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Giving the body position, nebulization and oxygen to the oxygen saturation of asthma patients
Corresponding Author(s) : Mira Tania
International Journal of Allied Medical Sciences and Clinical Research,
Vol. 8 No. 3 (2020): 2020 Volume - 8 Issue-3
Abstract
Asthma is a non-communicable disease which is a health problem that can be suffered by all ages both children to adults with the degree of disease ranging from mild to severe which causes increased morbidity and even death. Asthma can cause gas exchange disorders that cause hypoxemia, one indicator of the presence of hypoxemia is a decrease in oxygen saturation (SpO2). Efforts to treat asthma to increase oxygen saturation (SpO2) with pharmacological therapy are administering nebulizers using NRM and pouring 3 liters of oxygen per minute by adjusting body position of 60o (fowler).
Method
This research is a study true experimental with a pretest – posttest with control group design. This research arranged two groups: the intervention group that was given nebulization therapy using NRM masks (1-way valve) and 3 liters of oxygen per minute with 60° body position, while the control group was given nebulization therapy using nebulizer masks (2-way valve) and oxygen administration 3 liters per minute with 30° body position. Technique probability sampling with method stratified random sampling (per diagnosis of mild and medium asthma attacks). Were used to obtain 32 respondents were divided into 2 groups.
Results
Results of test repeated measure ANOVA showed differences percent SpO2 levels were significant with p value <0.05 that means intervention group is better at increasing oxygen saturation (SpO2) than the control group, especially in mild asthma attacks.
Conclusion
Giving pharmacological therapy nebulizer using NRM and pouring 3 liters of oxygen per minute with independent nursing measures body position of 60o (fowler) within 30 minutes with 3 measurements in 1 time giving intervention is very effective in increasing oxygen saturation (SpO2) on asthma patients.
Keywords
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- . Lumbantobing, V.B.M. Efektivitas Terapi Nebulizer Dengan Ipratropium Dan Fenoterol Terhadap Saturasi Oksigen. Jurnal Keperawatan. 5(1), 2017.
- . Kementerian Kesehatan Republik Indonesia. Riset Kesehatan Dasar (RISKESDAS). Jakarta: Balai Penelitian dan Pengembangan Kesehatan, Kementerian Kesehatan Republik Indonesia; 2018.
- . GAN. The Global Asthma Report Auckland, New Zealand: The Global Asthma Network; 2018. Available from: http://www.globalasthmareport.org
- . Collins, J.A, Rudenski, A., Gibson, J., Howard, L., O’Driscoll, R.,. Relating Oxygen Partial Pressure, Saturation And Content: The Haemoglobin–Oxygen Dissociation Curve. Breathe. 11(3), 2015, 194-201.
- . Takatelide, F.W., Kumaat, L.T., Malara, R.T.,. Pengaruh Terapi Oksigenasi Nasal Prong Terhadap Perubahan Saturasi Oksigen Pasien Cedera Kepala di Instalasi Gawat Darurat RSUP Prof. Dr. R. D. Kandou Manado. e-Jurnal Keperawatan. 5(1), 2017.
- . Dailey, P.A., Harwood, R., Walsh, K., Fink, J.B.,, Thayer T, Gagnon, G., Ari, A.,. Aerosol Delivery Through Adult High Flow Nasal Cannula with Heliox and Oxygen. Respiratory Care. 62(9), 2017, 1186-92.
- . Utama, S.Y.A. Buku Ajar Keperawatan Medikal Bedah Sistem Respirasi. Yogyakarta: Deepublish; 2018.
- . Alsagaff, H.M.A. Dasar-Dasar Ilmu Penyakit Paru. Surabaya: Airlangga University Press; 2002.
- . Tabrani, P.D.H.R. Ilmu Penyakit Paru. Jakarta: TIM; 2010.
- . Infodatin Asma. You Can Control Your Asthma Jakarta: Pusat Data dan Informasi Kementerian Kesehatan Republik Indonesia. 2015.
- . Ari, A. How To Optimize Aerosol Drug Delivery During Noninvasive Ventilation: What to use, how to use it, and why? Eurasian Journal of Pulmonology. 21(1), 2019, 1.
