time of blood sampling. The
infants are divided into two groups, the first group will receive sucrose orally and the second group listens to
their mother’s voice for 10 minutes, with a sound level maximum of 50 decibels. We calculated the difference
between both pain scores as a response to the pain caused by blood sampling, using paired t-tests.
Results:
Fourteen preterm infants participated in this study, with an average postmenstrual age of 34 weeks, consisting
of twelve using invasive mechanical ventilation. There is a significantly lower NIPS score in preterm infants that
used non-invasive compared to invasive mechanical ventilation (x̄ =2.9 ±0.9; x̄ =7.0 ± 0.0; p<0.005).
There was a significant decrease in NIPS scores in preterm infants who listened to the mother’s voice during
blood sampling (x̄ =2.7±1.1; x̄ =6.7±2.6; p<0.005).
Conclusion:
Mother’s voice decreases pain in preterm infants, which can reduce short-term and long-term effects of pain
in preterm infants.
Keywords: preterm infant, pain, NIPS
______________________________________________________________________________________
NEO-08
MULTISYSTEM INFLAMMATORY SYNDROME IN NEONATES WITH COVID-19 INFECTION MATERNAL
HISTORY: A RARE CASE REPORT
Fuka Priesley1, Reynaldo Rahima Putra1, Pinandita Annisa Pratiwi1, R. Adhi Teguh P. Iskandar2, Mulya
Rahma Karyanti2
General Practitioner, Bunda Women and Children Hospital, Jakarta, Indonesia

1
2
Departement of Child Health, Bunda Women and Children Hospital, Jakarta, Indonesia
Background: Multisystem inflammatory syndrome in neonates (MIS-N) has been increasingly reported, but
proof of vertical infection, transplacental antibody transfer, and inflammation in neonates are still lacking.
Diagnosis can be more difficult because the varied clinical manifestations, while early management are
required.

Case: A male baby, born by C-section, at 27 weeks of gestation and triplet pregnancy from a mother with
a confirmed history of COVID-19 during pregnancy. At birth, the breathing is inadequate, tachypnea, and
increased work of breathing. Patient was given oxygen therapy with nasal intermittent mandatory ventilation
(NIMV) and admitted to neonatal intensive care unit (NICU). On the third day, there was a history of apnea
and the left hand starts to appear hematom and swelling from the distal of the finger. Two days later the
right hand appear the same, which become bilateral. Doppler ultrasonography showed partial thrombosis and
decreased blood flow in the left distal radial artery. Echocardiography examination revealed pericardial effusion
accompanied by increased level of NT-Pro BNP(1838pg/mL). Laboratory results showed thrombocytopenia,
leukopenia, CRP was normal (1.62 mg/L) increased D-dimer (1.55µg/mL) and high level of SARS CoV-2
antibodies (3496U/mL). Patient was diagnosed with MIS-N and administered methylprednisolone (2mg/kgBW/
day divided into 2 doses) tappered-off within 3 weeks and intravenous immunoglobulin (IVIg) 2 gram/kgBW/
day. The clinical condition was improved, both hands recovered completely, and the laboratory values were
normal after treatment.
Conclusion: MIS-N should be considered in any neonate who has bilateral extremities hematom and swelling,
with maternal COVID-19 infection history. Ruling out other etiologies should be performed before diagnosis-
making.
______________________________________________________________________________________
NEO-09
MICROBIAL PATTERN AND ANTIBIOTIC SUSCEPTIBILITY IN NEONATAL INTENSIVE CARE UNIT,
SENTRA MEDIKA CIBINONG HOSPITAL
Ajeng Puspitasari1, Melisa Anggraeni2, Ryan Susanto3

1
General Practitioner, Department of Child Health, 3Department of Clinical Pathology, Sentra Medika
2
Cibinong Hospital, Bogor, Indonesia
Background/Objective: This descriptive study is to recognized Microbial Pattern and Antibiotic Susceptibility
in Neonatal Intensive Care Unit (NICU) level 2 and level 3. As a reference for clinicians in providing antimicrobial
therapy, either empirical and definitive therapy.
Methodology: This study is a descriptive cross-sectional analysis of prevalent microorganisms isolated from
various culture samples collected from NICU of Sentra Medika Cibinong Hospital. Data were analyzed using
Microsoft Excel. The inclusion criteria are patients who admitted into NICU with the risk factors for neonatal
sepsis, either major or minor factors. Patients whose admitted into NICU without signs of neonatal sepsis were
excluded from the study.
Result: A total of 27 microbial culture positive isolates from our NICU over 12 months (from January 2022
till January 2023). These isolates included samples taken from from blood and sputum culture specimens.
Most common isolated bacterial species were Acinetobacter baumannii (33.3%). The sensitivity percentage
of the antibiotics Amikacin, Amoxicillin-clavulanic, meropenem, Trimethoprim-sulfamethoxazole against
Acinetobacter baumannii is 85.7%. The percentage of sensitivity of Tigecycline and Piperacillin-tazobactam
antibiotics to Acinetobacter baumannii is 100% and 28.6%, respectively.
Conclusion: Current needs are the implementation of strict infection control measures and rationalized use
of broad-spectrum antibiotics and continuous surveillance of emergence of MDROs. Regular tracking of the
microbiological prevalence pattern kept us updated regarding prevailing organisms and emergence of MDROs.
Our NICU antimicrobial policy modified in accordance with the surveillance data.


NEO-10
MANAGEMENT OF CONGENITAL CHOLEDOCHAL CYST IN NEONATE
Markus Mualim Danusantoso1, Ariani Dewi Widodo2, Kemas Firman3, Amir Thayeb4,
Audi Yudhasmara5, Reynaldo Rahima Putra5, Fuka Priesley5
1
Neonatologist, Bunda Women and Children Hospital Jakarta, Indonesia
2
Pediatric Gastroenterohepatologist, Bunda Women and Children Hospital Jakarta, Indonesia
3
Pediatric Radiologist, Bunda Women and Children Hospital Jakarta, Indonesia
4
Pediatric Surgeon, Bunda Women and Children Hospital Jakarta, Indonesia
5
General Practitioner, Bunda Women and Children Hospital Jakarta, Indonesia
Background: Choledochal cyst is a rare entity with incidence of 1 in 100.000-150.000 live births in western
population compared to 1 in 13.000 live births in asian population. It is a congenital dilatation of biliary ducts.
4D fetal ultrasonography can help to recognize it prenatally. Early surgical intervention should be performed
to ameliorate long term sequelae.
Case Report: A term baby boy weighing 3860 grams was born from a primiparous 32-year-old mother,
diagnosed with fetal abdominal tumor in 28 weeks of gestational age. The infant experienced jaundice
and abdominal mass. Abdominal X-ray showed a retroperitoneal cystic mass. Abdominal ultrasonography
suggesting congenital choledochal cyst. Abdominal CT-Scan revealed a giant choledochal cyst type 1C with
size about 34,3mm x 67,2mm x 89,1mm. Complete cyst excision followed by Roux-en-Y hepaticojejunostomy
was performed. No complications encountered post surgery and the infant showed significant improvement.
Conclusion: Epidemiological data on congenital choledochal cyst in Indonesia are not yet available. Congenital
choledochal cyst surgery can be diagnosed prenatally. A multidisciplinary approach and planning of the optimal
surgical treatment strategy showed a good outcome in this high risk infant.
______________________________________________________________________________________
NEO-11
APLASIA CUTIS CONGENITA ASSOCIATED WITH TRISOMY 13: A CASE REPORT
Selina Natalia,1 Diana Adriani Banunaek2
General Practitioner, 2General Pediatrician,

1
Soe Regional General Hospital, Timor Tengah Selatan, East Nusa Tenggara, Indonesia
Background
Aplasia Cutis Congenita (ACC) is a rare congenital skin defect which associated with malformation syndromes.
We report a case of ACC associated with trisomy 13 in limited diagnostic tools hospital.
Case Report
A male newborn, presented with labored breathing after been delivered via spontaneous-vaginal delivery at
home. Apgar score and amniotic fluid status was unknown. Mother, 35-year-old; G3P2,41-42weeks’ gestation;
without any previous medical history. His weight, length and head circumference were 2770g, 46cm and 33cm
respectively. Clinical findings showed tachypnea, intercostals retraction, and dysmorphic trisomy 13 features
like large anterior fontanelle, frontal-bossing, low-set ears, shield-chest, clenched-hands, micropenis, and a

skin defect of 3*1.5cm on parietal region of the head with a depressed scalp, which was diagnosed as scalp
aplasia cutis congenita. No other family members reported having similar symptoms. Basic laboratory workups
within normal range, but at 2 days old it showed hyperbilirubinemia (total bilirubin 10 mg/dl, indirect bilirubin
9.4 mg/dl). Radiology investigation revealed absence of scalp with bilateral posterior parietal bone defect
and dextrocardia. Nasal CPAP, venous lines, and an orogastric tube were inserted. The baby was started on
intravenous infusion of Ampicillin (50 mg/kg/12hr), Gentamicin (5 mg/kg/24hr), and was given Phenobarbital
injection because he had seizures during treatment. 0.1% gentamicin skin ointment was topically given on the
scalp skin defect two times daily. The parents decided to bring him home at day 6 knowing all the major risks.
Conclusion
The case highlights the importance of examining dermatological abnormalities like ACC in cases of
chromosomopathy in remote areas.
______________________________________________________________________________________
NEO-12
A MALE INFANT WITH UNSUSPECTED CONGENITAL DIAPHRAGMATIC HERNIA AND
SIGMOID PERFORATION: A CASE REPORT
Naomi E. F. Dewanto1,2, Zaneth Sugiri1, Topan Brian Kiting3

1
NICU Department, Siloam Hospitals Kebon Jeruk, Jakarta, Indonesia
2
Pediatric Department, Medical Faculty, Tarumanegara University, Jakarta, Indonesia
3
Surgery Department, Siloam Hospitals Kebon Jeruk, Jakarta, Indonesia
OBJECTIVE
To share about Congenital Diaphragmatic Hernia (CDH) and how to support recovery process for a better
prognosis
CASE
A 38 weeks male infant was born from primigravida mother via caesarean section because of IUGR with
breech presentation, Apgar score 9/9, birthweight 2630 g. His mother completed ANC by midwife. While in the
transition room, he had respiratory distress and given oxygen supplementation. The chest X-ray showed Left-
sided Diaphragmatic Hernia, immediately intubated and consulted to pediatric surgeon. The echocardiography
showed PDA. The abdomen organs (small intestines, spleen) had herniated into the thoracic cavity which
was successfully restored back into the peritoneal cavity and diaphragmatic defect was closed. He was given
antibiotics (Ceftazidime, Amikacin, Metronidazole), Midazolam and TPN. His abdomen was distended. The
abdominal Doppler showed high resistence waveform in the superior mesenteric artery (suspected bowel
edema) while the abdomen X-ray showed gastic dilatation, suspected adhesion. Day 8th, he had to undergo
laparotomy exploration and sigmoid perforation was found. He was given Meropenem and Vancomycin
(according to wound culture result), albumin and blood transfusion. Day 11th, he vomited with distended
abdomen. The pediatric surgeon performed paracentesis (serous ascites). Day 15th, he feeded 5 mL breastmilk
and extubated to non-invasive ventilation.
CONCLUSION
CDH infants have a prolonged length of stay requiring multi-disciplinary approach. It is important to detect
anomalies during antenatal period for better preparation and prognosis.

NEO-13
THE IMPORTANCE OF PULSE OXYMETRY SCREENING FOR CRITICAL CONGENITAL HEART
DISEASE: NEONATE WITH HYPOPLASTIC LEFT HEART SYNDROME
Raden Diah Mutmainah1, Nuning Indriyani 2
1
General Practitioner Cicalengka Regional Hospital, Bandung, Indonesia
2
Pediatrician Cicalengka Regional Hospital, Bandung, Indonesia
Background
Hypoplastic left heart syndrome (HLHS) is a rare congenital heart disease in which the left side of the heart is
underdeveloped. Early intervention offers better outcome.
Case description
A male neonate was delivered from mom with premature rupture membrane, APGAR 7/9 and weigh 2.3 kg.
Physical examination were afebrile, no abnormal facie, tachypnoeic, with central and peripheral cyanosis. He
was not pale and jaundice. The second heart sound was normal, pansystolic murmur grade 4/6 best heard on
the left lower sternal edge, preductal saturation was 68% and postductal 84%. Critical congenital heart disease
(CCHD) was suspected.
Echocardiography shows HLHS, moderate Patent Ductus Arteriosus (PDA), and small secundum Atrial Septal
Defect (ASD). He died 4 weeks later while waiting for referral. HLHS is CCHD consists of malformed left heart
chambers, valves, and blood vessels which leads to inefficient pumping action. Consequently, the right side of
the heart takes over, causing right ventricle hypertrophy and heart failure. The infant may appear healthy at birth,
thus pulse oximetry screening is mandatory. Clinical features include poor feeding, weakness, and cyanosis.
Echocardiography reveals hypoplastic mitral valve, aortic root, small and hypertrophic left heart chambers.
Treatment for HLHS is limited in our setting, reflected by lack of intensive care, delayed echocardiography and
cardiothoracic surgeon intervention for Norwood Procedure.
Conclusion
Prompt use of pulse oximetry screening and echocardiography is vital for CCHD. Staged intervention offers
better outcome, but it is still limited in Indonesia.
Keywords
Congenital heart disease, echocardiography, hypoplastic left heart syndrome
______________________________________________________________________________________
NEO-14
MULTISYSTEM INFLAMMATORY SYNDROME IN NEONATES (MIS-N): INDONESIA EXPERIENCE
Nikita Shalifa1, Markus Mualim Danusantoso2, Mulya Rahma Karyanti3
General Practitioner, Bunda Women and Children Hospital, Jakarta

