CHRONIC LUNG DISEASE DENGAN PALATUM LETAK TINGGI, PATENT FORAMEN OVALE, GIZI BURUK TIPE MARASMIK, MISSED OPPRTUNITY OF IMMUNIZATION DAN GROSS MOTORIC DELAYED

TITI PAMBUDI K, Prof. dr. M. Juffrie, Ph.D, Sp.A(K) ; dr. Roni Naning, M.Kes, Sp.A(K)

2016 | Tesis-Spesialis | SP ILMU KESEHATAN ANAK

Chronic lung disease merupakan kondisi klinis yang dicirikan ketergantungan terhadap suplementasi oksigen pada periode tertentu setelah kelahiran disertai kelainan gambaran radiologis anatomi paru. Anak dengan chronic lung disease memerlukan pemantaun jangka panjang karena rentan mengalami masalah kesehatan dan komplikasi penyakit. Suatu pengamatan longitudinal terhadap seorang anak dengan chronic lung disease dilakukan untuk mengetahui luaran klinis berupa kejadian hospitalisasi, morbiditas penyakit berupa gangguan pernpasan dan komplikasi penyakit seperti gangguan tumbuh kembang maupun komplikasi terhadap organ lain. Pada laporan kasus ini, seorang anak perempuan usia 9 bulan 20 hari didiagnosis sebagai chronic lung disease berdasarkan terdapatnya kesulitan weaning oksigen pada 4 bulan pertama kehidupan, disertai dengan gambaran radiologis rontgen thoraks yang sesuai dengan diplasia bronkhopulmoner grade 2. Pasien juga menderita palatum letak tinggi, patent foramen ovale, gizi buruk tipe marasmik, missed opportunity of immunization dan gross motoric delayed. Selama pengamatan, pasien mendapatkan intervensi berupa terapi steroid inhalasi, manajemen gizi buruk, catch up imunisasi, fisioterapi dan pemeriksaan fisik berkala serta ekokardiografi. Gangguan pernapasan berat berupa pneumonia yang memerlukan rehospitalisasi hanya didapatkan sekali selama masa pemantauan. Gangguan pernapasan ringan berupa gangguan pernapasan ringan seperti wheezing infant, asma serangan ringan, bronkitis akut dan common cold hanya terjadi pada tahun pertama pemantauan, dan semakin jarang seiring dengan bertambahnya usia anak. Pada akhir pemantauan tidak didapatkan komplikasi hipertensi pulmonal, catch imunisasi tercapai, tercapai kejar tumbuh dan keterlambatan motorik kasar terkoreksi. Morbiditas yang minimal, pertumbuhan yang baik dan perkembangan yang sesuai usia diharapkan bertahan hingga akhir kehidupan.

Chronic lung disease is a clinical condition characterized dependence of supplemental oxygen for a certain period after the birth of radiology accompanied by abnormalities in radiological findings of lung. Children with chronic lung disease requiring long-term monitoring because it is vulnerable to health problems and complications of the disease. A longitudinal observation of a child with a chronic lung disease conducted to determine the clinical outcomes such as the incidence of hospitalization, morbidity of the disease especially pulmonary disorders and disease complications such as delay on growth and development, and also complications to other organs. In this case report, a girl aged 9 months 20 days were diagnosed as chronic lung disease based on the presence of difficulty on oxygen weaning at the first 4 months of life, accompanied by brochopulmonary dyplasia grade 2 on thoracic radiograph finding. Patients also suffer from high palate, patent foramen ovale, severe malnutrition marasmic type, missed opportunity of immunization and gross motoric delayed. During the observation, patients received some intervention in the form of inhalation steroid therapy, management of malnutrition, catch up immunization, physiotherapy and routine physical examination and echocardiography. Severe respiratory disorders such as pneumonia requiring rehospitalization obtained only once during monitoring period. Minor respiratory disorders such as wheezing infant, asthma mild attack, acute bronchitis and common cold occur during the first year of monitoring, then occur less frequent with increasing age of child. At the end of monitoring, there is no complications of pulmonary hypertension, catch upimmunization has been done, catch up growth has been reached, and gross motor delay has been corrected. Minimal morbidity and optimal growth and development of this patient are expected to last until the end of life.

Kata Kunci : chronic lung disease, anak, morbiditas, komplikasi, luaran klinis