Pengaruh Early Respiratory Physiotherapy and Mobilization terhadap Kadar PCO₂ dan SpO₂ pada Pasien dengan Ventilator di ICU RSUD Haji Jawa Timur

Pendahuluan: Pasien yang menggunakan ventilator mekanik di Intensive Care Unit (ICU) berisiko mengalami gangguan pertukaran gas akibat penurunan ventilasi alveolar, akumulasi sekret, dan imobilisasi berkepanjangan yang ditandai dengan peningkatan kadar PCO₂ dan penurunan SpO₂. Early respiratory physiotherapy and mobilization merupakan salah satu intervensi yang dapat membantu meningkatkan ventilasi dan oksigenasi pasien. Penelitian ini bertujuan menganalisis pengaruh pemberian early respiratory physiotherapy and mobilization terhadap kadar PCO₂ dan SpO₂ pada pasien dengan ventilator di Ruang ICU RSUD Haji Provinsi Jawa Timur. Metode: Penelitian pre-eksperimental dengan pendekatan one group pretest-posttest. Sampel penelitian berjumlah 67 pasien yang dipilih menggunakan teknik purposive sampling. Data kadar PCO₂ diperoleh melalui pemeriksaan analisis gas darah arteri, sedangkan SpO₂ diukur menggunakan pulse oximetry. Hasil dan Pembahasan: Sebelum intervensi, sebagian besar responden mengalami hiperkapnia (70,1%) dan hanya 6% memiliki kadar PCO₂ normal. Setelah intervensi, proporsi PCO₂ normal meningkat menjadi 61,2% dan hiperkapnia menurun menjadi 11,9%. Pada parameter SpO₂, kondisi normal meningkat dari 28,4% menjadi 86,8%, sedangkan hipoksemia berat menurun dari 37,3% menjadi 1,5%. Median kadar PCO₂ menurun dari 47,40 mmHg menjadi 39 mmHg, sedangkan median SpO₂ meningkat dari 91% menjadi 98%. Hasil uji Wilcoxon menunjukkan nilai p = 0,000 pada kedua parameter, yang menunjukkan bahwa early respiratory physiotherapy and mobilization berpengaruh terhadap perubahan kadar PCO₂ dan SpO₂.

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Introduction: Patients on mechanical ventilation in the Intensive Care Unit (ICU) are at risk of gas exchange disorders due to decreased alveolar ventilation, secretion accumulation, and prolonged immobilization, characterized by increased PCO₂ levels and decreased SpO₂. Early respiratory physiotherapy and mobilization are interventions that can help improve patient ventilation and oxygenation. This study aimed to analyze the effect of early respiratory physiotherapy and mobilization on PCO₂ and SpO₂ levels in ventilated patients in the ICU of the Haji Provincial General Hospital in East Java. Methods: A pre-experimental study using a one-group pretest-posttest design. The study sample consisted of 67 patients selected using purposive sampling. PCO₂ levels were obtained through arterial blood gas analysis, while SpO₂ was measured using pulse oximetry. Results and Discussion: Before the intervention, the majority of participants had hypercapnia (70.1%), and only 6% had normal PCO₂ levels. After the intervention, the proportion with normal PCO₂ levels increased to 61.2%, and hypercapnia decreased to 11.9%. Regarding SpO₂ levels, the proportion of normal values increased from 28.4% to 86.8%, while severe hypoxemia decreased from 37.3% to 1.5%. The median PCO₂ level decreased from 47.40 mmHg to 39 mmHg, while the median SpO₂ increased from 91% to 98%. The results of the Wilcoxon test showed a p-value of 0.000 for both parameters, indicating that early respiratory physiotherapy and mobilization had an effect on changes in PCO₂ and SpO₂ levels.