1
2
Neonatologist, Bunda Women and Children Hospital, Jakarta
3
Pediatric Infectious Disease, Bunda Women and Children Hospital, Jakarta
BACKGROUND: Neonates presenting with MIS-N are rare with an estimated mortality rate of 9%. Thirty-
two neonates were reported to have developed MIS-N after acquiring the SARS-CoV-2 antibody from their
mothers. Thirteen infants (40.6%) required ICU admission.
CASE: A 38-week gestational-age female newborn developed severe respiratory distress syndrome and

acute bleeding from the lung and stomach two hours after delivery. She also demonstrated neonatal fit, fever,
and hypotension the day after. A thoracoabdominal x-ray found transient tachypnea of the newborn (TTN),
necrotizing enterocolitis (NEC) grade 1, and abdominal sepsis. Abdominal ultrasound led to neonatal adrenal
hemorrage. Inflammatory markers were elevated for procalcitonin, CRP, D-dimer, troponin-T, troponin-I, and
NT-proBNP. The aldosterone level was also elevated. The antibody SARS-CoV-2 quantitative level was
positive. The ECG and echocardiography were normal. The mother never tested positive for SARS-CoV-2
during pregnancy. However, she had flu-like symptoms a month before delivery. The patient was diagnosed
with MIS-N, requiring mechanical ventilation and inotropic support. She was treated with methylprednisolone
(2 mg/kg/day for 7 days, then tapered off) until 3 weeks and received intravenous immunoglobulin (IVIG) at 2
g/kg with subsequent significant improvement.
CONCLUSION: Respiratory distress syndrome, fever, cardiac dysfunction, and acute bleeding manifestations
in neonates with elevated inflammatory markers during the COVID-19 pandemic should alert the pediatrician
to the possibility of MIS-N.
______________________________________________________________________________________
ERIA-01
CORRELATION OF URINARY ALBUMIN CREATININE RATIO WITH KIDNEY INJURY MOLECULE-1
(KIM-1) AS A MARKER OF KIDNEY INJURY IN CRITICALLY ILL CHILDREN
Visia Vrisca1, Rina Amalia C. Saragih1, Rizky Adriansyah1
1
Department of Paediatrics, Faculty of Medicine, Universitas Sumatera Utara, Haji Adam Malik General
Hospital, Medan, North Sumatra, Indonesia
Introduction: Inflammatory changes affect the critically ill children, with kidney as one of many organs
involved. As a gold standard in diagnosing acute kidney injury, creatinine level has some limitation, including
inability to detect early degradation of kidney function, with many determining factors such as gender, body
mass and nutritional status. Kidney Injury Molecule-1 (KIM-1) was a biomarker that is proved to be sensitive in
early cases of kidney injury, but is not widely available in daily practice and has higher price. Urinary Albumin
Creatinine Ratio (ACR), in some studies shows fluctuation in level due to kidney injury following systemic
inflammation. This study was aimed to evaluate correlation between urinary ACR and KIM-1 as marker of
kidney injury in critically ill children.
Method: This was a cross sectional study involving 44 critically ill children in Haji Adam Malik Hospital during
November 2021- February 2022. Urine samples were collected by trained professional and sent to laboratory
for ACR and KIM-1 assessment. The correlation was then evaluated by using statistical software.
Result: The median value of urinary ACR and KIM-1 were 156.66 and 1.55 respectively. The result of Spearman
correlation test showed a significant correlation between urinary ACR and KIM-1 (p<0.05) with correlation
coefficient R=0.417.
Conclusion: There was a significant correlation between the Urinary ACR and KIM-1 in critically ill children.
We suggest further study to evaluate applicability of urinary ACR in detecting early kidney injury in critically ill
children.
Keyword: Albumin Creatinine Ratio, Kidney Injury Molecule-1, critically ill children, kidney injury

ERIA-02
CASE SERIES OF RECRUITMENT MANEUVER USING HIGH FREQUENCY OSCILLATORY
VENTILATION AFTER PEDIATRIC CARDIAC SURGERY
Fathy Z Pohan, Sharfina F Hidayat, Yogi Prawira
Cipto Mangunkusumo Hospital, Jakarta
Introduction: Respiratory failure following pediatric cardiac surgery is not uncommon. These often lead to
higher ventilator settings, causing VILI and later compromising cardiac function. Several studies showed
HFOV benefits in reducing VILI incidence, yet concerns remain regarding to possible negative hemodynamic
consequences in right heart dysfunctions. Previous pediatric data hints at HFOV’s safety and feasibility while
giving favorable outcomes for cardiac patients, but few reported the use of recruitment maneuver while using
HFOV.
Method: Four cases of pediatric post cardiac surgery receiving HFOV as the treatment for ARDS in cardiac
intensive care unit from November 2022 to February 2023 are reported.
Result: With ages ranging from 9 – 30 months old, the cases consist of 2 TOF, VSD, and DORV subpulmonic
VSD. All had one or more comorbidities, including Down syndrome, PH, and recent severe COVID-19. Three
patients underwent definitive surgery, while one underwent palliative surgery. Serious post-op complications
such as low cardiac output syndrome, systemic inflammatory response syndrome, sepsis, TAVB, right heart
failure, and severe hypoxemia were found in all patients. HFOV was given for all patients, and recruitment
maneuver was performed at some points of HFOV. The longest HFOV duration was 18 days, whereas
the shortest was 9 days. Clinical and oxygenation metrics showed considerable results and no negative
hemodynamic effects despite aggressive MAP used. Two patients survived and were successfully discharged
from the hospital.
Conclusion: HFOV and recruitment maneuver following pediatric cardiac surgery for severe refractory
hypoxemia due to ARDS could be implemented without generating serious complications.
______________________________________________________________________________________
ERIA-03
RECRUITMENT MANEUVER USING HIGH FREQUENCY OSCILLATORY VENTILATION IN POST-
CARDIAC SURGERY PATIENT: A SUCCESS STORY
Fathy Z Pohan, Reni Fitriasari, Liza Fitria, Dian Kesumarini, Eva M Marwali, Novik Budiwardhana
National Cardiovascular Center Harapan Kita Hospital, Jakarta
Introduction
High Frequency Oscillatory Ventilation (HFOV) has long been used for managing refractory respiratory
failure after pediatric cardiac surgery, particularly acute respiratory distress syndrome (ARDS), and showed
acceptable outcomes. Only limited publication reporting recruitment maneuver (RM) using HFOV in this
specific population.
Case
We presented 6-month-old baby girl with intractable heart failure and recurrent pulmonary infections who
underwent surgical VSD closure during the last episode of hospitalization. She had complicated post-operative

course with signs of severe refractory hypoxemia due to severe ARDS and pulmonary hypertension (PH).
Hypoxemia persisted despite optimal respiratory and hemodynamic support, antimicrobial and PH therapy.
On the 3rd post-operative weeks she had severe refractory repiratory failure leading to cardiac arrest, followed
by cardiopulmonary rescucitation for almost 1 hour. Recruitment maneuver using conventional mechanical
ventilator (MV) performed later was unresponsive, so we decided to do RM using HFOV as published by
Kneyber et al which identified upper and lower inflection point at 38 and 23 cmH2O, respectively. We also used
low dose iNO at 5 ppm as a combination therapy. We were successfully improved hemodynamic, oxygenation
and ventilation parameters with these maneuvers. Subsequently, patient was switched to MV after 6 days
on HFOV, extubated after 15 days on MV, and discharge home without profound respiratory and neurologic
complication.
Conclusion
Recruitment maneuver using HFOV after pediatric cardiac surgery showed favorable outcomes without serious
complications, therefore it could be considered as rescue therapy while indicated.
______________________________________________________________________________________
ERIA-04
MANAGEMENT OF FLUID OVERLOAD IN OVERWEIGHT AND OBESE PEDIATRIC PATIENTS WITH
DENGUE SHOCK SYNDROME (DSS); A LITERATURE REVIEW
Zulfikar Caesar Narendra1, Tuty Rahayu2
1
General Practicioner, Pasar Rebo Regional General Hospital
Pediatric Intensivist, Pasar Rebo Regional General Hospital
2
BACKGROUND: Overweight and obese patients have a 38% more risk of developing dengue shock syndrome
(DSS) because of more complex immunology responses and lower cardiac output. Fluid overload is a
complication of DSS caused by mismanagement and overestimation of fluid administered during resuscitation
and defervescence period. Thus, fluid management and close monitoring is required to achieve hemodynamic
stability.
METHODS: We retrieved various journals for the last 15 years from reliable sources such as PUBMED,
Elsevier, Oxford Academic, BMJ, Sari Pediatri, and Paediatrica Indonesiana. The keywords were obesity,
overweight, pediatric, fluid management, fluid overload, and dengue shock syndrome.
RESULTS: Overweight children (BMI > 85th percentile) have an increased risk of developing severe plasma
leakage. The possible pathophysiology behind this phenomenon might be due to white adipose tissue
chronically releasing proinflammatory cytokines. Estimated body weight (EBW) often used to calculate
the required resuscitation fluid for overweight and obese patients. Colloid or hypertonic solution might be
considered as bolus fluid instead of crystalloid. If the patient is hemodynamically stable, furosemide 0.1-0.5
mg/kg/dose once or twice daily can be given as diuretics. Renal replacement therapy might be indicated if the
patient is hemodynamically unstable.
CONCLUSION: Obesity is known to be one of the risk factors of developing DSS. There was a 6% increase
in odds of mortality for every 1% increase in fluid overload percentage. Knowing when to stop the intravenous
fluid and recognizing signs of fluid overload in obese children with DSS is crucial to avoid further complication.

ERIA-05
WITHDRAWAL OF THE MECHANICAL VENTILATOR IN
THE PEDIATRIC INTENSIVE CARE UNIT
Asri Yuniastuti, Nurnaningsih, Desy Rusmawatiningtyas, Intan Fatah Kumara
Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada-DR.
Sardjito General Hospital Yogyakarta Indonesia
BACKGROUND
It's common in emergency situation that mechanical ventilation shoud be performed for live saving, while the
definite diagnosis and prognosis still uncertain. With parental or share decision making, it is ethically possible
to discontinue a mechanical ventilation in PICU for condition with poor prognosis but dependent long-term
breathing assistance.
CASES
At the PICU Sardjito Hospital in Yogyakarta, 4 cases of MV withdrawal were carried out between October 2021
and March 2023. A clinical discussion and parent education were completed prior to the parents' decision to
withdraw the MV. Spinal muscular atrophy (SMA) was found in 2 cases, while Congenital pulmonary airway
malformation (CPAM) type 1 was found in 2 additional cases. The medical team recommended employing a
home ventilator in the SMA cases since they believed the patient will require a MV for a considerable amount
of time. The child was taken home after the parents decided to withdraw the ventilator.
The first case passed away 8 days after the MV was withdrawn, while the second case passed just 2 hours
afterwards. The medical team came to the conclusion that both of the two further cases—both of which had
been diagnosed with CPAM—were inoperable (both were 2 months old). The MV was withdrawn at the parental
decision making. The third patient passed away 6 hours after the MV withdrawal, while the other patient
passed away at home 24 hours later.
CONCLUSION
With the permission or parental decision making, MV support may be discontinued in the PICU for patients
who are dependent on a ventilator or who are in terminal condition.
Keywords: withdrawal mechanical ventilator, parental decision making, pediatric intensive care unit
______________________________________________________________________________________
ERIA-06
LEPTOSPIROSIS: SOMETHING THAT IS INITIALLY MILD, BUT CAN BE DEATHLY
Sutanto, Ivana Lola1, Munster, Robby Godlief2
1
General practitioner, Siloam Hospitals Purwakarta, West Java, Indonesia
2
Pediatrician, Siloam Hospitals Purwakarta, West Java, Indonesia
Leptospirosis is a tropical infectious disease that often occurs in tropical and subtropical regions, especially in
the rainy season. This disease had become an extraordinary event several years ago. Until now, people still
underestimate this disease and often carry out activities without using simple personal protective equipment,
such as boots.

The patient was a boy, 14 years old, with jaundice and weakness noticed by the parents since 1 day before
admission. Complaints were accompanied by the patient becoming restless and incommunicado, fever,
vomiting spray containing fresh blood, diarrhoea, and dark red urine accompanied by dark red blood clots. The
patient's consciousness was somnolent, conjunctiva anaemic, sclera icteric, tenderness in the gastrocnemius,
and skin icteric. The supporting examination showed haemoglobin 4.7, leukocytes 33,600, index bilirubin
10.77, SGOT 131, urinalysis showed gross haematuria and proteinuria. The patient was given supportive
therapy, doxycycline during treatment and packed red cell transfusion, and showed a good response.
History of illness or contacts can help in diagnosis but is often not done. The patient's family often thought that
jaundice was only due to infection from hepatitis A, but it had progressed to icteric leptospirosis and could lead
to meningitis. This leads to delayed treatment until it has progressed to severe leptospirosis.
______________________________________________________________________________________
ERIA-07
MENINGITIS TUBERCULOSIS WITH COMPLICATION OF PNEUMONIA IN A 9-YEARS OLD CHILD: A
CASE REPORT
Marsha Kurnia Chyntia Maharani1, Martinus M. Leman2, Helen Yudi,3

1
General Practitioner, 2 Pediatric Department, 3 Intensive Care Unit
Sentra Medika Cibinong Hospital, Bogor, Jawa Barat, Indonesia
Background:
Meningitis Tuberculosis (MTB) is an infection of meningeal membrane caused by Mycobacterium tuberculosis.
Although the incidence is only 1% of the total tuberculosis cases, MTB is the most severe form of the disease,
which can be deadly with severe sequelae.
Case Illustration:
A 9-year-old girl came with chief complaint of fever, cough, severe headache for more than 7 days. Chest x-ray
revealed bronchopneumonia, suspect miliary tuberculosis. Initial therapy given was ceftriaxone antibiotic. Anti-
tuberculosis medication has not been given, waiting for tuberculin test. The next day, she had seizure and
lost consciousness. Neck stiffness, Brudzinski-I, and positive clonus sign were found. GCS E2M5V1. Chest
retraction with crackles were detected. She was transferred to PICU with diagnosis MTB with respiratory
distress. Ventilation support, anti-tuberculosis (RHZE), and steroid were given immediately. Cerebrospinal
fluid analysis was carried out with the result of MTB, also the GeneXpert found Mycobacterium tuberculosis,
sensitive to rifampicin. There was no improvement after 5 days, with worsening chest x-ray. Ceftriaxone was
switched to levofloxacin. She had significant improvement, regained consciousness on day-8, and ventilation
weaned on day-10. Later on, the result of endotracheal tube was Streptophomonas maltophilia, sensitive to
levofloxacin. She was discharged after 20 days with no sequelae.
Conclusion:
Every child with complaint of prolonged fever and severe headache should be suspected of meningitis. Anti-
tuberculosis drugs should be given as soon as chest x-ray detected miliary TB and should be aware of other
complications. Immediate and prompt treatment could prevent further life-threatening and sequalae risks.