- . Ibrahim, M., Verma, R., Garcia-Contreras, L, Inhalation Drug Delivery Devices: Technology Update. Medical Devices (Auckland, NZ). 8, 2015, 131.
- . Ari, A., Ad, A.D., Sheard, M., Al Hamad, B., & Fink, J.B.,. Performance Comparisons of Jet and Mesh Nebulizers Using Different Interfaces in Simulated Spontaneously Breathing Adults and Children. Journal of Aerosol Medicine and Pulmonary Drug Delivery. 28(4), 2015, 281-9.
- . Kurnianti, N.R., Sari, R., Widhyastuti, E.,. Perbedaan Efektivitas Pemberian Nebulizer Dengan Menggunakan Mouthpiece Dibandingkan Dengan Masker Pada Penderita Asma Akut Di Balai Besar Kesehatan Paru Masyarakat (BBKPM) Surakarta. Surakarta: Universitas Muhammadiyah Surakarta; 2015.
- . Reminiac, F., Vecellio, L., Boet-Contentin, L., Gissot, V., Le Pennec, D., Salmon Gandonniere, C., Ehrmann, S., et al.,. Nasal high-flow bronchodilator nebulization: a randomized cross-over study. Annals of Intensive Care. 8(1), 2018.
- . Bhashyam, A.R., Wolf, M.T., Marcinkowski, A.L., Saville, A., Thomas, K., Carcillo, J.A., Corcoran, T.E.,. Aerosol Delivery Through Nasal Cannulas: An In Vitro Study. Journal of aerosol medicine and pulmonary drug delivery. 21(2), 2018, 181-8.
- . Rihiantoro, T. Pengaruh Pemberian Bronkodilator Inhalasi Dengan Pengenceran Dan Tanpa Pengenceran NaCl 0,9% Terhadap Fungsi Paru Pada Pasien Asma. Jurnal Ilmiah Keperawatan Sai Betik. 10(1), 2017, 129-37.
- . Patria, Y.N, Fairuz, M.,. Terapi Oksigen, Aplikasi Klinis. Jakarta: EGC; 2012.
- . Vargas, F., Saint-Leger, M., Boyer, A., Bui, N.H., Hilbert, G.,. Physiologic Effects Of High-Flow Nasal Cannula Oxygen In Critical Care Subjects. Respiratory Care; 2015.
- . Kozier, B., Glenora, E., Audreya, B., Snyder, S. Buku Ajar Pratik Keperawatan Klinis, Edisi 5. Alih Bahasa: Eny Meiliya EW, Devi Yulianti, editor. Jakarta: EGC; 2009.
- . Nurarif, A.H., Kusuma, H.,. Aplikasi Asuhan Keperawatan Bredasarkan Diagnosa Medis NANDA NIC-NOC Jilid 2. Yogyakarta: Mediaction Andayani; 2015.
- . Chanif, P., D. Position of Fowler and Semi-fowler to Reduce of Shortness of Breath (Dyspnea) Level While Undergoing Nebulizer Therapy. South East Asia Nursing Research. 1(1), 2019, 14-9.
- . Kubota, S., Endo, Y., Kubota, M., & Shigemasa, T. Assesment of effects of differences in trunk posture during Fowler's position on hemodynamics and cardiovascular regulation in older and younger subjects. Clinical Interventions in Aging. 2017.
- . Meilirianta, Tohir, T., Suhendra. Posisi Semi Fowler dan Posisi High Fowler Terhadap Perubahan Saturasi Oksigen Pada Pasien Asma Bronkial di Ruang Rawat Inap D3 dan E3 Rumah Sakit Umum Daerah Cibabat Cimahi. STIKES Rajawali. 2016.
- . Ewens, P.Ja.B. Pemantauan Pasien Kritis. 2 ed: PT Gelora Aksara Pratama; 2009.
- . GINA. Global Strategy For Management And Prevention 2018. Available from: www.ginasthma.org
- . Gustiawan, D. Hubungan Penggunaan Masker Sungkup Selama Nebulizer Terhadap Saturasi Perifer Oksigen Pada Pasien PPOK. Jurnal Riset Kesehatan Nasional STIKES Bali. 1(1), 2017.
