Efektivitas Early Respiratory Physiotherapy and Mobilization terhadap Perubahan Status Hemodinamik Pasien ICU dengan Ventilator di RSUD Haji

Pendahuluan: Pasien yang menggunakan ventilator mekanik di Intensive Care Unit (ICU) berisiko mengalami ketidakstabilan hemodinamik akibat gangguan ventilasi, retensi sekret, dan imobilisasi. Kondisi tersebut dapat menyebabkan perubahan tekanan darah, frekuensi nadi, dan frekuensi pernapasan sehingga menghambat pemulihan. Penelitian ini bertujuan menganalisis efektivitas Early Respiratory Physiotherapy and Mobilization terhadap status hemodinamik pasien menggunakan ventilator mekanik di ruang ICU RSUD Haji Provinsi Jawa Timur. Metode: Penelitian ini menggunakan desain Pre-Eksperimental dengan pendekatan One-Group Pretest-Posttest Design. Sebanyak 66 responden dipilih menggunakan purposive sampling. Variabel independen adalah Early Respiratory Physiotherapy and Mobilization, sedangkan variabel dependen meliputi tekanan darah sistolik, tekanan darah diastolik, frekuensi nadi, dan frekuensi pernapasan. Analisis data dilakukan menggunakan uji Wilcoxon Signed Rank Test dengan tingkat signifikansi α = 0,05. Hasil: Setelah pemberian intervensi, proporsi responden kategori normal meningkat pada tekanan darah sistolik (25,8% menjadi 45,5%), tekanan darah diastolik (56,1% menjadi 67,7%), frekuensi nadi (39,4% menjadi 69,7%), dan frekuensi pernapasan (37,9% menjadi 86,4%). Hasil uji Wilcoxon menunjukkan perbedaan signifikan pada tekanan darah sistolik (p < 0,001), tekanan darah diastolik (p = 0,022), frekuensi nadi (p < 0,001), dan frekuensi pernapasan (p < 0,001). Analisis: Intervensi membantu meningkatkan ventilasi, oksigenasi, pengeluaran sekret, dan sirkulasi. Pembahasan: Early Respiratory Physiotherapy and Mobilization efektif memperbaiki status hemodinamik pasien ICU yang menggunakan ventilator mekanik.

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Background: Patients receiving mechanical ventilation in the Intensive Care Unit (ICU) are at risk of hemodynamic instability due to impaired ventilation, secretion retention, and prolonged immobilization. These conditions may lead to alterations in blood pressure, heart rate, and respiratory rate, thereby delaying patient recovery. This study aimed to analyze the effectiveness of Early Respiratory Physiotherapy and Mobilization on the hemodynamic status of mechanically ventilated patients in the ICU of Haji Regional General Hospital, East Java Province. Methods: This study employed a pre-experimental design using a one- group pretest-posttest approach. A total of 66 respondents were selected through purposive sampling. The independent variable was Early Respiratory Physiotherapy and Mobilization, while the dependent variables included systolic blood pressure, diastolic blood pressure, heart rate, and respiratory rate. Data were analyzed using the Wilcoxon Signed-Rank Test with a significance level of α = 0.05. Results: Following the intervention, the proportion of respondents within the normal range increased for systolic blood pressure (from 25.8% to 45.5%), diastolic blood pressure (from 56.1% to 67.7%), heart rate (from 39.4% to 69.7%), and respiratory rate (from 37.9% to 86.4%). The Wilcoxon Signed-Rank Test demonstrated statistically significant differences in systolic blood pressure (p < 0.001), diastolic blood pressure (p = 0.022), heart rate (p < 0.001), and respiratory rate (p < 0.001).Discussion: Early Respiratory Physiotherapy and Mobilization improves ventilation, oxygenation, secretion clearance, and circulation, thereby contributing to improvements in the hemodynamic status of mechanically ventilated ICU patients.