ERIA-08
APPROACH TO CRITICALLY ILL CHILDREN WHO PRESENTED WITH SEVERE METABOLIC
ACIDOSIS: A CASE SERIES
Desy Rusmawatiningtyas, Asri Yuniastuti, Nurnaningsih, Intan Fatah Kumara,

Weda Kusuma
Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada-DR.
Sardjito General Hospital Yogyakarta Indonesia
BACKGORUND
Metabolic acidosis is the most common acid-base disturbance that can be found in critically ill children admitted
to Pediatric Intensive Care Unit (PICU). All blood gas analysis (BGA) results that indicate metabolic acidosis
must include a calculation for the anion gap. Since the treatment for metabolic acidosis depends on the
underlying etiology, an accurate anion gap calculation can help a physician determine the patient's underlying
etiology and diagnosis. Here we discussed 3 cases of severe metabolic acidosis with various underlying
causes.
CASES
From March to May 2023, three patients with severe metabolic acidosis admitted to our PICU in DR Sardjito
Hospital in Yogyakarta.
The first case was a 17-month-old girl with chief complaint was acute dyspnea, non febrile seizure, and
decreased of consciousness. She also in severe malnutrition state and had global development delay. Initial
Laboratory findings showed: Hb 11 g/dL; Leucocytes 13,500/µL; Platelets 203,000/µL; Glucose 201 mg/dL.
BGA pH 6.9, pCO2 10.4 mmHg, pO2 163 mmHg, HCO3 2.0 mmol/L, BE <-30, SaO2 98%, Lactat 1.14 mmol/L,
Sodium 131 mmol/L, Potassium 4.8 mmol/L, Chloride 100 mmol/L, Calcium 2.02 mmol/L. BUN 17 mg/dL,
creatinine 0.56 mg/dL, ammonia 225 µmol/L, urine ketones 3+. The combination of anamnesis, physical
examination, and BGA results that revealed metabolic acidosis with high anion gap helped us to diagnose an
inborn error of metabolism (IEM). We treated the patient by administering intravenous sodium bicarbonate and
a protein-free diet.
Second case was An 18-month-old girl presented with dyspnea, decreased of consciousness, cough, fever,
frequent vomiting but no diarrhea. She was underweight. Laboratory findings: Hb 7.4 g/dL, Leucocytes 73,000/
µL, platelets 418,000/µL, Glucose 135 mg/dL. BGA: pH 6.80, pCO2 17.9 mmHg, pO2 93 mmHg, HCO3 2.8
mmol/L, BE -29.58, SaO2 96%, Lactat <1.0. Sodium 142 mmol/L, Potassium 4.4 mmol/L, Chloride 105 mmol/L,
Calsium. 2.22 mmol/L; ammonia 200 µmol/L, urine ketones 2+; procalcitonin >100 ng/mL; BUN 66 mg/dL,
creatinine 1.39 mg/dL. The combination of anamnesis, physical examination, and BGA results that revealed
metabolic acidosis with high anion gap helped us to diagnose Acute Kidney injury failure phase. Later, we
discovered that this patient's underlying condition was sepsis. Furosemide, fluid restriction, and antibiotics are
the main treatments we use for this patient.
Third case was a 2.5-month-old boy who had a fever for two days prior to his arrival and unable to drink.
He was severe malnutrition. Laboratory findings: Hb 7.4 g/dL, Leucocytes 16,400/µL, Platelets 201,000/µL;
Glucose 68 mg/dL; BGA: pH 6.990, pCO2 35.8 mmHg, pO2 184.6 mmHg, HCO3 8.4 mmol/L, BE -21.5 SaO2
100%, Lactat 1.2, Sodium 164 mmol/L, Potassium 4.0 mmol/L Chloride 142 mmol/L Calcium 2.11 mmol/L;
Albumins 2.97; Procalcitonin 9.19 ng/mL; ammonia <17 µmol/L; negative urine ketones. The combination
of anamnesis, physical examination, and BGA results that revealed metabolic acidosis with high anion gap
helped us to diagnose severe dehydration. We manage this patient with rehydration fluid.
CONCLUSION:
Since treatment for metabolic acidosis depends on identifying the underlying cause, accurately calculating the
anion gap can help physicians diagnose their patients and give specific treatment.
Keywords: metabolic acidosis, anion gap, diagnosis

ERIA-09
A CASE REPORT: FOCAL-ONSET WITH IMPAIRED AWARENESS SEIZURE AS AN ADVANCED
CLINICAL MANIFESTATIONS OF ACUTE POST-STREPTOCOCCAL GLOMERULONEPHRITIS (APGN)
Rufaida Mudrika1, Yuliana Masnita D2
1
General Practitioner, Pediatric Intensive Care Unit, RSUP Dr. Sitanala Tangerang
2
Pediatrician, KSM Pediatric, RSUP Dr. Sitanala Tangerang
Introduction: Focal-onset with impaired seizure is a clinical manifestation of heterogeneous etiologies.
Developing hypertensive encephalopathy following post-streptococcal glomerulonephritis is a known but
uncommon manifestation. We report a case of focal-onset with impaired awareness seizure in the background
of acute post-streptococcal glomerulonephritis.
Case Description: A 9-year-old Indonesian boy came to the emergency room with recurrent seizures eight
times for > 10 minutes. The type of seizure is a focal-onset seizure with impaired awareness. The seizure
begins with nausea and vomiting five times, a headache, and brownish-yellow urination. Three weeks ago,
the patient had pharyngitis. On examination, hemodynamically unstable with severe hypertension and oxygen
desaturation. Urinalysis results showed proteinuria (2+), occult blood (4+), and albuminemia. The left and
right kidney parenchyma were still within normal limits sonographically. The patient was diagnosed with
encephalopathy hypertensive on APGN. The patient was treated with fluid restriction management, nicardipine
syringe pump, omeprazole, ondansetron, furosemide, ceftriaxone, phenytoin, and valproic acid. The patient
was discharged from PICU after 3x24 hours seizure-free with a good outcome without sequelae.
Conclusion: Post-streptococcal glomerulonephritis is an important cause of acute nephritic syndrome,

especially in children. This case report illustrates a rare association of focal-onset seizures with impaired
awareness in a patient with post-streptococcal glomerulonephritis.
Keywords: focal-onset seizure, hypertensive encephalopathy, acute post-streptococcal glomerulonephritis,

acute nephritic syndrome, Indonesia.
______________________________________________________________________________________
ERIA-10
INTRAVENOUS IMMUNOGLOBULIN (IVIG) IN AN INFANT WITH SEVERE PNEUMONIA ASSOCIATED
VARICELLA: CASE REPORT
Ronald Chandra, Petra Leatemia
Pediatric Intensive Care Department, Graha Hermine Hospital, Batam, Riau Island, Indonesia
BACKGROUND. Varicella (chickenpox) is highly contagious disease with a broad range of clinical presentation
from mild to severe complicated episodes requiring hospitalisation and intravenous therapy. Varicella
pneumonia as severe and fatal complication in adults is rare in children, more notably infants.
CASE. A 1-month-old boy was admitted to PICU with severe acute respiratory failure. Previously, he was treated
in pediatric ward for 2 days with fever, grunting and vesicular lesions with different stages of development
predominantly at face and trunk. Fever began 4 days before his hospitalization, grunting and vesicular lesions
occurred on the day of hospitalization. His mother got chickenpox a few days before. He appeared pale,
irritable, confused and dyspnea during PICU’s admission. His blood pressure, heart rate, respiratory rate,
temperature and oxygen saturation were 103/47mmHg, 186 beats/minutes, 69 breaths/minutes, 37.8oC and
81% with nonrebreathing mask. Breath sounds decreased and diffuse cracles were auscultated during physical
examination in addition to severe respiratory distress signs. Laboratory findings showed haemoglobin 13.9 g/

dL, leucocyte 12,580/mm3, platelet 176,000/mm3, ferritin 1,200ng/mL, C-reactive protein 24mg/dL and acidosis
respiratory. Chest X-ray showed infiltrates on both lungs. He was intubated and mechanically ventilated under
continuous sedation and muscle relaxant, treated with meropenem, acyclovir and paracetamol. IVIG was
given on 3rd day due to unimproved clinical state. His condition improved gradually and he was extubated after
4 days of IVIG administration.
CONCLUSION. Early administration of IVIG and antiviral combined with mechanical respiratory support in
severe pneumonia associated varicella has been proved as an adequate treatment and may result in positive
outcome.
Keywords: varicella, chickenpox, infants, pneumonia, ivig
______________________________________________________________________________________
ERIA-11
RARE EVENT OF ANAPHYLAXIS REACTION IN A RABIES POST-EXPOSURE PROPHYLAXIS
VACCINE: A CASE REPORT
Janet Tee1, Ronald Sugianto1, Derryl Ravertio Timothy Subroto1, Dian Purnama Sari2
Faculty of Medicine, Universitas Udayana, Bali, Indonesia

1
2
Department of Pediatric, Komodo Regional Hospital, Labuan Bajo, Indonesia
BACKGROUND: One of the most fatal infectious illnesses, rabies can result in severe symptoms in humans
and almost 100% fatality if patients don't receive prompt and sufficient PEP (Post Exposure Prophylaxis).
Despite the rarity of allergic responses following rabies immunization, vaccines that protect against infectious
illnesses can cause anaphylaxis. Determine if the patient will respond quickly to therapy, pass away in a matter
of minutes, or recover on their own as a result of endogenous adrenaline, angiotensin II, and endothelin I
secretion. The care of children suffering from anaphylactic shock will be the main topic of this case report.
CASE: A six-year-old male patient was admitted to emergency department with shortness of breath, swelling
of the whole face and body, gasping for air, and cyanosis of lips, hands, and feet. Previously, the patient
was bitten by a dog on the front and right side of his neck 90 minutes prior. He was sent to the community
health care facility and administered PEP immediately. It was administered in two ampules without any direct
adverse reactions were seen in the following 30-minute observation. Neither previous illnesses nor allergies
were reported by his parents. When the patient arrived in emergency room, cyanosis was evident, and he
was agitated. Airway was secured using head tilt and chin lift. Oxygen saturation was 60%, thus was given 10
liters/minutes oxygen. He was then given an intramuscular injection of 1:1000 0.3 mg epinephrine and fluid
challenge of 300 cc ringer’s lactate solution. Upon reassessing, his vitals sign was not getting better. He had
cardiac arrest, resuscitated, but to no avail.
CONCLUSION: During the treatment of rabies, anaphylaxis reactions were inevitable. Post procedure
monitoring and emergency management of anaphylaxis reactions must always be prepared to prevent a fatal
adverse reaction. Adequate preparation for both equipment and medical personnel is necessary to produce a
better outcome.
Keywords: Anaphylaxis, Rabies, Post-Exposure Prophylaxis, Vaccine, Children, Case Report

ERIA-12
ACUTE KIDNEY INJURY IN PEDIATRIC WITH NEPHROTIC SYNDROME: A CASE REPORT
Amirah Muhammad Abdullaha, Abdul Haris Khoironib
a
Emergency Department, PKU Muhammadiyah Mojoagung Public Hospital, Jombang, Indonesia
b
Pediatric Department, PKU Muhammadiyah Mojoagung Public Hospital, Jombang, Indonesia
Background One of the most prevalent kidney illnesses in children is nephrotic syndrome (NS). Children with
NS have been known to experience a number of problems, including infections, thrombosis, hypovolemia, and
acute kidney damage (AKI). AKI that is more prominent in NS, however, is multifactorial. Although other causes
may also be present, hypovolemia, nephrotoxic medications, and infections are the most frequent secondary
causes. AKI has become more prevalent in NS over the past few years. Data on the relationship between AKI
in pediatric NS and long-term outcomes are scarce.
Case Report
A 12-year-old kid (weight:39 kg) appeared with face and legs swollen for 4 days, along with nausea, oliguria,
and abdominal pain. When he presented, BP was 100/80 mmHg and HR was 112. Investigations found that
the patient had nephrotic syndrome and renal insufficiency (serum creatinine 5.49 mg/dl). Urinalysis revealed
proteinuria +3 and albumin 2.5 g/dl. He received treatment with furosemide 0.5 mg/kg/day and 2 mg/kg/day
of prednisone. He continued to be edematous after receiving medication for 5 days, and his serum creatinine
level decreased to 1.47 mg/dl. Steroid was continued in the same dosages. He didn't have any edema when
he returned for a follow-up visit two weeks later, and his serum creatinine decreased to 0.8 mg/dl.
Conclusion
Given the relatively high prevalence of NS in children and the seemingly rising rates of AKI, it's important to be
able to identify and treat AKI early on to avoid complications later on.
Keyword: Nephortic Syndrome, AKI, serum creatinine
______________________________________________________________________________________
ERIA-13
SEVERE DIABETIC KETOACIDOSIS IN TYPE I DIABETES MELLITUS WITH NON-COMPLIANT
SUBCUTANEOUS INSULIN ADMINISTRATION
Sutanto, Ivana Lola1, Hamik, Welli2
1
General practitioner, Siloam Hospitals Purwakarta, West Java, Indonesia
2
Pediatrician, Siloam Hospitals Purwakarta, West Java, Indonesia
Diabetic ketoacidosis is common in children under 2 years of age with type I diabetes mellitus. This is due to
late treatment. The incidence of diabetic ketoacidosis is 1-10% per patient per year. The risks of ketoacidosis
include poor metabolic control, previous history of diabetic ketoacidosis, non-compliance with insulin use,
children with eating disorders, and low socioeconomic status.
The patient is a girl, 11 years old, who came to the emergency room with an unconscious and restless condition.
Complaints were accompanied by shortness of breath, nausea, and vomiting. The patient had a history of type
I diabetes mellitus but the patient never wanted to inject insulin and the parents also did not want to help with
administration. At the emergency room, the patient was in a somnolent state of consciousness with blood

