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
Abstrak
ARDS adalah kondisi yang mengancam jiwa yang ditandai dengan buruknya oksigenasi dan
kekakuan di paru-paru. Tujuan dari penelitian ini adalah untuk menilai pengaruh posisi
duduk terhadap pertukaran gas dan mekanisme pernapasan setelah perubahan dari posisi
terlentang ke posisi duduk pada pasien ARDS yang diberi ventilasi mekanis. Penelitian ini
merupakan penelitian pre-eksperimen dengan desain pre and post test tanpa kontrol. Dua
belas subjek penelitian direkrut. Pengaruh posisi duduk dianalisis dengan
membandingkan pertukaran gas dan mekanisme pernafasan antara posisi duduk
terlentang dan 70º. Uji Paired t-test digunakan untuk menganalisis perubahan nilai
pertukaran gas [PaO2, PaCO2, PaO2/FiO2 (PF rasio), dan AaDO2] dan uji Repeated
Measures Anova digunakan untuk menganalisis perubahan mekanika pernafasan (static
lungcompliance/Cstat). dan resistensi saluran napas/ Ri). Hasil penelitian menunjukkan
nilai rasio PF pada posisi terlentang rata-rata sebesar 196.99 (SD=105.44) dan posisi
duduk sebesar 258.09 (SD=137.92) dengan nilai p sebesar 0.038; nilai rata-rata AaDO2
pada 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 sebesar
1,000; Perubahan nilai resistensi saluran nafas (Ri) dari posisi terlentang ke posisi duduk
pada menit ke 30, 45 dan 60 diperoleh nilai p sebesar 0,012; 0,008; dan 0,010. Posisi duduk
70° adalah teknik sederhana dan dapat ditoleransi dengan baik yang meningkatkan fungsi
pertukaran gas dan mekanisme pernapasan pada pasien ARDS. Efek menguntungkan ini
mungkin disebabkan oleh mekanisme fisiologis yang kompleks dimana perekrutan
alveolar tampaknya menjadi komponen penting. Investigasi lebih lanjut diperlukan untuk
mengkonfirmasi temuan ini.
Kata Kunci: Sindrom gangguan pernafasan akut, ventilasi mekanis, posisi duduk,
pertukaran gas, mekanik pernafasan
Abstract
ARDS is a life-threatening condition characterized by poor oxygenation and stiffness in the
lungs. The aim of this study was to assess the effect of the sitting position on gas exchange and
respiratory mechanics after changing from the supine position to the sitting position in ARDS
patients who were mechanically ventilated. This research is a pre-experiment research with
a pre and post test design without control. Twelve research subjects were recruited. The effect
of sitting position was analyzed by comparing gas exchange and respiratory mechanics
between supine and 70º sitting positions. The Paired t-test was used to analyze changes in
gas exchange values [PaO2, PaCO2, PaO2/FiO2 (PF ratio), and AaDO2] and the Repeated
Jurnal Perawat Indonesia, Volume 8 No 1, Hal 1604-1617, Mei 2024
e-ISSN2 548-7051
Persatuan Perawat Nasional Indonesia Jawa Tengah p-ISSN 2714-6502
1605
Measures Anova test was used to analyze changes in respiratory mechanics (static lung
compliance/Cstat and airway resistance/ Ri). The results show that the PF ratio value in the
supine 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 was
266.85 (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 sitting
position 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 obtained
a p value of 0.012; 0.008; and 0.010. The 70° sitting position is a simple and well-tolerated
technique that improves gas exchange function and respiratory mechanics in ARDS patients.
These beneficial effects may be due to complex physiological mechanisms of which alveolar
recruitment appears to be an important component. Further investigation is needed to
confirm these findings.
Keywords: Acute respiratory distress syndrome, mechanical ventilation, sitting position, gas
exchange, respiratory mechanics
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