- . Santosa, A., Endiyono,. Evaluasi Penggunaan Ooksigen Sebagai Penghasil Uap Terapi Nebulizer Pada Pasien Asma. Bidan PRADA: Jurnal Publikasi Kebidanan AKBID YLPP Purwokerto. 2017.
- . Purnama, E., Aprillia, H. Hubungan Pemberian Terapi Oksigen Sistem Aliran Rendah Dengan Status Fisiologis (Revised Trauma Score) Pada Pasien Trauma di Rumash Sakit Umum Daerah Ulin Banjarmasin. Dinamika Kesehatan Jurnal Kebidanan dan Keperawatan. 10(2), 2019.
- . Sutrisno, R.Y., Sitorus, R., Kariasa, I.,. Analisis Praktik Residensi Keperawatan Medikal Bedah dengan Pendekatan Teori Henderson pada Pasien dengan Gangguan Sistem Respirasi: Tuberkulosis dengan Pneumotoraks Spontan Sekunder di RSUP Persahabatan Jakarta. Yogyakarta 2016.
- . Messika, J., Ahmed, K.B., Gaudry, S., Miguel-Montanes, R., Rafat, C., Sztrymf, B., Dreyfuss, D., Ricard, J.D.,. Use of High-Flow Nasal Cannula Oxygen Therapy In Subjects With ARDS: A 1-Year Observational Study. Respiratory Care. 60(2), 2015, 162-9.
- . Kozier & Erb's. Fundamental of Nursing Concepts, Process and Practice Tenth Edition. USA: Julie Levin Alexander; 2016.
- . GINA. Global Strategy For Management And Prevention 2018. Available from: www.ginasthma.org
- . Menteri Kesehatan Republik Indonesia. Keputusan Menteri Kesehatan Republik Indonesia Nomor 1023/MENKES/SK/XI/2008. In: Indonesia KKR, editor. Jakarta: Kementerian Kesehatan Republik Indonesia; 2008
- . Wijayati, S., Ningrum, D.H., Putrono,. Pengaruh Posisi Tidur Semi Fowler 45° Terhadap Kenaikan Nilai Saturasi Oksigen Pada Pasien Gagal Jantung Kongestif Di RSUD Loekmono Hadi Kudus. Medica Hospitalia: Journal of Clinical Medicine. 6(1), 2019, 13-9.
- . Elliott, D., Dunne, P. Guide To Aerosol Delivery Devices for Physicians, Nurses, Pharmacists, and Other Health Care Professionals. USA: American Association for Respiratory Care; 2011.
- . Ari, A., Andrade, A.D., Sheard, M., AlHamad, B., & Fink, J.B.,. Performance Comparisons of Jet and Mesh Nebulizers Using Different Interfaces in Simulated Spontaneously Breathing Adults and Children. Journal of Aerosol Medicine and Pulmonary Drug Delivery. 28(4), 2015, 281-9.
- . Dunitz, M. Practical Handbook of Nebulizer Therapy. United Kingdom: Taylor & Francis e-Library; 2005.
- . Lin, H.L., Wan, G.H., Chen, Y.H., Fink, J.B., Liu, W.Q., & Liu, K.Y.,. Influence of Nebulizer Type With Different Pediatric Aerosol Masks on Drug Deposition in a Model of a Spontaneously Breathing Small Child. Respir Care. 57, 2012, 1894-900.
- . Skoczyński, S., Zejda, J., Brożek, G., Glinka, K., Clinical Importance of Sex Differences in Dyspnea and Its Sex Related Determinants in Asthma and COPD Patients. Advances in Medical Sciences. 64(2), 2019, 303-8.
- . Al-Shamrani, A., Al-Harbi, Adel, S., Bagais, K., Alenazi, A., Alqwaiee, M.,. Management of Asthma Exacerbation in The Emergency Departments. International Journal of Pediatrics & Adolescent Medicine. 6(2), 2019, 61.
- . Morton, P.G., Fontaine, D., Hudak, C.M., & Gallo, B.M.,. Keperawatan Kritis: Pendekatan Asuhan Holistik Volume 1 Edisi 8 Jakarta: EGC; 2011.