pressure 100/60, heart rate 123 per minute, respiratory rate 40-50 per minute, oxygen saturation 94-96% free
air, and Kussmaul breathing pattern. When a blood sugar test was carried out, the result was 546, then a blood
gas analysis was carried out and obtained pH 6.839, pCO2 10.1, HCO3- 1.7, total CO2 1.8, and base excess
-31.2. Electrolyte examination revealed sodium 139.6, potassium 4.56, and calcium 1.307. The patient's family
refused intubation and sodium bicarbonate, and only wanted insulin drip. Close monitoring of general condition
and vital signs, serial blood glucose checks per hour, serial blood gas analysis checks per 6 hours, and dose
adjustment of insulin drip until it can be changed to subcutaneous insulin. The patient returned in a stable
condition and compos mentis consciousness, with stable blood sugar levels in the range of 90-180.
The importance of the role of parents in the level of compliance with insulin use in pediatric patients is still
considered unnecessary. The need for increased education to the worst conditions needs to be done so that
parents can understand and can prevent diabetic ketoacidosis or even cerebral edema in type I diabetes
mellitus. It is necessary to find other ways of giving insulin so that pediatric patients can comply and feel that
insulin administration is not traumatic, but for their own good.
______________________________________________________________________________________
ERIA-14
A CASE OF SPONTANEOUS INTRACRANIAL HAEMORRHAGE WITH UNRECOGNIZED
HAEMOPHILIA A
Ajeng Puspitasari1, Daniel1, Martinus M. Leman2, Yudi Yuwono Wiwoho3
1
General Practitioner, 2Department of Child Health, 3Department of Neurosurgery,
Sentra Medika Cibinong Hospital, Bogor, Jawa Barat, Indonesia
Background/Objective: Spontaneous Intracranial haemorrhage (ICH) is an uncommon manifestation of

haemophilia that presents in childhood. ICH in children with inherited bleeding disorders is a potentially life-
threatening complication and presents a significant therapeutic challenge.
Case: A 3-year old boy presented to the hospital with a chief complaint of sudden deterioration of consciousness
after vomiting several times. There were histories of easy bruising from mild impacts. The GCS was 9/15
(E2V2M5) and he had a left hemiparesis (grade 4/5) and anisocoria. Blood pressure was 95/58 mmHg, heart
rate 178 bpm, respiratory rate 40 bpm, oxygen saturation 98% with 7lpm of oxygen. Head CT-scan revealed
an acute subdural hematoma along the subdural fronto-temporo-occipital and subarachnoid hemorrhage
along falx cerebral interhemisphere. Seizures were found during treatment in PICU. Emergency craniotomy
was planned but then postponed due to prolonged PT and aPTT. Conservative therapy was carried out by
administering FFP and cryoprecipitate, with periodic clinical evaluations. In further evaluation there was a
low Factor VIII (3.1%), which lead to the diagnosis of Moderate Haemophilia A. Due to clinical improvements
during treatment, no craniotomy was performed. He was then discharged from the hospital without sequelae
and later sent to referral hospital for haemophilia routine management.
Conclusion: It is important to consider inherited bleeding diseases in spontaneous intracranial hemorrhage.

Emergency craniotomy was neither always possible nor always necessary to be performed, depending
on patients’ conditions. Inherited and acquired bleeding disorders are important considerations in children
presenting with ICH regardless of their age or history of bleeding.

ERIA-15
EFFECTIVENESS OF ISOTONIC RESUSCITATION FLUID COMPARED WITH
HYPOTONIC SOLUTIONS IN CHILDREN WITH SEPTIC SHOCK
AT H. ADAM MALIK HOSPITAL MEDAN
Rahmi Silviyani, Ririe Fachrina Malisie, Rizky Adriansyah
Department of Pediatrics, Faculty of Medicine, Universitas Sumatera Utara
Introduction
Early fluid resuscitation is essential to stabilize tissue hypoperfusion and crystalloid are the mainstay of choice
for resuscitation in septic shock. This study to determine the effectiveness of isotonic compared to hypotonic
in septic shock resuscitating.
Methods
Experimental study with open label study, which was conducted on septic shock children aged 1 month - 18
years at H. Adam Malik Hospital. The study was conducted on September to December 2022. The samples
divided into 2 arms, this received Ringer,s solution and hypotonic solution. Analysis with SPSS program with
95% CI and a significance p <0.05.
Results
There were 42 children in this study. From analysis, no significant difference in resuscitation targets among two
groups at initial. After 24 hours, consciousness (p=0.009) Relative Risk (RR) 1.8 (95% CI = 1.112-2.913) and
blood pressure (p=0.011) RR 1.889 (95% CI = 1.106-3.227) were significance. The difference of resuscitation
targets between the initial and 24-hour examination in group Ringer,s solution showed significance differences
for PELOD-2 score, heart rate and respiratory rate, cardiac index (CI), stroke volume resistance (SVR). In
group hypotonic solution showed significant differences for PELOD-2 scores, respiratory rate, blood pressure,
SVI, CI, and stroke volume resistance (SVR).
Conclusion
From group Ringer,s solution and hypotonic solution have archieved targets same at initial, but after
resuscitation there was differences of level of consciousness and blood pressures
Keywords: Septic shock, resuscitation, isotonic solution, hypotonic solution
______________________________________________________________________________________
ERIA-16
MULTI-SYSTEM INFLAMMATORY SYNDROME (MIS-C) IN CHILDREN: A SYSTEMATIC REVIEW OF
CLINICAL FEATURES, TREATMENT AND POSSIBLE OUTCOMES
Ni Luh Putu Diaswari Predani1, Celine1, I Gde Doddy Kurnia Indrawan2

Child health Department, Wangaya General Hospital, Denpasar, Bali, Indonesia
1
2
Pediatric Intensive Care Unit, Wangaya General Hospital, Denpasar, Bali, Indonesia
BACKGROUND: More than two years have passed since the pandemic of new coronavirus (Covid-19). A newly
described Multi-system inflammatory syndrome (MIS-C) is a hyper-inflammatory disorder among children with
severe Covid-19 infection. The diagnosis of MIS-C remain uncertain for the treating physician because it
shares many clinical features similar to other disease. This systematic review aim to better understanding of
clinical features, treatment and possible outcomes of this novel syndrome.
METHODOLOGY: Multiple articles in Pubmed were found using the search terms "MISC" or "MIS-C"
or "multisystem inflammatory disease" and "children" or "pediatric" with “clinical feature” or “treatment” or

“outcome”. Those article were published in English from January 1st 2020 until February 2023. The retrieved
articles were reviewed by the authors using standardize collection tool. Data were analysed with descriptive
statistic.
RESULT: Total of 23 articles (3729 patients) of were included for clinical features, treatment and outcome of
patient diagnosed with MIS-C. The average age of children with MIS-C were 2-10 years. Fever (100%) and
gastrointestinal symptoms (80%) were common in patients with MIS-C. Cardiac symptoms (70%) predominated
over respiratory (38%) and neurological (24%) symptoms. Many other organs are also affected and children
required hospitalization, fluid and respiratory support.
CONCLUSION: Multi-organs involvement in children with Covid-19 infection can occur in previously healthy
child without pre-existing condition. MIS-C raises concern about cardiac presentation, frequent intensive care
and immunomodulatory therapy. Short-term outcomes shown cardiac dysfunction recovery and low mortality
rates but further study was warranted to assess long-term effects.
______________________________________________________________________________________
ERIA-17
METABOLIC RESUSCITATION IN PEDIATRIC SEPTIC SHOCK: A CASE REPORT
Ronald Chandra
Pediatric Intensive Care Department, Graha Hermine Hospital, Batam, Riau Island
BACKGROUND. Paediatric sepsis outcomes and survival rates have not improved sufficiently despite the
adoption of International guideline for the management of Septic shock and sepsis in children. Recently, a
regimen combining hydrocortisone, ascorbic acid and thiamine termed “metabolic resuscitation” or “HAT
therapy” has been reported to decreasing mortality in adult with septic shock.
CASE. A 6-month-old girl was admitted to emergency department (ED) with seizures, fever and cough. While
in ED, she experienced cardiac arrest, return of spontaneous circulation after being resuscitated, intubated and
then transferred to PICU. She was undernourished with level of consciousness E2M3B3R1, blood pressure
(BP) 106/23 mmHg, heart rate 124 bpm, respiratory rate 30 breaths/minutes, and body temperature 36.8oC.
On physical examination, diffuse rales were auscultated. Her laboratory findings showed haemoglobin 8.4g/
dL, leucocyte 6,800/mm3, platelet 469,000/mm3, ferritin 619.6ng/mL, and acidosis metabolic and respiratory.
Chest X-ray showed an infiltrate on both lungs. Her PELOD-2 score was 10. She diagnosed with respiratory
failure, bronchopneumonia and sepsis, and treated with meropenem, phenytoin, and paracetamol. On day 2
of treatment, her BP fell below P5 and inotrope was initiated. The BP was still bellow P5 after being given two
inotropes and HAT therapy was given on day 5. After 4 hours HAT therapy started, the BP increased above P5
and then the inotropes can be tapered off and stopped on the 9th day of treatment.
CONCLUSION. “HAT therapy” may be considered as an adjunct to standard therapy for sepsis especially in
shock septic children in order to improve its outcomes.
Keywords: Hydrocortisone, Ascorbic acid, Thiamine, HAT therapy, Sepsis, Septic Shock.

ERIA-18
DIAGNOSTIC AND THERAPEUTIC DILEMMAS IN TUBERCULOUS MENINGITIS: A CASE REPORT
FROM A RURAL SETTING
Felicia Imanuella Thorion,1 Rizki Ayu Rizal2

1
Dr Johannes Leimena Central General Hospital, Ambon, Moluccas, Indonesia
Background
TB Meningitis (TBM) is rare but associated with high mortality rate and severe morbidity, especially in young
children. This case focuses on diagnosis and treatment of MTB despite limitations in rural areas in Moluccas.
Case
A 1-year-old girl presented with one week of decreased consciousness and vomiting. She received initial
treatment for four days at the district hospital in Moluccas and was then referred to our hospital for imaging. The
patient had close contact with her grandfather, who was diagnosed with pulmonary TB. Physical examination
showed a GCS score of 11, sunken eyes, rhonchi, delayed light pupillary reflex, anisocoria, and bilateral
clonus. Laboratory investigations revealed low hemoglobin level, MCV, MCH, high platelet count, and normal
electrolyte values. Her chest x-ray suggested primary TB lesions and pneumonia. The head CT scan showed
acute communicating hydrocephalus. She was treated with ceftriaxone, dexamethasone, mannitol, and anti-
tuberculosis treatment (ATT). The patient subsequently developed ptosis in the right eye. The tuberculin skin
test yielded a positive result. Due to the unavailability of a shunt kit in our hospital, the patient underwent
ventriculoperitoneal (VP) shunt surgery on the fifth day of admission. Cerebrospinal fluid sampling during VP
shunting showed clear, colorless fluid with a glucose level of 46 mg/dL and 46 cells (mononuclear cells 80%).
The baby girl was discharged without decreased consciousness but had slight left hemiparesis.
Conclusion
This emphasizes the importance of early recognition, prompt treatment, and multidisciplinary care in improving
outcomes for TBM patients, particularly in resource-limited settings.
______________________________________________________________________________________
ERIA-19
RELATIONSHIP BETWEEN PEDIATRIC EARLY WARNING SYSTEM IN EMERGENCY ROOM WITH THE
CLINICAL OUTCOME AND LENGTH OF STAY IN PICU WARD
Cynthia Margaretha1, Sanny1, Shanti Natalia Nababan1 , Eric Yudhianto1 , Ririe Fachrina Malisie2
Department of Child Health, PICU Murni Teguh Memorial Hospital, Medan, Indonesia;
1
2
Department of Child Health, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia; PICU
Adam Malik General Hospital, Medan, Indonesia
Background. Pediatric Early Warning Systems (PEWS) is one of the simple and fast scoring systems used to
identify hospitalized children at increased risk of deterioration by assessing a patient’s clinical status objectively
based on physiologic parameters. Children who had great acuity of illness would require a prolonged hospital
stay.
Objective. To analyze the association between PEWS and clinical outcome of patients who admitted in
Emergency Room.

