P2 Ispa Diagnosis Dan Penatalaksanaan H1N1 091214
P2 Ispa Diagnosis Dan Penatalaksanaan H1N1 091214
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DEPARTEMEN KESEHATAN
REPUBLIK INDONESIA
2009
KATA PENGANTAR
DIREKTUR JENDERAL
PENGENDALIAN PENYAKIT DAN PENYEHATAN LINGKUNGAN
Meskipun saat ini jumlah kasus influenza yang disebabkan Influenza A Baru
(H1N1) di dunia mulai menurun, tetapi ada kekhawatiran dari para ahli akan
adanya kemungkinan terjadinya peningkatan kasus (gelombang kedua) di
pergantian musim mendatang.
Hal
I. PENDAHULUAN
c. Surveilans Virologi
a. Kasus ringan.
Sebagian besar kasus akan sembuh dalam waktu satu minggu.
Kasus ringan tidak pemerlukan perawatan RS, tidak memerlukan
pemberian antivirus kecuali kasus klaster serta hanya diberikan
pengobatan simtomatik dan Komunikasi Informasi Edukasi (KIE)
untuk pasien dan keluarganya. Pasien diamati selama 7 hari.
Pengobatan simtomatik diberikan sesuai gejala. Salisilat tidak
Pedoman Diagnosis dan Penatalaksanaan Influenza A Baru (H1N1) 7
b. Kasus sedang.
Perawatan dilakukan di ruang isolasi dan diberikan antivirus.
Pemeriksaan RT-PCR hanya dilakukan satu kali pada awal
perawatan. Jika keadaan umum dan klinis baik dapat dipulangkan
dengan KIE. Jika terjadi perburukan, dilakukan perawatan di ICU
dengan penatalaksanaan sesuai kasus berat (pengawasan ketat
tanda kegawatdaruratan misal pemeriksaan laktat dehidrogenase
> 4, analisis gas darah menunjukkan PaCO2 <30 mmHg,
C-reactive protein atau procalcitonin).
c. Kasus berat.
Dilakukan perawatan di ruang isolasi ICU/PICU/NICU dan
diberikan antivirus serta diperiksa RT-PCR satu kali pada awal.
Pada influenza A baru (H1N1) yang berat dengan pneumonia
ditemukan gambaran yang sama dengan pneumonia pada flu
burung .
Antiviral
Antibiotik
Kortikosteroid
Antibiotik
Pemberian Nutrisi
• Basal metabolic rate sesuai umur
o 1 tahun : 55 kkal/kgBB/hari
o 5 tahun : 45 kkal/kgBB/hari
o 10 tahun : 38 kkal/kgBB/hari
VII. LABORATORIUM
X. PENUTUP
Mengingat situasi influenza A baru (H1N1) masih terus berkembang
perlu dilakukan pemantauan secara terus menerus serta merevisi
setiap muncul fenomena baru atau hal hal baru yang bermakna baik
dari aspek epidemiologik, virologik, klinik, terapi maupun imunisasi
dengan tujuan mencegah meluasnya penyakit, mencegah kematian
dan menekan angka kematian seminimal mungkin.
22 Pedoman Diagnosis dan Penatalaksanaan Influenza A Baru (H1N1)
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26 Pedoman Diagnosis dan Penatalaksanaan Influenza A Baru (H1N1)
TIM PENYUSUN
1. Ketua Pelaksana:
Prof. dr. Hadiarto Mangunnegoro, Sp. P (K) RS Persahabatan
2. Sekertaris:
dr. Priyanti Z Soepandi, Sp. P (K) RS Persahabatan
3. Prof. dr. Herdiman Pohan, Sp. PD (K) FKUI
4. Prof. dr. Sri Rezeki S. Hadinegoro, Sp. A(K), Ph.D TAG
5. Prof. dr. Amir Madjid, Sp. An, KIC IDSAI
6. dr. Iwan Muljono, MPH Direktur P2ML
7. dr. T. Marwan Nusri, MPH Direktur Yanmedik
Dasar
8. dr. Sardikin Giriputro, Sp. P, MARS Dirut RSPI
9. Dr. dr. Trihono, MSc. Kapuslit Biomedis
dan Farmasi
10. dr. I Nyoman Kandun, MPH PAEI
11. dr. David Mulyono, Sp. PD, PhD. Lembaga Eijkman
12. Dr. dr. Bambang Supriyatno, Sp. A (K) RSCM
13. dr. Sri Suprapti RSCM
14. dr. Rudi P RSCM
15. dr. Rismala Dewi, Sp. A RSCM
16. dr. C Martin Rumende Sp. PD-KP RSCM
17. dr. Julianto Witjaksono, MGO, Sp. OG, KFER RSCM
18. dr Zuswayudha Samsu Sp. An KIC, KAKV RS Harapan Kita
19. dr. Dewa RS Persahabatan
20. dr. Sulastri, Sp. A RSPI-SS
21. dr. Yohanes W.H George, SpAn. KIC FKUI
Pedoman Diagnosis dan Penatalaksanaan Influenza A Baru (H1N1) 27
TIM EDITOR