- . Firdaus, S., Ehwan, M.M., Rachmadi A. Efektivitas Pemberian Oksigen Posisi Semi Fowler Dan Fowler Terhadap Perubahan Saturasi Pada Pasien Asma Bronkial Persisten Ringan. JKEP. 4(1), 2019, 31-43.
- . Andani, E.F. Efektifitas Posisi High Fowler (90°) dan Semi Fowler (45°) Dengan Kombinasi Pursed Lips Breathing Terhadap Peningkatan Saturasi Oksigen Pada Pasien Penyakit Paru Obstruktif Kronik. Madiun: STIKES Bhakti Husada Mulia Madiun; 2018.
- . Lisyati. Analisis Posisi High Fowler Terhadap Perubahan Saturasi Oksigen Pada Pasien Asma Bronkial. Gombong: STIKES Muhammadiyah Gombong; 2017.
References
. Lumbantobing, V.B.M. Efektivitas Terapi Nebulizer Dengan Ipratropium Dan Fenoterol Terhadap Saturasi Oksigen. Jurnal Keperawatan. 5(1), 2017.
. Kementerian Kesehatan Republik Indonesia. Riset Kesehatan Dasar (RISKESDAS). Jakarta: Balai Penelitian dan Pengembangan Kesehatan, Kementerian Kesehatan Republik Indonesia; 2018.
. GAN. The Global Asthma Report Auckland, New Zealand: The Global Asthma Network; 2018. Available from: http://www.globalasthmareport.org
. Collins, J.A, Rudenski, A., Gibson, J., Howard, L., O’Driscoll, R.,. Relating Oxygen Partial Pressure, Saturation And Content: The Haemoglobin–Oxygen Dissociation Curve. Breathe. 11(3), 2015, 194-201.
. Takatelide, F.W., Kumaat, L.T., Malara, R.T.,. Pengaruh Terapi Oksigenasi Nasal Prong Terhadap Perubahan Saturasi Oksigen Pasien Cedera Kepala di Instalasi Gawat Darurat RSUP Prof. Dr. R. D. Kandou Manado. e-Jurnal Keperawatan. 5(1), 2017.
. Dailey, P.A., Harwood, R., Walsh, K., Fink, J.B.,, Thayer T, Gagnon, G., Ari, A.,. Aerosol Delivery Through Adult High Flow Nasal Cannula with Heliox and Oxygen. Respiratory Care. 62(9), 2017, 1186-92.
. Utama, S.Y.A. Buku Ajar Keperawatan Medikal Bedah Sistem Respirasi. Yogyakarta: Deepublish; 2018.
. Alsagaff, H.M.A. Dasar-Dasar Ilmu Penyakit Paru. Surabaya: Airlangga University Press; 2002.
. Tabrani, P.D.H.R. Ilmu Penyakit Paru. Jakarta: TIM; 2010.
. Infodatin Asma. You Can Control Your Asthma Jakarta: Pusat Data dan Informasi Kementerian Kesehatan Republik Indonesia. 2015.
. Ari, A. How To Optimize Aerosol Drug Delivery During Noninvasive Ventilation: What to use, how to use it, and why? Eurasian Journal of Pulmonology. 21(1), 2019, 1.
. Ibrahim, M., Verma, R., Garcia-Contreras, L, Inhalation Drug Delivery Devices: Technology Update. Medical Devices (Auckland, NZ). 8, 2015, 131.
. Ari, A., Ad, A.D., Sheard, M., Al Hamad, B., & Fink, J.B.,. Performance Comparisons of Jet and Mesh Nebulizers Using Different Interfaces in Simulated Spontaneously Breathing Adults and Children. Journal of Aerosol Medicine and Pulmonary Drug Delivery. 28(4), 2015, 281-9.
. Kurnianti, N.R., Sari, R., Widhyastuti, E.,. Perbedaan Efektivitas Pemberian Nebulizer Dengan Menggunakan Mouthpiece Dibandingkan Dengan Masker Pada Penderita Asma Akut Di Balai Besar Kesehatan Paru Masyarakat (BBKPM) Surakarta. Surakarta: Universitas Muhammadiyah Surakarta; 2015.