Method. We conducted a retrospective study at Murni Teguh Memorial Hospital Medan. All patients in PICU
ward from January - June 2022 were eligible. We analyzed the data from medical record based on inclusion
dan exclusion criteria.
Results. The most common diseases in PICU ward were neurology disorder (28.3%). We also found that
most patients admitted to PICU were babies (1 month - 1 year) and Red PEWS color. From 23 patients with
Red PEWS color, 10 patients died (43.4%) and 13 patients (56.6%) were discharged. We also found red and
Orange PEWS color has longer LOS (orange: mean 11.25 SD ± 6.702, Red: mean 10.74 SD ± 11.529). There
is no significant relationship between PEWS and LOS (analyzing with Kruskal-Wallis).
Conclusion. There is no relationship between PEWS and Length of Stay, although it is found that Orange
PEWS has longer LOS in PICU ward.
Keywords: PEWS, Clinical Outcome, LOS

______________________________________________________________________________________
ERIA-20
A RARE CASE OF AN 6-MONTH-OLD INFANT WITH DENGUE MENINGOENCEPHALITIS

Selina Natalia,1 Felicia Imanuella Thorion,1 Elizabeth Kristine,1 Melanie Widjaja 2
1
Siloam General Hospital, Lippo Karawaci, Banten, Indonesia

Background
Expanded Dengue Syndrome is used to describe dengue infection with atypical manifestations, including
neurological complications such as meningoencephalitis. Such condition is considered rare in infant population.
Case Report
We report a well-nourished 6-month-old boy who presented with first generalized tonic-clonic seizure, fever,
and projectile vomiting upon admission. There was no history of decreased consciousness or bleeding.
Neurological examination revealed a bulging anterior fontanelle, bilateral hyperreflexia and clonus. Initial
laboratory workups showed WBC 9020 cells/ul, hemoglobin 11.9 g/dL, hematocrit 34.30%, platelets 264.000
cells/ul, and electrolytes within normal limits. Cerebrospinal fluid was clear, colorless, and showed 2 cells
100% mononuclear (normal range <10), protein 0.18 g/dl (normal value 0.15-0.45), and normal glucose.
The patient was managed conservatively with intravenous fluids, antipyretics, dexamethasone, and oral
anticonvulsant. The third day of hospitalization, his condition worsened with repeated seizures, decreased
consciousness, fever and hepatomegaly. This was followed by petechiae, melena, pleural effusion, and
ascites. Laboratory investigations revealed positive anti-dengue IgM, hypoalbuminemia (2.14 g/dL), along with
decreased hemoglobin, hematocrit, and platelet counts of 8.4g/dL, 24.10%, and 16.000 cells/ul, respectively.
Stool analysis showed positive occult blood. He was given phenobarbital injection, albumin, packed red cells
(PRC), and fresh frozen plasma (FFP) transfusions. The patient showed improvements by the 8th day and was
discharged by the 13th day of hospitalization in stable condition without any neurological deficits.
Conclusion
Dengue should be considered as a possible differential diagnosis in cases of viral meningitis or
meningoencephalitis, particularly in endemic areas.

Supported by
SPEAKERS/MODERATORS RESUME

61
Full Name & Title
dr. Abdul Latief, Sp.A(K)
Educational Background
• MD; Faculty of Medicine University of Indonesia (1968-1974)
• Pediatrician; Faculty of Medicine University of Indonesia (1978-1981)
• Residency; Pediatric Critical Care Medicine, Faculty of Medicine
University of Indonesia (1984-1992)
Latest Position
• Member of SCCM (Society of Critical Care Medicine) - (1997-Present)
• Member of IDAI (Indonesian Pediatrics Society) - (1981-Present)
Full Name & Title

Dr. dr. R. Adhi Teguh Perma Iskandar, Sp.A(K)
• MD; Faculty of Medicine, University of Indonesia (2002)
• Pediatrician; Faculty of Medicine, University of Indonesia (2012)
• Consultant of Neonatology; Faculty of Medicine, University of Indonesia
(2017)
Latest Position
• Neonatology Division Staff; Department of Child Health, Cipto
Mangunkusumo Hospital, Jakarta, Indonesia (2012-Present)
Full Name & Title

Alex Gooi, FRACP, FCSANZ, MBBS, BSc (Med)
• Medical Training at The University of New South Wales
• Basic Paediatric Training in Sydney Children’s Hospital, Randwick
Latest Position
• Consultant Paediatric & Fetal Cardiologist/ Echocardiologist Position at
the Queensland Children’s Hospital in Brisbane
• Co-Lead in Fetal Cardiology in Sydney Children's Hospitals Network in
May 2020
• Paediatric and Fetal Cardiologist in Westmead (the Heart Centre for
Children)
62 SPEAKERS, MODERATOR & FASILITATOR

Full Name & Title
dr. Alifah Anggraini, M.Sc, Sp.A(K)
• Medical Doctor; Universitas Gadjah Mada
Latest Positions
• Dokter Anak konsultan Neonatologi yang berpraktik Dr. Sardjito General
Hospital
• Dokter Anak konsultan Neonatologi yang berpraktik di RSU Hermina
Yogya
Full Name & Title

Prof. Andreas Schibler
• Medical Doctor; University of Queensland
Latest Positions
• paediatric critical care supported by the National Health Medical
Research Council Australia.
• visionary leader behind the Lady Cilento’s Paediatric Critical Care
Research Group
Full Name & Title

Prof. Dr. dr. Antonius H. Pudjiadi, Sp.A(K)
• Pediatrician, Faculty of Medicine Universitas Indonesia (1988)
• Cardiac Intensive Care Unit, National Cardiovascular Center, Harapan
Kita Hospital, Jakarta (1989)
• Pediatric Intensive Care, University of Washington, Seattle, USA (1990)
• Doctor, Faculty of Medicine Universitas Indonesia (2018)
Latest Position
• Lecturer, Child Health Department, Faculty of Medicine - Universitas
Indonesia
• Pediatric Consultant, Faculty of Medicine - Universitas Indonesia,
RSUPN. Dr. Cipto Mangunkusumo – Jakarta
SPEAKERS, MODERATOR & FASILITATOR 63

Full Name & Title
Dr. Arata Oda, MD
• Resident of pediatrics, Showa General Hospital, (2005)
• Staff of PICU, Nagano Children’s Hospital, (2010)
• Staff of NICU, Nagano Children’s Hospital, (2012)
• Clinical research fellow ,Turku university hospital, Finland (2016)
Latest Position
• Deputy director of NICU, Nagano Children’s Hospital (2018)
Full Name & Title

dr. Arina Setyaningtyas, Sp.A(K)
• S1; UNIVERSITAS AIRLANGGA (1993-1997)
• Profesi; UNIVERSITAS AIRLANGGA (1999)
• Sp I; UNIVERSITAS AIRLANGGA (2006-2011)
• S2; UNIVERSITAS AIRLANGGA (2001-2003)
• Sp II; UNIVERSITAS INDONESIA (2015)
Latest Position
• Medical Staff at Department of Child Health Faculty of Medicine,
Airlangga University, RSUD Dr. Soetomo, Surabaya (2010 –until now)
• Eria Division Staff at Department of Child Health Faculty of Medicine,
Airlangga University, RSUD Dr. Soetomo, Surabaya (2010 –until now)
Full Name & Title

dr. Aris Primadi, Sp.A(K)
• Kedokteran Umum, Fakultas Kedokteran Universitas Padjadjaran, 1982
– 1988
• Spesialis Ilmu Kesehatan Anak, Fakultas Kedokteran Universitas
Padjadjaran 1992 – 1995
• Training of Neonatal Screening di Sapporro, Jepang 2001
• NICU Clinical Attachment di Kuala Lumpur, Malaysia 2004
• Konsultan Neonatologi, 2008
Latest Position
• Pengurus Pusat IDAI
• Ketua Satgas AKB IDAI
• Ketua MPPK IDI Jawa Barat
• Dewan Pakar APKESMI
• Staf Departemen Ilmu Kesehatan Anak Fakultas Kedokteran
Universitas Padjadjaran RSUP Dr. Hasan Sadikin – Bandung

Full Name & Title
Dr. dr. Bastian Lubis, MKed (An), SpAn, KIC
• S1 Dokter umum - FK USU (2008)
• S2 Magister Kedokteran Anastesi - FK USU (2013)
• Sp1 Dokter Spesialis Anastesiologi - FK USU (2014)
• Sp2 Konsultan Intensive Care - FK UI/RSCM Jakarta (2018)
• S3 Doktor - FK USU (2021)
Latest Position
• Staff Pengajar - Departemen Anastesiologi & Terapi Intensif FK USU/
RSUP H Adam Malik Medan (2010 – Sekarang)
• Kepala ICU - RS Grandmed Lubuk Pakam (2018 – Sekarang)
• Kepala ICU - RSUP H Adam Malik Medan (2019 – Sekarang)
Full Name & Title

Dr. dr. Bugis Mardina Lubis, M.Ked(Ped), Sp.A(K)
• Pediatrician: Pediatric Department, Medical Faculty North Sumatera
University,
• Medan (2002 – 2007)
• General Practitioner: Medical Faculty, Christian University of Indonesia,
• Jakarta (1989 – 1996)
• Senior High School, SMA 1 Medan, North Sumatera (1986 – 1989)
• Junior High School, SMP 1 Padangsidimpuan, North Sumatera (1983 –
1986)
• Elementary School, SDN 142431 Padangsidimpuan, North Sumatera
(1977 – 1983)
Latest Position
• Head of Puskesmas Bawolato, Nias (1998 – 2001)
• Head of Puskesmas Idanogawo, Nias (1999 – 2000)
• General Practitioner at Puskesmas Sunggal, Medan (2001-2002)
• Attending Staff at Neonatology Division, Pediatric Department, Medical
Faculty North Sumatera University/Haji Adam Malik Hospital Medan,
North Sumatera, Indonesia (2002-present)
Full Name & Title

Prof. dr. Chairul Yoel, Sp.A(K)
• Lulus Dokter Umum, Fakultas Kedokteran USU, Medan (1976)
• Lulus Dokter Spesialis Anak, Fakultas Kedokteran USU, Medan (1984)
• Dikukuhkan sebagai Spesialis Anak Konsultan Pediatri Gawat Darurat/
ICUAnak, MPPDS IDAI, Jakarta (1992)
Latest Position
• Ketua Dewan Pengawas RS USU (2020-sekarang)
• Dosen Purnabakti Departemen Ilmu Kesehatan Anak FK USU
(2020-sekarang)

Full Name & Title
Prof. Dr. dr. Damayanti Rusli Sjarif, Sp.A(K)
• MD; Faculty of Medicine, University of Indonesia (1983)
• Paediatrician; Faculty of Medicine, University of Indonesia (1992)
• Fellowship Pediatric Nutrition; Division of Pediatric Nutrition, Child
Health Department, RSCM, Jakarta (1996)
• Clinical Training in Metabolic Diseases; Wilhelmina Children Hospital –
Utrecht (2000)
• Clinical Training in Medical Genetics; Clinical Genetics Center – Utrecht
(2000)
• Certificate Kinderarts Metaboleziekten, Wilhelmina Children Hospital,
Utrecht, The Netherlands (2000)
• PhD; Universiteit Utrecht, The Netherlands (2000)
• Consultant in Paediatric Nutrition and Metabolic Disease; Indonesian
Pediatric College, Jakarta (2001)
• Professor in Paediatric Nutrition and Metabolic Disease. Faculty of
Medicine, University of Indonesia (2019)
Latest Position
• Ketua Pusat Pelayanan Penyakit Langka Indonesia
• Ketua Human Genetic Research Center (HGRC) IMERI – Fakultas
Kedokteran Universitas Indonesia
• Guru Besar Departemen Ilmu Kesehatan Anak Fakultas Kedokteran
Universitas Indonesia – RSUPN Cipto Mangunkusumo
Full Name & Title

dr. Dwi Putri Lestari, Sp.A(K)
• General Practioners, Airlangga University/Dr.Soetomo General
Academic Teaching Hospital (2004)
• General Pediatrician, Airlangga University/Dr. Soetomo General
Academic Teaching Hospital (2013)
• Consultant Emergency & Intensive Care, Indonesia University/Dr. Cipto
Mangunkusumo National Central Public Hospital (2023)
Latest Positions
• Medical Staff, Division of Pediatric Emergency & Intensive Care, Child health
Department, Dr. Soetomo General Academic Teaching Hospital / 2013
• Member of Pediatric Emergency & Intensive Care Working Group (ERIA)/ 2013
• Member of Indonesian Pediatric Sosciety (IDAI)/ 2013
Full Name & Title

dr. Eny Yantri, Sp.A(K)
• Dokter Spesialis Anak di Universitas Andalas (Year)
Latest Positions
• Anggota IDAI Cabang Padang
• Dokter Anak di RSI Siti Rahma
• Dokter Anak di RSUP Dr. M. Djamil

Full Name & Title
Dr. dr. Eva Miranda Marwali, Sp.A(K)
• Medical Doctor, Faculty of Medicine, University of Indonesia, Jakarta (1987-1993)
• Residency in Pediatrics, Department of Child Health, Medical School,
University of Indonesia, Jakarta (1997-2002)
• Fellow in Neonatology, Neonatal Division, Department of Child Health
Medical School, University of Indonesia, Jakarta (2003)
• Clinical Observer in Cardiac Intensive Care Unit, Children’s Hospital
Boston, University of Harvard, USA (2004)
• Clinical Fellow in Pediatric ICU Hospital for Sick Children, University of
Toronto, Canada (2007-2008)
• PhD program, Faculty of Medicine, University of Indonesia, Jakarta (2010-2015)
• Consultant of Pediatric Emergency & Intensive Care, Universitas
Padjajaran, Bandung (2014-2015)
Latest Positions
• Staff Physicians of Pediatric Cardiac Intensive Care Unit in National
Cardiovascular Center, Harapan Kita Hospital, Jakarta, Indonesia
(2003-Present)
• Pediatric Cardiac Intensivist in Jakarta Heart Center, Jakarta
(2013-Present)
• Pediatric Cardiac Intensivist in Siloam Hospital Kebun Jeruk, Jakarta
(2015-Present)
Full Name & Title

dr. Fatima Safira Alatas, Ph.D, Sp.A(K)
• Pediatric Gastroenterology and Hepatology course, Department of Child
Health, Faculty of Medicine University of Indonesia – Jakarta (2013- 2015)
• Doctoral Course for Doctor of Philosophy (PhD) in Department
of Pediatric Surgery, Reproductive and Developmental Medicine,
Graduate School of Medical Sciences, Kyushu University, Fukuoka,
Japan (2009- 2013)
• Visiting Doctor in Department of Pediatric Surgery, Reproductive and
Developmental Medicine, Graduate School of Medical Sciences,
Kyushu University, Fukuoka, Japan (2008- 2009)
• Residency training in Pediatrics, Department of Child Health, Faculty of
Medicine University of Indonesia – Jakarta (2002-2006)
• Medical Doctor in Faculty of Medicine University of Indonesia (1995-1997)
• Bachelor of Science and Surgery in Faculty of Medicine University of
Indonesia - Jakarta (1991-1995)
Latest Position
• President of Indonesian Pediatric College (2021 – Present)
• Head of Department of Child Health, Faculty of Medicine Universitas
Indonesia, Cipto Mangunkusumo Hospital (2021 – Present)
• Chief Editor of Archive of Pediatric Gastroenterology, Hepatology, and
Nutrition (2021 – Present)
• Member of International Liver Transplantation Society (2019 – Present)
• Member of Asian Society of Pediatric Research Council Board (2017 - Present)
• Head of Research and Human Resources, Indonesian Pediatric Society
(2017 - 2021)
• Vice Chair of Liver transplantation team, Cipto Mangunkusumo Hospital,
Faculty of Medicine University of Indonesia – Jakarta (2015 - Present)

