PENGARUH POSISI DUDUK TERHADAP PERTUKARAN GAS DAN MEKANIKA PERNAPASAN PADA PASIEN ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) YANG TERPASANG VENTILASI MEKANIS
EFFECTS OF SITTING POSITION ON GAS EXCHANGE AND RESPIRATORY MECHANICS IN ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) PATIENTS WHO WERE MECHANICALLY VENTILATED
DOI:
https://doi.org/10.32584/jpi.v8i1.2621Abstract
AbstrakARDS adalah kondisi yang mengancam jiwa yang ditandai dengan buruknya oksigenasi dankekakuan di paru-paru. Tujuan dari penelitian ini adalah untuk menilai pengaruh posisiduduk terhadap pertukaran gas dan mekanisme pernapasan setelah perubahan dari posisiterlentang ke posisi duduk pada pasien ARDS yang diberi ventilasi mekanis. Penelitian inimerupakan penelitian pre-eksperimen dengan desain pre and post test tanpa kontrol. Duabelas subjek penelitian direkrut. Pengaruh posisi duduk dianalisis denganmembandingkan pertukaran gas dan mekanisme pernafasan antara posisi dudukterlentang dan 70º. Uji Paired t-test digunakan untuk menganalisis perubahan nilaipertukaran gas [PaO2, PaCO2, PaO2/FiO2 (PF rasio), dan AaDO2] dan uji RepeatedMeasures Anova digunakan untuk menganalisis perubahan mekanika pernafasan (staticlungcompliance/Cstat). dan resistensi saluran napas/ Ri). Hasil penelitian menunjukkannilai rasio PF pada posisi terlentang rata-rata sebesar 196.99 (SD=105.44) dan posisiduduk sebesar 258.09 (SD=137.92) dengan nilai p sebesar 0.038; nilai rata-rata AaDO2pada posisi terlentang sebesar 266.85 (SD=159.90) dan pada posisi duduk 189.41(SD=113.63) dengan nilai p sebesar 0.047; perubahan nilai komplians statik paru (Cstat)dari posisi terlentang ke posisi duduk pada menit ke 30, 45 dan 60 diperoleh nilai p sebesar1,000; Perubahan nilai resistensi saluran nafas (Ri) dari posisi terlentang ke posisi dudukpada menit ke 30, 45 dan 60 diperoleh nilai p sebesar 0,012; 0,008; dan 0,010. Posisi duduk70° adalah teknik sederhana dan dapat ditoleransi dengan baik yang meningkatkan fungsipertukaran gas dan mekanisme pernapasan pada pasien ARDS. Efek menguntungkan inimungkin disebabkan oleh mekanisme fisiologis yang kompleks dimana perekrutanalveolar tampaknya menjadi komponen penting. Investigasi lebih lanjut diperlukan untukmengkonfirmasi temuan ini.Kata Kunci: Sindrom gangguan pernafasan akut, ventilasi mekanis, posisi duduk,pertukaran gas, mekanik pernafasanAbstractARDS is a life-threatening condition characterized by poor oxygenation and stiffness in thelungs. The aim of this study was to assess the effect of the sitting position on gas exchange andrespiratory mechanics after changing from the supine position to the sitting position in ARDSpatients who were mechanically ventilated. This research is a pre-experiment research witha pre and post test design without control. Twelve research subjects were recruited. The effectof sitting position was analyzed by comparing gas exchange and respiratory mechanicsbetween supine and 70º sitting positions. The Paired t-test was used to analyze changes ingas exchange values [PaO2, PaCO2, PaO2/FiO2 (PF ratio), and AaDO2] and the RepeatedJurnal Perawat Indonesia, Volume 8 No 1, Hal 1604-1617, Mei 2024e-ISSN2 548-7051Persatuan Perawat Nasional Indonesia Jawa Tengah p-ISSN 2714-65021605Measures Anova test was used to analyze changes in respiratory mechanics (static lungcompliance/Cstat and airway resistance/ Ri). The results show that the PF ratio value in thesupine position is an average of 196.99 (SD=105.44) and the sitting position is 258.09(SD=137.92) with a p value of 0.038; the average AaDO2 value in the supine position was266.85 (SD=159.90) and in the sitting position 189.41 (SD=113.63) with a p value of 0.047;changes in lung static compliance (Cstat) values from the supine position to the sittingposition at 30, 45 and 60 minutes obtained a p value of 1.000; The change in airway resistance(Ri) value from the supine position to the sitting position at 30, 45 and 60 minutes obtaineda p value of 0.012; 0.008; and 0.010. The 70° sitting position is a simple and well-toleratedtechnique that improves gas exchange function and respiratory mechanics in ARDS patients.These beneficial effects may be due to complex physiological mechanisms of which alveolarrecruitment appears to be an important component. Further investigation is needed toconfirm these findings.Keywords: Acute respiratory distress syndrome, mechanical ventilation, sitting position, gasexchange, respiratory mechanicsDownloads
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