. Reminiac, F., Vecellio, L., Boet-Contentin, L., Gissot, V., Le Pennec, D., Salmon Gandonniere, C., Ehrmann, S., et al.,. Nasal high-flow bronchodilator nebulization: a randomized cross-over study. Annals of Intensive Care. 8(1), 2018.
. Bhashyam, A.R., Wolf, M.T., Marcinkowski, A.L., Saville, A., Thomas, K., Carcillo, J.A., Corcoran, T.E.,. Aerosol Delivery Through Nasal Cannulas: An In Vitro Study. Journal of aerosol medicine and pulmonary drug delivery. 21(2), 2018, 181-8.
. Rihiantoro, T. Pengaruh Pemberian Bronkodilator Inhalasi Dengan Pengenceran Dan Tanpa Pengenceran NaCl 0,9% Terhadap Fungsi Paru Pada Pasien Asma. Jurnal Ilmiah Keperawatan Sai Betik. 10(1), 2017, 129-37.
. Patria, Y.N, Fairuz, M.,. Terapi Oksigen, Aplikasi Klinis. Jakarta: EGC; 2012.
. Vargas, F., Saint-Leger, M., Boyer, A., Bui, N.H., Hilbert, G.,. Physiologic Effects Of High-Flow Nasal Cannula Oxygen In Critical Care Subjects. Respiratory Care; 2015.
. Kozier, B., Glenora, E., Audreya, B., Snyder, S. Buku Ajar Pratik Keperawatan Klinis, Edisi 5. Alih Bahasa: Eny Meiliya EW, Devi Yulianti, editor. Jakarta: EGC; 2009.
. Nurarif, A.H., Kusuma, H.,. Aplikasi Asuhan Keperawatan Bredasarkan Diagnosa Medis NANDA NIC-NOC Jilid 2. Yogyakarta: Mediaction Andayani; 2015.
. Chanif, P., D. Position of Fowler and Semi-fowler to Reduce of Shortness of Breath (Dyspnea) Level While Undergoing Nebulizer Therapy. South East Asia Nursing Research. 1(1), 2019, 14-9.
. Kubota, S., Endo, Y., Kubota, M., & Shigemasa, T. Assesment of effects of differences in trunk posture during Fowler's position on hemodynamics and cardiovascular regulation in older and younger subjects. Clinical Interventions in Aging. 2017.
. Meilirianta, Tohir, T., Suhendra. Posisi Semi Fowler dan Posisi High Fowler Terhadap Perubahan Saturasi Oksigen Pada Pasien Asma Bronkial di Ruang Rawat Inap D3 dan E3 Rumah Sakit Umum Daerah Cibabat Cimahi. STIKES Rajawali. 2016.
. Ewens, P.Ja.B. Pemantauan Pasien Kritis. 2 ed: PT Gelora Aksara Pratama; 2009.
. GINA. Global Strategy For Management And Prevention 2018. Available from: www.ginasthma.org
. Gustiawan, D. Hubungan Penggunaan Masker Sungkup Selama Nebulizer Terhadap Saturasi Perifer Oksigen Pada Pasien PPOK. Jurnal Riset Kesehatan Nasional STIKES Bali. 1(1), 2017.
. Santosa, A., Endiyono,. Evaluasi Penggunaan Ooksigen Sebagai Penghasil Uap Terapi Nebulizer Pada Pasien Asma. Bidan PRADA: Jurnal Publikasi Kebidanan AKBID YLPP Purwokerto. 2017.
. Purnama, E., Aprillia, H. Hubungan Pemberian Terapi Oksigen Sistem Aliran Rendah Dengan Status Fisiologis (Revised Trauma Score) Pada Pasien Trauma di Rumash Sakit Umum Daerah Ulin Banjarmasin. Dinamika Kesehatan Jurnal Kebidanan dan Keperawatan. 10(2), 2019.