Full Name & Title
dr. Frida Soesanti, Sp.A(K), M.Sc
• PhD students in Julius Center, Utrecht Medical Centrum, Utrecht
University, the Netherlands.
• Consultant in Pediatric Endocrinology: Faculty of Medicine-Universitas
Indonesia, (2015)
• ISPAD Science School, Tokyo, Japan, (2018)
• Clinical Fellowship in Pediatric Endocrinology, Royal Children Hospital,
Melbourne, Australia, (2018)
• Clinical Fellowship Training of Pediatric Endocrinology, Tokyo, Japan, (2010-2011)
• ISPAD Science School, Japan, (2012 & 2018)
• APPES Fellows Meeting, Xian, China, (2010)
• Pediatrician: Faculty of Medicine – Universitas Indonesia, (2008)
Latest Position
• Head of Pediatric Endocrinology Division, Faculty of Medicine –Universitas
Indonesia, Cipto Mangunkusumo Hospital, Jakarta, (2018-now)
• Chief of Growth and Development modul for undergraduate. Faculty of
Medicine- Universitas Indonesia, (2018-2020)
• Secretary of Indonesian Pediatric Society Task Force for Newborn
screening, (2014-now)
• Pediatric Endocrinology Division, Medical School-Universitas Indonesia
• Committee of Indonesian Pediatric Society Task Force for Adolescence
Health, (2014-now)
• Committee of Endocrinology Working Group of the Indonesian Pediatric
Society, (2014-now)
Full Name & Title

dr. Gatot Irawan Sarosa, Sp.A(K)
• Medical Doctor (dr) ; Universitas Dipenogoro (1988)
• Pediatricient (SpA); Universitas Dipenogoro(2000)
• Consultant Neonatologist (SpAK); Colegium IDAI (2011)
Latest Position
• Chief of Pediatrician Medical Staf, RSUP dr Kariadi Semarang (2016- 2019)
• Chief of Neonatology Division RSDK/ FK Undip Semarang (2016- Now)
• Training Team Coordinator ; Perinasia (2016 - Now)
• Member of Vaccinology TF ; Indonesian Pediatric Society(2015 - Now)
Full Name & Title

dr. Henny Adriani Puspitasari, Sp.A(K)
• Pediatric Nephrology Sub-Specialist Program, Universitas Indonesia,
Indonesia, 2017-2020
• Pediatric Nephrology Fellowship Training, Awardee Japanese Pediatric
Society Scholarship, Mt. Shizuoka Children Hospital, Shizuoka, Japan, 2019
• Pediatrics Residency Program, Universitas Indonesia, Indonesia, 2015
• Medical Doctor Degree, Diponegoro University, Indonesia, 2008
Latest Position
• Medical staff, Nephrology Division, Department of Child Health, Faculty
of Medicine, Universitas Indonesia – Dr. Cipto Mangunkusumo General
Hospital Jakarta, Indonesia

Full Name & Title
Dr. dr. I Made Kardana, Sp.A(K)
• S1, Fakultas Kedokteran Universitas Udayana (1993)
• S2, Dokter Spesialis Ilmu Kesehatan Anak Universitas Udayana (2003)
• Fellowship Anak Div. Perinatologi Universitas Indonesia – RS Cipto
Mangunkusumo, Jakarta (2004-2005)
• Obeserver – In – Training (Neonatology) : National University Hospital-
National Univesity Of Singapore (2007)
• Konsultan Neonatologi Universitas Indonesia (2011)
• Program Doktor Pasca Sarjana Fakultas Kedokteran Universitas
Udayana (2016)
Latest Position
• Staf Pediatri, Divisi Neonatologi, RSUP Prof.Dr. I.G.N.G Ngoerah
Denpasar (2005-sekarang)
Full Name & Title

dr. Ida Bagus Gede Suparyatha, Sp.A(K)
• MD, Medical Faculty, Universitas Udayana (1993)
• Residencies at Child Health Department, Universitas Udayana Sanglah
Hospital, Denpasar (2004)
• Fellowship at Pediatric Intensive Care Division, Child Health Department
Universitas Indonesia, RSUPN Cipto Mangunkusumo Jakarta (2007 -
2009)
Latest Position
• Head of Child Health Department/KSM Udayana University, Sanglah
Hospital (Present)
• Head of Pediatric Intensive Care Division, Department of Child Health,
Udayana University, Sanglah Hospital (2010 – Present)
Full Name & Title

dr. Indra Ihsan, M.Biomed, Sp.A(K)
• Medical Doctor, Universitas Andalas (2008)
• Pediatrician, Universitas Andalas (2015)
• Magister of Biomedical Science, Universitas Andalas (2015)
• Pediatric Intensivist, Universitas Indonesia (2021)
Latest Position
• Member of Emergency and Intensive Care Working Group, Indonesian
Pediatric Society/2016 - now
• Pediatric Intensivist/ Dr. M. Djamil Hospital/2016 – now
• Secretary Department of Pediatric, Medical Faculty, Universitas
Andalas/ Dr. M. Djamil Hospital/2022-now

Full Name & Title
dr. Indra Saputra, Sp.A (K), M.Kes
• Dokter Umum, Fakultas Kedokteran Universitas Sumatera Utara, (2000)
• Dokter Spesialis Anak, Fakultas Kedokteran Universitas Sriwijaya,
(2009)
• Magister Kesehatan, Magister Biomedik Universitas Sriwijaya, (2009)
• Dokter Spesialis Anak Konsultan, Fakultas Kedokteran Universitas
Indonesia, (2019)
Latest Position
• Wakil Ketua, IDAI Cabang Jambi, (2014-2017)
• Anngota Pokja Resusitasi, UKK ERIA, (2017-2020)
• Staf Divisi ERIA, KSM/Bagian Kesehatan Anak RSMH/FK UNSRI,
(2017-sekarang)
Full Name & Title

dr. Indrayady, Sp.A(K)
• MD, Faculty of Medicine, Sriwijaya University, Palembang
• Pediatrician, Faculty of Medicine, Sriwijaya University, Palembang
• Consultant of Pediatric, Faculty of Medicine, University of Indonesia,
Jakarta
Latest Position
• Medical Staff, Neonatology Division, Child Health Department, RSUP
Moh. Hoesin Palembang
Full Name & Title

Dr. dr. Irene Yuniar, Sp.A(K)

• MD, Fakultas Kedokteran Universitas Indonesia (1999)
• Sp.A, Fakultas Kedokteran Universitas Indonesia (2006)
• Konsultan PGD, Fakultas Kedokteran Universitas Indonesia (2014)
• Doktor, Fakultas Kedokteran Universitas Indonesia (2018)
Latest Position
• Staf Divisi Emergensi dan Rawat Intensif Anak Departemen Ilmu
Kesehatan Anak, FKUI RSCM, (2008 s.d. sekarang)
• Ketua Unit Kerja Emergensi dan Rawat Intensif Anak, IDAI Jakarta
Raya, (2014 s.d sekarang)
• Anggota Satgas Farmasi Terapi Pediatri, IDAI, (2014 s.d sekarang)
• Pengurus Harian Peserta Program Pendidikan Dokter Spesialis 1 Ilmu
Kesehatan Anak, FKUI RSCM, (2014 s.d sekarang)
• Sekretaris Satgas Penelitian dan Pengembangan SDM IDAI, (2011 s.d.
2014)
• Sekertaris UKK ERIA IDAI - Sekarang

Full Name & Title
Prof. Dr. dr. Ismoedijanto, DTMH, Sp.A(K)
• Dokter Umum, Fakultas Kedokteran Universitas Airlangga (1968)
• Diploma in Tropical Medicine and Hygiene (DTM&H), Faculty of Tropical
Medicine, Mahidol University (1978)
• Dokter Spesialis Anak Universitas Airlangga (1977)
• Konsultan Infeksi Tropik dari Majelis Akhli IDAI (1987)
• Doktor Dalam Bidang Kedokteran Universitas Airlangga (1993)
Latest Position
• Chairman of Expert Comm on Diphtheria Outbreak from KemKes
• Staf /Pengajar Bagian Ilmu Kesehatan Anak (1977-sekarang)
• Ketua Expert committee on Surveillance of Acute Flaccid Paralysis
(SAFP) , Indonesia (2005 –sekarang)
• Anggota National Verification Committee for Measles-Rubella,
Kementerian Kesehatan (2015- sekarang)
• Anggota Indonesia Technical Advisory Group on Immunization (ITAGI)
• Anggota SatGas Imunisasi IDAI
Full Name & Title

Dr. dr. Johanes Edy Siswanto, Sp.A(K)

• General Practitioner, Faculty of Medicine University of Indonesia,
Jakarta, Indonesia,1989
• Pediatrician, Faculty of Medicine, Diponegoro University, Semarang,
Central Java, Indonesia,1997
• Fellow of Neonatology, Groningen, Netherlands, 2003
• Pediatrics Consultant in Neonatology, 2008
• Doctor in Clinical Epidemiology, Faculty of Public Health University of
Indonesia, 2015
Latest Position
• Neonatology Working Group, Harapan Kita Women and Children,
Jakarta Clinical Education Doctor of the Ministry of Health of the
Republic of Indonesia, since (2010)
• Ajunct Lecturer, Faculty of Medicine, University of Indonesia
• TOT (Trainer of Trainee) program of PONED / PONEK, Ministry of
Health Republic of Indonesia, HSP-USAID Program, since (2005)
• TOT NRP (Neonatal Rescucitation Program) PERINASIA, since (2012)
• TOT Neonate Stabilization"Registered Lead Instructor" S.T.A.B.L.E
Program since (2013)
• TOT Neonatal Rescusitation IPA Program, since (2017)
• Chairman of Birth Defects Integrated Centre since 2013)

Full Name & Title
dr. Jose M. Mandei, Sp.A(K)
• Dokter Umum - FK UNSRAT (1996)
• Dokter Spesialis Anak – FK UNSRAT (2007)
• Dokter Spesialis Anak Konsultan ERIA - FK UI (2014)
Latest Position
• Ketua Divisi Emergensi dan Rawat Intensif Anak - RSUP Prof. R. D.
Kandou, Manado
• Wakil Ketua Ikatan Dokter Anak Indonesia Cabang Sulawesi Utara
• Anggota Ikatan Dokter Indonesia
• Anggota International Society for Infectious Diseases
• Anggota International Society for Social Pediatrics and Child Health
(ISSOP) in 2020
Full Name & Title

dr. Julianti, M.Kes, Sp.A(K)
• General Practioners, Syiah Kuala University/Dr. Zainoel Abidin Hospital/
2001
• Magister of Science, Sriwijaya University/Dr. Moh. Husien Hospital
Palembang /2011
• General Pediatrician, Sriwijaya University/Dr. Moh. Husien Hospital
Palembang /2012
• Consultant Emergency and Intensive Care, Indonesia University/ Dr.
Cipto Mangunkusumo National Central Public Hospital/ 2022
Latest Position
• Medical Staff, Division of Pediatric Emergency and Intensive Care, Dr.
Fauziah Hospital, Aceh/2021
• Member of Pediatric Emergency and Intensive Care/2021
• Member of Indonesian Pediatric Society (IDAI)/2012
Full Name & Title

Dr. Kevin Ives
Kevin Ives has been working as a Consultant Neonatologist in Oxford, England

since 1991.
He was a member of the team that placed the first baby in the United Kingdom
on nasal High Flow Therapy 18 years ago. Ever since, he has been an outspoken
enthusiast for this form of non-invasive respiratory support, lecturing in Europe
and the United States.
Kevin was a contributing author of an ‘International Consensus Document on the

use of nasal High Flow Therapy in Neonatology’ in 2017 and collaborated with Dr
Peter Reynolds in a randomised crossover study of automated oxygen control
using the Vapotherm Precision Flow in 2018.

