STATUS HEMODINAMIK PASIEN YANG TERPASANG VENTILASI MEKANIK DENGAN POSISI LATERAL KIRI ELEVASI KEPALA 300
Abstract
Changes in position is one of the nursing interventions in the management of patients with mechanical ventilation. Several studies found contradictory effects in different groups of patients. Subiyanto (2018) states that the elevation position of the head 30 degrees lateral left with a time of 5 minutes to 30 minutes has been effective to provide positive changes to the hemodynamic status. But at the Hospital the time used to position the patient is 120 minutes, so it is necessary to know the hemodynamic changes that occur during 120 minute. This studyaaimed to determineathe effective time for the left lateral position of the head elevation of 30 degrees to the hemodynamic status. The research design used was a quasi experimental pre-test-posttest design with a control group. The population was all patients who were installed mechanically at the ICU General Hospital (RSU) Tangerang District in April to July 2019. Samples of 15 respondents in the intervention group and 15 respondents in the control group used purposive sampling technique. Results Estimated significant influence between the left lateral position of the head elevation of 30 degrees to the hemodynamic status on systolic blood pressure P value 0.045, diastolic blood pressure value P 0.001, MAP value P 0.000, Heart Rate value P 0.002 and respiratory rate P value 0.09. There is no effect on SPO2 P value 0.334. No effective time was identified for the implementation of the left lateral position of the head elevation of 30 degrees to the hemodynamic status. in systolic blood pressure, diastolic blood pressure, MAP, Hearth Rate and Respiratory Rate there was a significant increase in the mean value for 120 minutes, while in SPO2 there was a change in the average value of SPO2.
Keywords: Left Lateral Position, 300 Head Elevation, HemodynamicDownloads
References
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Elhy, A.H.A. (2017). Effect of Semifowler’s Positions on Oxygenation and Hemodynamic Status among Critically III Patients With Traumatic Brain Injury.
Gullo, A. (2008). Anaestesi Pain Intensive Care Intesive and Emergency Medicine. Italy: Springer.
Ignatavicius D.D., & Workman, M.L (2006). Medical Surgical Nursing : Critical Thinking For Collaborative Care. 5tn Ed., Vol.2. St. Louis : Elsevier Saunders.
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Thomas PJ, Paratz JD, Lipman J & Stanton WR. (2007). Lateral Positioning Ventilated Intensive Care Patients: A Study Of Oxygenation, Respiratory Mechanics, Hemodynamics
Almeida F, Pavan M, Rodringues C, (2009). The Haemodynamic, Renal Excretory And Hormonal Changes Induced By Resting In The Left Lateral Position In Normal Pregnant Women During Late Gestation. BJOG 2009;116:1749–1754.
Antonelli, M., Conti, G., Curtis, J. R., Maggiore, S. M., Mebazaa, A. and Wernerman, J. (2013), Year in Review in Intensive Care Medicine 2012. II : Pneumonia and Infection, Sepsis, Coagulation, Hemodynamics, Cardiovascular and Microcirculation, Critical Care Organization, Imaging, Ethics and legal issues, Intensive Care Medicine, 39, pp. 345–364
Benumof J.L. (2000). Scientific Principles Physiology and Anesthesia Respiratory Physiology and Respiratory Fungtion During Anesthesi. Willians & Wilkins. Inc. Lippincott Company.
Black dan Hawks. (2014). Keperawatan Medikal bedah Manajemen Klinis Untuk Hasil Yang Diharapkan Edisi * Buku 3. Singapura: Elsevier
Cicolini, G., Gagliardi, G., & Ballone, E. (2010). Effect of Fowler’s Body Position on Blood Pressure Measurement. Journal of Clinical Nursing, Volume 19, Issue 23-24.
Elhy, A.H.A. (2017). Effect of Semifowler’s Positions on Oxygenation and Hemodynamic Status among Critically III Patients With Traumatic Brain Injury.
Gullo, A. (2008). Anaestesi Pain Intensive Care Intesive and Emergency Medicine. Italy: Springer.
Ignatavicius D.D., & Workman, M.L (2006). Medical Surgical Nursing : Critical Thinking For Collaborative Care. 5tn Ed., Vol.2. St. Louis : Elsevier Saunders.
Kim, H.J., Sohng, K.Y. (2006). Effects of Backrest Position on Central Venous Pressure and Intracranial Pressure in Brain Surgery Patients. Taehan Kanho Hakhoe Chi, 36(2):35 3-60
Kirchhoff KT, Rebenson-Piano M & Patel MK. (1984). Mean Arterial Pressure Readings: Variations With Positions And Transducer Level. Nursing Research 33, 343–345
Morton, P. G., Reck, K., Hamel, J., Walther, A. S., Rueden, K. T. Von and Headley, J. M. (2013), Patient Assessment: Cardiovascular System, in Morton, P. G. and Fontaine, D. K., Critical Care Nursing A Holistic Approach, 12th edn, Wolters Kluwer Health/Lippincott Williams & Wilkins, Philadelphia, USA.
Nofiyanto, M. dan Adhinugraha, T.S. (2016). Pengaruh Tindakan Mobilisasi Dini terhadap Denyut Jantung dan Frekuensi Pernapasan pada Pasien Kritis di ICU RSUD Sleman Yogyakarta. Media Ilmu Kesehatan, Vol. 5, No. 3, Desember 2016, hlm. 213-223
Osborn, S., dan Adam, K.S., (2009). Oxford Hand Book of Critical Care Nursing. United State: Oxford University Press.
Purnawan, I., & Saryono. (2010). Mengelola pasien dengan ventilator mekanik. Jakarta: Rekatama
Price, S.A., dan Wilson, L.M., 2006, Patofisiologi, Konsep Klinis Proses-Proses Penyakit,Edisi 6, hal. 1271; Huriawati H, Natalia S, Pita Wulansari, Dewi Asih (eds), Penerbit Buku Kedokteran, EGC, Jakarta.
Ricky K. (2017). Gambaran Pasien Gagal Nafas dengan Kelainan Paru Pada Rawat Inap Di Rumah Sakit Umum Haji Adam Malik Medan Bulan Januari Sampai Agustus 2017. Universitas Sumatera utara : Skripsi
Rhodes, A., Phillips, G., Beale, R., Cecconi, M., Chiche, J. D., Backer, D. et al. (2015), The Surviving Sepsis Campaign bundles and outcome : results from the International Multicentre Prevalence Study on Sepsis (the IMPreSS study), Intensive Care Medicine, Springer Berlin Heidelberg, 41(9), pp. 1620–1628.
Rodney, R.A., (2001). Ventilasi Perfusi Apakah dipengaruhi Posisi dan Gravitasi,), www.dokterzarra.wordpress.com, diakses pada 03 Februari 2019
Schellongowski, P., Sperr R., & Staudinger T. (2007). Critically ill patients with cancer: chances and limitations of intesive care medicine – a narrative review. Diakses http://dx.doi.org/10.1136/esmoopen-2015-000018
Subiyanto, (2018). Pengaruh Posisi Lateral Terhadap Status Hemodinamik Pasien Dengan Ventilasi Mekanik di Ruang ICU RSUP DR Kariadi Semarang. Diakses melalui www.respository.unimus.ac.id pada tanggal 4 Januari 2019
Thomas PJ, Paratz JD, Lipman J & Stanton WR. (2007). Lateral Positioning Ventilated Intensive Care Patients: A Study Of Oxygenation, Respiratory Mechanics, Hemodynamics
