Penilaian HB WHO

Kelompok Tidak Anemia Ringan Sedang Berat

Anak usia 6-59 ≥11 10-10,9 7-9,9 <7
bulan
Anak usia 5-11 ≥11,5 11-11,4 8-10,9 <8
tahun
Anak usia 12-14 ≥12 11-11,9 8-10,9 <8
tahun
Bukan wanita ≥12 11-11,9 8-10,9 <8
hamil (usia ≥ 15
tahun)
Wanita hamil ≥11 10-10,9 7-9,9 <7
Laki-laki ≥13 11-12,9 8-10,9 <8
World Health Organization (WHO). Haemoglobin concentrations for the diagnosis of
anaemia and assessment of severity. Vitamin and Mineral Nutrition Information System.
Geneva, World Health Organization; 2011. [cited 26 October 2017]; Available from :
(http://www.who.int/vmnis/indicators/haemoglobin.pdf.)

Status gizi melalui pengukuran LILA

MUAC dapat dihitung dengan rumus percentil

Caranya adalah :

1. Mengukur MUAC (LILA)

2. Setelah mendapatkan data hasil MUAC, maka dapat dicari persamaan

median, dengan rumus :

Tabel Persentil Tabel MUAC Berdasarkan Usia dan Kelamin ( Gibson, 1993 )
3,Setelah mendapatkan persentase median, maka kita bisa menginterpretasikan
hasil median tersebut ke dalam tabel klasifikasi dibawah ini
Tabel Klasifikasi dan Evaluasi Muscle Status ( Frisancho, 1990 )

Untuk mengukur LILA pada usia 3 – 5 tahun menggunakan rumus

standart deviation (z-score. Rumusnya sebagai berikut :

Hematologi rutin
Nilai normal pada dewasa
Pria Wanita
 Hemoglobin 14-18 g/dl 12-16 g/dl
Hematokrit 41,5-50,4% 36-45%
MCV 80-96 fL 80-96 fL
MCH 27,7-33,2 pg 27,7-33,2 pg
MCHC 32-36 g/dl 32-36 g/dl
/Retikulosit 0,5-2,0% 0,5-2,0%
Leukosit 4-11x109/l 4-11x109/l
Platelet 150.000-400.000/mcl 150.000-400.000/mcl
Turgeon ML. Clinical hematology : theory and procedures. Philadelphia: Lippincott Williams
& Wilkins;2004.

Haematological and biochemical reference intervals for infants

and children in Gabon
Alexander Humberg1,2, Judith Kammer1,2, Benjamin Mordmu¨ ller1,2, Peter G. Kremsner1,2 and Bertrand Lell1,2

volume 16 no 3
Kegawatdaruratan leukosit tinggi
Elevated white blood cells (WBC) count is therefore regarded as a reliable indicator of an
underlying disease, and blood count is one of the laboratory tests more frequently carried out
to diagnose a wide variety of clinical conditions. For instance, leukocytosis in patients with
fever is considered as a strong indicator of a serious infection that often requires hospital
admis-sion,4 while in subjects with abdominal pain it is associated with conditions requiring
surgical intervention.5 Moreover, leukocytosis is often used to define patients’ prognosis: in
patients with acute stroke it is related to the area of infarction,6 and in subjects with trauma
it is a predictor of a worse outcome.7
The finding of high WBC count is particularly important in the Emergency Room (ER), where
leukocytosis alert to the presence of a serious underlying disease and therefore, the
hospitalization of subjects who could otherwise be managed as outpatients, might be
prompt.
Leukocytosis is considered a marker of serious disease in case of extreme leukocytosis (WBC
>25,000/mmc)10 or in association with other laboratory findings and patients’ characteristics
(advanced age, low Glasgow coma scale or mini mental state examination score,
hypotension, leukocytosis, metabolic acidosis, and azotemia).11

The term ‘‘leukemoid reaction’’ has been used to describe patients with dramatically elevated
leukocyte counts or leukocytosis with a marked left shift that simulates leukemia, but specific
definitions of this term vary widely (1–5). The absence of a widely accepted definition hampers
understanding of this topic.

Hyperleukocytosis is defined as peripheral blood leukocyte count exceeding

100,000/mm3. Acute leukemia is the most common etiology in pediatric
practice. Hyperleukocytosis is a medical emergency. The increased blood
viscosity, secondary to high white cell count and leukocyte aggregates, results
in stasis in the smaller blood vessels. This predisposes to neurological,
pulmonary or gastrointestinal complications. In addition, patients are at risk
for tumor lysis syndrome due to the increased tumor burden. Initial
management includes aggressive hydration, prevention of tumor lysis
syndrome, and correction of metabolic abnormalities. A red cell transfusion
is not indicated in a hemodynamically stable child, as it adversely affects the
blood viscosity. Leukapheresis is the treatment of choice for a very high
count, or in patients with symptomatic hyperleukocytosis. The technical
expertise required, a relative difficult venous access in younger children, risk
of anticoagulation and possible non-availability of the procedure in
emergency hours are limitations of leukapheresis. However, it is a rewarding
procedure and performed with relative ease in centers that perform the
procedure frequently. An exchange transfusion is often a practical option
when hyperleukocytosis is complicated with severe anemia. The partial
exchange aids in correcting both, without the risk of volume overload or
hyperviscosity, which are the limitations of hydration and blood transfusion,
respectively. Etiology and management of hyperleukocytosis in relevance to
the pediatric emergency room is outlined.

The Indian Journal of Pediatrics

February 2013, Volume 80, Issue 2, pp 144–148 | Cite as

Hyperleukocytosis: Emergency Management

Richa JainDeepak BansalEmail authorR. K. Marwaha

Pemberian oksigen, berapa dan jenisnya

Terapi oksigen aliran rendah dan aliran tinggi (pdf)

Kenapa PRC pada kasus

Karena anak ini memiliki Hb 4,7 g/dL. Dan Transfusi sel darah merah (PRC)
hampir selalu diindikasikan pada kadar Hemoglobin (Hb) <7 g/dl, terutama
pada anemia akut. Transfusi dapat ditunda jika pasien asimptomatik dan/atau
penyakitnya memiliki terapi spesifik lain, maka batas kadar Hb yang lebih
rendah dapat diterima.

In a patient with normal cardiopulmonary and vascular performance, an Hb

level of 6 g/dL or less (Hb <3.7 mmoL/L or hematocrit <18%) is seen as an
“absolute“ indication for transfusion (4). In individual cases, particularly in the
presence of chronic adaptation to anemia, the transfusion trigger may be lower
(e.g., Hb 5.5 g/dL).

Markus M. Müller, Christof Geisen, Kai Zacharowski, Torsten Tonn,

.Transfusion of Packed Red Cells. Indications, Triggers and Adverse Events.

Erhard SeifriedDeutsches Ärzteblatt International | Dtsch Arztebl Int 2015; 112:
507–18

Antibiotik yang digunakan pada kasus

Prophylaxis for the Immunocompromised Host

Initial Management of the High-Risk Febrile Neutropenic Patient

Continued Management of the Neutropenic Patient After 3 Days of
Intravenous Antibiotics
Managing Infection in Cancer Patients and Other Immunocompromised Children. Russell W. Steele,
MD. The Ochsner Journal 12:202–210, 2012