Full Name & Title
dr. Lily Rundjan, Sp.A(K).,FRACP
• MD; Faculty of Medicine, University of Indonesia (1986–1992)
• Pediatrician; Faculty of Medicine, University of Indonesia (2000–2004)
• Neonatal Training in Melbourne, Australia (2006-2008)
• Consultant of Neonatology; Indonesian College of Pediatrics, Jakarta,
Indonesia (2011)
• Fellowship in Neonatal Perinatal Medicine Australia, Canberra Hospital
and Westmead Hospital, Sydney (2019-2022)
• FRACP (Neonatal Perinatal Medicine), Australia (2022)
Latest Position
• Neonatal Consultant at Department of Child Health, Neonatology
Division Cipto Mangunkusumo Hospital (2011-Present)
Full Name & Title

dr. M. Supriatna, Sp.A(K)
• Sp1 Pediatric Specialist Educational Program – Diponegoro University,
Dr. Kariadi Hospital Semarang, 2000 - 2004
• Sp2 Pediatric Emergency and Critical Care Consultant University of
Indonesia – Dr. Cipto Mangunkusumo Hospital Jakarta, 2010
• Fellowship Pediatric Program on Critical Care Medicine, UMC Nijmegen
Netherlands, 2010
Latest Positions
• Head of Intensive Care Instalation; Pediatric Emergency and Critical
Care Division, Department of Pediatrics Dr. Kariadi Hospital, Faculty of
Medicine Diponegoro University, Semarang
Full Name & Title

dr. Made Sukmawati, Sp.A(K)
• Dokter Umum, Fakultas Kedokteran Universitas Udayana (1999)
• Dokter Spesialis Anak, Fakultas Kedokteran Universitas Udayana
(2007)
• Konsultan, Fakultas Kedokteran Universitas Indonesia (2010)
• Clinical Fellowship in Nagano Hospital, Japan (2017)
Latest Positions
• Child Health Department, Faculty of Medicine Universitas Udayana
RSUP Prof.Dr.I.G.N.G Ngoerah - Denpasar

Full Name & Title
Prof. dr. Munar Lubis, Sp.A(K)
• Sarjana Kedokteran, FK USU (1975)
• Profesi Dokter, FK USU (1977)
• SpA, FK USU (1987)
• Consultant, Kolegium IDAI (1994)
• Guru Besar Ilmu Kesehatan Anak, Universitas Sumatera Utara (2004)
Latest Positions
• Staf Departemen Ilmu Kesehatan Anak, FK USU (1985-now)
• Ketua Program Studi Ilmu Kesehatan Anak, FK USU (2002 - 2012)
• Komda KIPI SUMUT (2000 – 2017)
• Ketua Departemen Ilmu Kesehatan Anak, FK USU (2012 - 2017)
• Ketua KAMAS Wilayah 7 (2017 – sekarang)
• Ketua IDAI Cabang Sumatera Utara (2014 – 2021)
Full Name & Title

dr. Mulya Rahma Karyanti, Sp.A(K)
• Dokter Umum - Fakultas Kedokteran UI, 1988 - 1994
• Spesialis Anak - Fakultas Kedokteran UI, 2004
• Training tropical Infectious disease on public health, WHO-SEARO, April
2009
• Master of Science in Clinical Epidemiology - Utrecht Medical Centre, 2011
• Konsultan Infeksi dan Pediatri Tropis - Fakultas Kedokteran UI, 2011
Latest Positions
• Ketua divisi Infeksi Penyakit Tropik, Dep IKA RSCM-FKUI
• Ketua Subkomite PRA RSCM-FKUI
• Anggota IDAI Jaya, 2004 – Sekarang
• Bendahara PP IDAI 2008 - 2010
• Pengurus UKK Infeksi dan Pediatri Tropik, 2017 - 2024
• Ketua Satgas Farmasi Pediatri PP IDAI, 2017 –2021
• Anggota Asian Society of Pediatric Infectious Disease (ASPID), 2005
sampai sekarang
• Komite Ahli Kemenkes Dengue, Malaria, Difteri, verifikasi nasional
eliminasi campak dan pengendalian rubella/ CRS
• Anggota Satgas Angka Kematian Bayi (AKB) PP IDAI 2022-2024
• Anggota PP Perhimpunan Pengendalian Infeksi Indonesia (PERDALIN)
2020-2024
• Anggota Satgas Monkeypox PB ID 2022 sampai sekarang

Full Name & Title
dr. Nathanne Septhiandi, Sp.A(K)
• General Practioners, University of Indonesia/ Dr. Cipto Mangunkusumo
National Central Public Hospital / 2008
• General Pediatrician, University of Indonesia/ Dr. Cipto Mangunkusumo
National Central Public Hospital / 2015
• Consultant Emergency and Intensive Care, Indonesia University/ Dr.
Cipto Mangunkusumo National Central Public Hospital/ 2022
Latest Positions
• Medical Staff, Division of Pediatric Emergency and Intensive Care,
Harapan Kita Women and Children Hospital, Jakarta/2016
• Member of Pediatric Emergency and Intensive Care/2016
• Member of Indonesian Pediatric Society (IDAI)/2015
Full Name & Title

dr. Neurinda P. Kusumastuti, Sp.A(K)
• MD, Faculty of Medicine, Universitas Airlangga (2003)
• Pediatrician, Faculty of Medicine, Universitas Airlangga (2010)
• Fellowship of Pediatric Critical Care, Shizuoka Children’s Hospital (2013)
• Consultant of Pediatric Emergency and Critical Care (ERIA), FKUI (2017)
Latest Positions
• Lecturer, Faculty of Medicine, Universitas Airlangga, Surabaya
• Medical staff, Child Health Department, RSUD Dr. Soetomo
Full Name & Title

dr. Nina Dwi Putri, Sp.A(K), M.Sc(TropPaed)
• Master of Tropical Pediatric, Liverpool School of Tropical Medicine, United
Kingdom (2018/19)
• Executive Fellowship in Pediatric Infectious Disease, The Children
Hospital at Westmead, Sydney (2018)
• Pediatric ID Consultant Training, Universitas Indonesia (2015-2017)
• Clinical Fellowship in Infectious Disease for Institute of Infectious Disease
and Epidemiology, National Center of Infectious Disease, Tan Tock Seng
Hospital, Singapore (2014)
• Pediatric Residency Training, Universitas Indonesia (2007 -2012)
• Medical Doctor, Universitas Indonesia (2000-2006)
Latest Positions
• Lecturer in Pediatric Infectious Disease and Tropical Pediatrics
Universitas Indonesia (2013 – present)
• Head of COVID-19 Ward of Cipto Mangunkusumo Hospital (2020 – present)
• Head of Pediatric Outpatient Parenteral Antibiotic Therapy Clinic, Cipto
Mangunkusumo Hospital (2015 – present)
• Pediatric ID Consultant in Cipto Mangunkusumo National Referral Hospital
• Pediatric ID Consultant Universitas Indonesia Hospital

Full Name & Title
• Kedokteran Umum - Universitas Indonesia (2007)
• Pediatrician - University of Indonesia (2014)
• Fellowship Pediatric ICU – NCCHD Tokyo Japan (2018)
• Emergensi dan Rawat Intensif Anak (consultant) - University of Indonesia
(2020)
Latest Positions
• Staff of pediatric ICU RSUPN Dr. Cipto Mangunkusumo – Jakarta
• Pediatric intensivist - RSIA Bunda Menteng Jakarta
• Secretary of Unit Kerja Emergensi dan rawat Intensif Anak IDAI Jaya
• Secretary of Koordinator Adminkeu Department of Child Health Cipto
Mangunkusumo Hospital
• Member of liver transplantation team Cipto Mangunkusumo Hospital
• Member of SatGas Bencana PP IDAI
Full Name & Title

dr. Novik Budiwardhana, Sp.A
• MD. Faculty of Medicine, University of Indonesia (1991)
• Pediatrician. Faculty of Medicine, University of Indonesia, Cipto
Mangunkusumo Hospital, Jakarta (2003)
• PICU Fellows at Royal Children Hospital Melbourne, Australia (2004-
2005)
• Doctor candidate Gadjah Mada University
Latest Positions
• SMF ICU anak RS Jantung dan Pembuluh Darah Harapan Kita
Full Name & Title

Dr. dr. Nurnaningsih, Sp.A(K)
• Medical Doctor; Universitas Gadjah Mada (1977-1983)
• Pediatrician; Universitas Gadjah Mada (1992-1997)
• Pediatric Intensivist; University of Indonesia (2005-2007)
• Doctoral Program (Medical Science); Universitas Gadjah Mada (2017-
2021)
Latest Positions
• Head of Pediatric Intensive Care Unit Dr. Sardjito General Hospital
(2007-now)
• Head of Emergency and Pediatric Critical Care Division; Department
of Child Health, Faculty of Medicine, Public Health and Nursing,
Universitas Gadjah Mada (2008-now)
• Head of Professional Quality Sub-Committee, Dr. Sardjito Hospital
(2015-now)

Full Name & Title
Dr. Pranav Jani [FRACP, MD (Paeds), CCPU (Neonatal), M Clin Epid, MBBS]
• Higher research qualification (PhD) in Medicine from The University of
Sydney
Latest Position
• Staff Specialist in the Department of Neonatology at Westmead Hospital
Full Name & Title

Dr. dr. Putri Maharani Tristanita Marsubrin, Sp.A(K)
• Medical Doctor Program–Degree: Doctor of Medicine; Faculty of
Medicine, University of Indonesia, Jakarta (2002-2008)
• Residency in Pediatrics; Faculty of Medicine, University of Indonesia,
Jakarta (2010-2014)
• Sub-specialty of Pediatrician (Neonatology Fellowship); Faculty of
Medicine, University of Indonesia, Jakarta (2016-2018)
• Doctoral Program; Faculty of Medicine, University of Indonesia, Jakarta
(2018-2021)
Latest Position
• Staff of Neonatology Division, Department of Child and Health, Faculty
of Medicine, University of Indonesia, Cipto Mangunkusumo Central
General Hospital, Jakarta.
• Secretary of Indonesian College of Pediatrics (Kolegium Ilmu Kesehatan
Anak Indonesia).
• Representative of Komkordik, Faculty of Medicine, University Indonesia
Hospital.
• Education and Research Coordinator of Child Health Department,
Faculty of Medicine, Cipto Mangunkusumo Central General Hospital,
Jakarta.

Full Name & Title
Prof. Dr. dr Rinawati Rohsiswatmo, Sp.A(K)
• MD; Faculty of Medicine University of Indonesia (1986)
• Pediatrician; Faculty of Medicine University of Indonesia (1998)
• Neonatal Intensive Care Unit, Royal Women’s Hospital, Melbourne,
Australia (1999-2001)
• Consultant Pediatrician; Faculty of Medicine University of Indonesia
(2005)
• Doctor; Faculty of Medicine University of Indonesia (2011)
• Pediatric Total Nutrition Therapy, Singapore (April 2011)
• Developmental Origins of Health and Disease, USA (September 2011)
• Neonatal ventilation Strategies and HFOV 3100A Neonatal Application
Training, Amsterdam (March 2012)
• Professor of Pediatrics (Neonatology); Faculty of Medicine University of
Indonesia (2020)
• Basic Echocardiography Workshop, National Neonatology Forum, India
(2020)
Latest Position
• Lecturer; Child Health Departement, Faculty of Medicine University of
Indonesia (2002-Present)
• Neonatologist; Child Health Departement, Cipto Mangunkusumo
National General Hospital (1999-Present)
• Head of Maternal and Child Health Center KIARA, Department Faculty
of Medicine University of Indonesia, Cipto Mangunkusumo General
Hospital
• Peer Reviewer for Frontiers Pediatrics, British Medical Journal, Medical
Journal of Indonesia, Sari Pediatri
Full Name & Title

Dr. dr. Risa Etika, Sp.A(K)

• Medical Doctor, Airlangga University (1987)
• Pediatrician, Airlangga University (1997)
• Consultant of Neonatology (2008)
• Doctoral, Airlangga University (2016)
Latest Position
• Chief of Neonatology Division Department of Child Health, Faculty of
Medicine, Airlangga University/ Dr. Soetomo Hospital
• Comittee Member of Indonesian Pediatric Society, East Java Branch
(2011 – 2014, 2014 – 2017, 2017 – 2020)
• Comittee Member of Neonatology Working Group, IPS – 2014 – 2017
• Indonesian Society of Perinatology (PERINASIA), East Java Branch

Full Name & Title
Dr. dr. Ririe Fachrina Malisie, Sp.A(K)
Educational Qualifications
• Medical Doctor (MD) from Sumatra Utara University (1992)
• Pediatrician (SpA) from Andalas University (2003)
• Consultant of Pediatric Critical Care of Child Health Collegium and
Indonesian Pediatric Society (2011)
• Doktor / PhD of Medicine from University of Indonesia (2014)
Current Positions Held

• Secretary of Emergency and Pediatric Intensive Care Working Group -
Indonesian Pediatric Society (2014 - 2017)
• Chairman of Emergency and Pediatric Intensive Care Working Group -
Indonesian Pediatric Society (2017- now)
• Medical Staff Faculty of Medicine, Department of Child Health,
Universitas Sumatera Utara – Medan, Indonesia (2017 - now)
• Research Committee Member of World Federation Pediatric Intensive
and Critical Care Societies (2019 – 2022)
• Member of Pediatric Acute and Critical Care Medicine Asian Networking
(PACCMAN) (2019 – now)
• Member of Pediatric Sepsis Co-Lab (2021 – now)
• Secretary of Magister Bio-Medic Science - Faculty of Medicine
Universitas Sumatera Utara (2021 – now)
• Member of main committee of PERDICI (2022 – now)
Full Name & Title

Dr. dr. Rizalya Dewi, Sp.A(K)
Educational Qualifications
• GP: Medical Faculty of Andalas University - Padang, 1997
• Specialist: Medical Faculty of Andalas University / Dr. M. Djamil Hospital
- Padang, 2005
• Consultant (Neonatology): Indonesian Pediatrics Society Collegium,
2013
Current Positions Held

• Pediatrician-Neonatologist, Budhi Mulia Women and Chidren’s Hospital,
Pekanbaru, 2010-now
• Pediatrician-Neonatologist, Eka Hospital, Pekanbaru, 2010-now
• Steering committee members of The AsianNeo (asian-neo.org), 2020-
now
• Board member of Imaging working group, Indonesian Pediatrics Society,
2021-2024
• Member of Technical Advisory Group of Newborn Screening, WHO-
SEARO, 2023-now

Full Name & Title
Dr. dr. Rocky Wilar, Sp.A(K)
• Bachelor in Medicine, Sam Ratulangi University (1994)
• Medical Doctor, Sam Ratulangi University (1996)
• Pediatrician, Sam Ratulangi University (2005)
• Consultant of Neonatology (2011)
• Doctoral, Hasanuddin University (2015)
Latest Position
• Chief of Neonatology Division Department of Child Health, Faculty of
Medicine, Sam Ratulangi University / Prof. Dr. Kandou Hospital
• Lecturer and Head of Child Health Department, Faculty of Medicine,
Sam Ratulangi University
Full Name & Title

dr. Rosalina Dewi Roeslani, Sp.A(K)
• MD; Faculty of Medicine, Padjajaran University (1993)
• Pediatrician; Faculty of Medicine Universitas Indonesia (2003)
• Consultant Pediatrician; Faculty of Medicine Universitas Indonesia (2014)
Latest Position
• Lecture Associate University of Indonesia, Department of Child Health,
CiptoMangunkusumo Hospital, Jakarta, Indonesia (2006-present)
• Head of Neonatology Division, Department of Child Health, Cipto
Mangunkusumo Hospital, Jakarta, Indonesia (2018-present)
• Treasurer of Indonesian Pediatric Society (2014-present)
Full Name & Title