. Sutrisno, R.Y., Sitorus, R., Kariasa, I.,. Analisis Praktik Residensi Keperawatan Medikal Bedah dengan Pendekatan Teori Henderson pada Pasien dengan Gangguan Sistem Respirasi: Tuberkulosis dengan Pneumotoraks Spontan Sekunder di RSUP Persahabatan Jakarta. Yogyakarta 2016.
. Messika, J., Ahmed, K.B., Gaudry, S., Miguel-Montanes, R., Rafat, C., Sztrymf, B., Dreyfuss, D., Ricard, J.D.,. Use of High-Flow Nasal Cannula Oxygen Therapy In Subjects With ARDS: A 1-Year Observational Study. Respiratory Care. 60(2), 2015, 162-9.
. Kozier & Erb's. Fundamental of Nursing Concepts, Process and Practice Tenth Edition. USA: Julie Levin Alexander; 2016.
. GINA. Global Strategy For Management And Prevention 2018. Available from: www.ginasthma.org
. Menteri Kesehatan Republik Indonesia. Keputusan Menteri Kesehatan Republik Indonesia Nomor 1023/MENKES/SK/XI/2008. In: Indonesia KKR, editor. Jakarta: Kementerian Kesehatan Republik Indonesia; 2008
. Wijayati, S., Ningrum, D.H., Putrono,. Pengaruh Posisi Tidur Semi Fowler 45° Terhadap Kenaikan Nilai Saturasi Oksigen Pada Pasien Gagal Jantung Kongestif Di RSUD Loekmono Hadi Kudus. Medica Hospitalia: Journal of Clinical Medicine. 6(1), 2019, 13-9.
. Elliott, D., Dunne, P. Guide To Aerosol Delivery Devices for Physicians, Nurses, Pharmacists, and Other Health Care Professionals. USA: American Association for Respiratory Care; 2011.
. Ari, A., Andrade, A.D., Sheard, M., AlHamad, B., & Fink, J.B.,. Performance Comparisons of Jet and Mesh Nebulizers Using Different Interfaces in Simulated Spontaneously Breathing Adults and Children. Journal of Aerosol Medicine and Pulmonary Drug Delivery. 28(4), 2015, 281-9.
. Dunitz, M. Practical Handbook of Nebulizer Therapy. United Kingdom: Taylor & Francis e-Library; 2005.
. Lin, H.L., Wan, G.H., Chen, Y.H., Fink, J.B., Liu, W.Q., & Liu, K.Y.,. Influence of Nebulizer Type With Different Pediatric Aerosol Masks on Drug Deposition in a Model of a Spontaneously Breathing Small Child. Respir Care. 57, 2012, 1894-900.
. Skoczyński, S., Zejda, J., Brożek, G., Glinka, K., Clinical Importance of Sex Differences in Dyspnea and Its Sex Related Determinants in Asthma and COPD Patients. Advances in Medical Sciences. 64(2), 2019, 303-8.
. Al-Shamrani, A., Al-Harbi, Adel, S., Bagais, K., Alenazi, A., Alqwaiee, M.,. Management of Asthma Exacerbation in The Emergency Departments. International Journal of Pediatrics & Adolescent Medicine. 6(2), 2019, 61.
. Morton, P.G., Fontaine, D., Hudak, C.M., & Gallo, B.M.,. Keperawatan Kritis: Pendekatan Asuhan Holistik Volume 1 Edisi 8 Jakarta: EGC; 2011.
. Firdaus, S., Ehwan, M.M., Rachmadi A. Efektivitas Pemberian Oksigen Posisi Semi Fowler Dan Fowler Terhadap Perubahan Saturasi Pada Pasien Asma Bronkial Persisten Ringan. JKEP. 4(1), 2019, 31-43.
. Andani, E.F. Efektifitas Posisi High Fowler (90°) dan Semi Fowler (45°) Dengan Kombinasi Pursed Lips Breathing Terhadap Peningkatan Saturasi Oksigen Pada Pasien Penyakit Paru Obstruktif Kronik. Madiun: STIKES Bhakti Husada Mulia Madiun; 2018.
. Lisyati. Analisis Posisi High Fowler Terhadap Perubahan Saturasi Oksigen Pada Pasien Asma Bronkial. Gombong: STIKES Muhammadiyah Gombong; 2017.