Roxana M. Culcer, M.D., FRACP
• 2013: Title of Senior Neonatologist. National Senior Doctor Certificate,
Ministry Of Public Health, Romania, Bucharest
• 07/2011: The Chinese Language Proficiency Test (HSK) level IV-
Certificate of language proficiency for higher education and professional
purposes, Nanjing, China
• 05/2011: Chinese Medical Board License for Foreign Doctors - Paediatrics
/Neonatology licensing examination, Beijing, China
• 07/2011-10/2010: Advanced Chinese Language Course, Anhui University
(安徽大学), Hefei, China
• MBBS - Medical Doctor (2001)
• University of Medicine and Pharmacy Targu-Mures, Romania (2001 – 1995)
Latest Position
• 2022/06/06 – Ongoing: Neonatal Consultant, Nepean Hospital NICU.
• 2021/01/01 – Neonatal Fellow, Westmead Hospital NICU
• 2018/02/04 – Provisional Fellow, Westmead Hospital NICU
• 2018/02/03 – 2017/05/26 Trainee (Neonatal Registrar), Westmead Hospital NICU
• 2017/05/25 – 2007 Senior Consultant in Neonatology, Department of
Neonatology-Level III NICU, University Hospital Bucharest, UNICEF-
based Baby Friendly Hospital- permanent position

Full Name & Title
Satoshi Nakagawa, MD
• Graduated Tohoku University School of Medicine in 1984
• National Children’s Hospital, Tokyo, Japan (Pediatric Anesthesia and
Critical Care, 1988 to 1991)
• Hospital for Sick Children, Toronto, Canada (1993 to 1994)
• Massachusetts General Hospital and New England Medical Center,
Boston, USA (1995 to 1996)
Latest Position
• Division Chief, Critical Care Medicine, and Associate Director, Patient
Safety and Quality Improvement, at
• National Center for Child Health and Development, Tokyo, Japan
Full Name & Title

dr. Setya Dewi Lusyati, Sp.A(K), Ph.D
• Doctor in Neonatology. Theses: Infection biomarker, UMCG-Groningen,
The Netherlands, 2011
• Consultant in Neonatology, Kolegium IDAI, 2007
• Neonatologist, UMCG Groningen, The Netherlands, 2005
• Pediatrician, UNPAD, 1999
• General practitioner, UNAIR, 1990
Latest Position
• Pediatrician-Neonatology, Neonatology Working Group, Harapan Kita
Women and Children Hospital, 2002- Present
• General Pediatrician, Ende Hospital, Glores-NTT, 2001-2002
• General Practitionar, Puskesmas Liquisa, Liquisa-East Timor, 1991-
1993
Full Name & Title

dr. Setya Wandita, Sp.A(K)
• MD, Universitas Gadjah Mada (1986)
• Pediatrician, Universitas Gadjah Mada (1999)
• Master of Maternal-Perinatal Medicine (2000)
• Neonatology Consultant, Indonesian Medical Council) (2007)
Latest Position
• Lecturer, Universitas Gadjah Mada, since 1999
• Medical staff, Sardjito Hospital, 1999

Full Name & Title
dr. Stanza Uga Peryoga, Sp.A(K), M.Kes

• MD, University of Padjajaran/Hasan Sadikin General Hospital (1994)
• Pediatrician, University of Padjajaran/Hasan Sadikin General Hospital
(2004)
• Master of Health, University of Padjajaran/Hasan Sadikin General
Hospital (2004)
• Consultan of Emergency and Pediatric Intensive Care, University of
Padjajaran/Hasan Sadikin General Hospital (2017)
Latest Positions
• Staff of Child Health Department, Emergency and Pediatric Intensive
Care Division; Faculty of Medicine University of Padjajaran/Hasan
Sadikin General Hospital (2007- now)
Full Name & Title

dr. Sri Martuti, Sp.A(K)
• MD, Faculty of Medicine, Diponegoro University - Semarang (1998)
• Pediatrician, Faculty of Medicine, Sebelas Maret University - Surakarta
(2007)
• Magister of Health Program, Faculty of Medicine, Sebelas Maret
University - Surakarta (2007)
• Pediatric Consultant, FKUI 2015
Latest Positions
• Pediatrician at RSUD Dr. Moewardi, Surakarta
• Lecturer Staff at FK UNS/RSUD Dr. Moewardi, Surakarta (2007 –
Present)
Full Name & Title

dr. Silvia Triratna, Sp.A(K)
• Dokter Umum; FK Universitas Tarumanegara (1984)
• Spesialis Anak; FK Universitas Sriwijaya (1994)
• Pediatric Critical Medicine Fellowship at FK Universitas Indonesia
(2002)
Latest Positions
• Lecturer in Pediatrics at Faculty of Medicine, Sriwijaya University
(1999-Present)
• Medical Staff Division of Pediatric Critical Care Medicne, Department
of Child Health, Medical Faculty of Sriwijaya University / Mohammad
Hoesin Hospital (2003-Present)
• General Secretary of Association of Indonesian Pediatricians, South
Sumatera (2008-2011)
• Leader of Association of Indonesian Pediatricians, South Sumatera
(2014-2017 and 2017-2021)

Full Name & Title
Dr. dr. Toto Wisnu Hendrarto, Sp.A(K)
• Fellowship in Advance Vaccinology Course, Foundation Merieux,
Feyrier-Du-Lac, France (2017)
• PhD Program in Neonatology, Medical Faculty, University of Indonesia
(2015)
• Consultant in Neonatology, Indonesian College of Pediatric (2010)
• Fellowship in Neonatology, Sophia Children Academic Hospital,
University of Erasmus, Rotterdam, The Netherlands (1996)
• Pediatrician, Medical Faculty, University of Indonesia (1994)
• Diploma in Tropical Medicine and Hygiene, SEAMEO (1989)
• General Practitioner: Medical Faculty, University of Indonesia (1985)
Latest Positions
• Neonatology Staff, RSAB Harapan Kita Jakarta
• Vice Chairman of National Committee of AEFI (Present)
• Member of MKEK Jakarta (Present)
• Member of ITAGI (Present)
• Chairman of Neonatology Working Group – IDAI (2017-2021)
Full Name & Title

Dr. dr. Tetty Yuniati, Sp.A(K), M.Kes
• Kedokteran Umum, Fakultas Kedokteran Universitas Padjadjaran,
Bandung (1980-1986)
• Spesialisasi Ilmu Kesehatan Anak, Fakultas Kedokteran Universitas
Padjadjaran, Bandung (1993-1996)
• Magister Kesehatan, Fakultas Kedokteran Universitas Padjajaran,
Bandung (2003)
• Konsultan Perinatologi, Fakultas Kedokteran Universitas Padjajaran,
Bandung (2005)
• Program Studi Doktor, Fakultas Kedokteran Universitas Padjajaran,
Bandung (2012)
Latest Positions
• Kepala Divisi Neonatologi Departemen Ilmu Kesehatan Anak, Fakultas
Kedokteran UNPAD / RS Hasan Sadikin Bandung
Full Name & Title

dr. Yogi Prawira, Sp.A(K)
Education Background
• Pediatric Intensivist Consultant, CMH/FMUI, Jakarta (2017)
• Fellowship Trainee, Pediatric and Congenital ICU, Pediatric and
Congenital Heart Center, National Heart Institute (IJN), Kuala Lumpur,
Malaysia (2015)
• Pediatrician, Faculty of Medicine, University of Indonesia, Jakarta (2010)
• Doctor of Medicine, Faculty of Medicine, Diponegoro University,
Semarang, Indonesia (2005)
Latest Positions
• Academic Staff and Clinical Lecturer at Pediatric Emergency and Critical
Care Division, Child Health Department, Cipto Mangunkusumo Hospital
/ Faculty of Medicine Universitas Indonesia, Jakarta

Full Name & Title
Anda Bowring
• 09.2014- 03.2019- Master of Science (Merit) in Advance Clinical
Practice: Advanced Neonatal Nurse Practitioner, University of
Southampton.
• 2012 -02.2014 - Degree in Newborn and Neonatal care practice, Oxford
Brookes University.
• 2011 - 2012 - Facilitating Workplace Learning course, Oxford Brookes
University.
• 09.2009. – 05.2011. – Neonatal Intensive Care Practice course, Oxford
Brookes University.
• 10.2007. – National Pharmacy Associations Dispensary Assistant
course, distance learning at Sainsbury’s Pharmacy.
• 03.2007. - National Pharmacy Associations Counter Assistant course,
distance learning at Sainsbury’s Pharmacy.
Latest Positions
• 01.2016 – currently- Advanced Neonatal Nurse Practitioner
• 12.2022- (9 months post)- Thames Valley Perinatal Optimisation Lead
for implementation of all perinatal optimisation elements as per British
Association of perinatal Medicine (BAPM), Maternal and Neonatal
Safety Improvement Program, Patient Safety, Oxford Academic Health
Science Network.
• 02. 2021-12.2022- Thames Valley Neonatal Network Lead for
implementing Optimal cord management, Maternal and Neonatal Safety
Improvement Program, Patient Safety, Oxford Academic Health Science
Network.
• 09.2014- 01.2016- Trainee Advanced Neonatal Nurse Practitioner
• 01.2012. – 09.2014 - John Radcliffe Oxford University Hospital,
Neonatal Unit, senior staff nurse.
• 05.2008. – 01.2012. – John Radcliffe Oxford University Hospital,
Neonatal Unit, staff nurse.
• 07.2006. – 05.2008. – Sainsbury’s Pharmacy, Witney, Dispensary
Assistant.
• 09.2005. – 06.2006. – Barchester Healthcare Ltd., Hailey, Witney,
Healthcare Assistant.
• 02.2005. – 08.2005. – ‘’Holly Cross’’ Travel Clinic, Larnaca, Cyprus,
Staff nurse.
• 09.2004. – 02.2005. – I. Priedniece Dental Surgery, Riga, Latvia, Dental
Nurse.
• 09.2003. – 02.2005. – Children’s Clinical University Hospital, Neonatal
Unit, Staff nurse.
• 07.2002. – 04.2003. – U. Spinga Neurosurgery Private Practice,
Liepaja, Latvia, Staff nurses assistant.
• 06.2002. – 08. 2003. – Orphanage ‘’Liepaja’’, Liepaja, Latvia, nursery
assistant for newborn’s, infants and young children.

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Program &amp; Abstract Book 14th Indoneisan PICU NICU Update 2023

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Program &amp; Abstract Book 14th Indoneisan PICU NICU Update 2023

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Organized in Collaboration By

-Pediatric Emergency & Intensive Care Working Group (ERIA)/

PROGRAM & ABSTRACT BOOK

SAT - SUN, TUE, 27 JUNE 2023

Warmest welcoming you to the Island of Gods!

Chairman Scientific Team

PRE & POST SYMPOSIUM WORKSHOPS

HYBRID 14TH INDONESIAN PICU NICU UPDATE

NICU UPDATE - BASIC

PICU NICU UPDATE - ADVANCED

EVENT Hybrid 14th Indonesian PICU NICU Update

ON SITE REGISTRATION FACILITY

HOW TO ACCESS ONLINE SESSIONS:

OFFLINE PARTICIPANTS WRISTBANDS

REGISTRATION FEE INCLUDES

CME ACTIVITY FOR PEDIATRIANS

REGISTRATION & ROOM RESERVATION NO SHOW POLICY

SPEAKERS SLIDE PREVIEW

SPEAKERS AND CHAIRPERSON’S TIPS

Grand Hyatt Bali - Indonesia

PRE-SYMPOSIUM WORKSHOP – PICU SERIES

DAY 1 THURSDAY, 22 JUNE 2023

DAY 2 FRIDAY, 23 JUNE 2023

11.40 - 13.00 Friday Pray & Lunch

"Recognition and Preparedness for Appropriate Management of Neonatal

WITA Friday 23 June 2023, GRAND BALLROOM 1

SATURDAY, 24 JUNE 2023

“Building Knowledge of Neonatal and Pediatric Emergencies to Advanced Practice”

SUNDAY, 25 JUNE 2023

POST-SYMPOSIUM WORKSHOP – NICU SERIES

DAY 2 TUESDAY, 27 JUNE 2023

POST-SYMPOSIUM WORKSHOP – PICU SERIES

ONE DAY MONDAY, 26 JUNE 2023

POST-SYMPOSIUM WORKSHOP – PICU SERIES

ONE DAY TUESDAY, 27 JUNE 2023

IDS MEDICAL SYSTEM INDONESIA

SESSION: BASIC NICU UPDATE

SATURDAY, 24 JUNE 2023

FRESENIUS KABI INDONESIA

UBC MEDICAL INDONESIA

INDOMEDIK NIAGA PERKASA

Grand Hyatt Bali - Indonesia

RSUP Prof. Dr. R.D. Kandou, Manado

STRATEGIES OF RESPIRATORY SUPPORT IN NEONATES:

Gatot Irawan Sarosa

RSUP Dr. Kariadi, Semarang

Neonatology Division of Dr. M Djamil Hospital Padang

MANAGEMENT OF NEONATAL HYPOGLYCEMIA AND HYPERGLYCEMIA

Neonatal working group – Budhi Mulia Women and Children Hospital

MANAGEMENT OF HYPOXIC ISCHEMIC ENCEPHALOPATHY INFANTS

RSUP Dr. Hasan Sadikin, Bandung

INVESTIGATION AND MANAGEMENT OF LATE ONSET SEPSIS IN NEONATE

Keywords: Late onset sepsis, neonate, investigation, management

HEMODYNAMIC INSTABILITY IN CRITICALLY ILL NEONATE

Faculty of Medicine University of Gadjah Mada

Endocrinology Division - Child Health Department

Fatima Safira Alatas

Child Health Department

NEONATAL REFEEDING SYNDROME

Putri Maharani Tristanita Marsubrin, Kanya Lalitya Jayanimitta Sugiyarto

Neonatology Division of Cipto Mangunkusumo Hospital Jakarta

Refeeding syndrome (RS) is characterized by a decrease of one or a combination of phosphorus, potassium,

Niken Wahyu Puspaningtyas

Pediatric Emergency and Intensive Care Division

Program & Abstract Book 14th Indoneisan PICU NICU Update 2023

Program & Abstract Book 14th Indoneisan PICU NICU Update 2023