Manajemen Jalan Nafas dengan Kombinasi Chest Physiotherapy dan Terapi Oksienasi pada Pasien Pneumonia
DOI:
https://doi.org/10.33096/e4gk9b06Keywords:
Pneumonia, airway clearance, chest physiotherapy, oxygen therapy, emergency departmentAbstract
Pneumonia is a lower respiratory tract infection that may cause secretion retention, crackles, tachypnea, and reduced oxygenation, requiring measurable airway clearance and oxygen support in the emergency department. This case report describes clinical improvement in a single case following a combination of Chest Physiotherapy (CPT) and oxygen therapy. The patient presented with dyspnea, productive cough, and fever. Baseline assessment showed crackles, thick sputum difficult to expectorate, RR 27–28 breaths/min, SpO₂ 93%, temperature 38°C, and chest X-ray infiltrates consistent with pneumonia. The primary nursing diagnosis supported ineffective airway clearance with the need for oxygenation support. Interventions included structured CPT (postural drainage, percussion/vibration, deep-breathing, and effective coughing) and oxygen via nasal cannula titrated to target saturation. Outcomes were assessed quantitatively at T0 (baseline), T1 (after one session, ~1–2 h), and T2 (~24 h): RR, SpO₂, lung sounds, sputum characteristics, dyspnea (Borg 0–10), accessory muscle use, and temperature. Gradual clinical improvement was observed (RR 27–28 to 22 breaths/min; SpO₂ 93% to 96%), with reduced crackles, easier sputum expectoration, decreased dyspnea, and lower temperature. Generalization is limited due to the single-case design and concurrent medical therapies.
References
1. Lim WS. Pneumonia—Overview. Encycl Respir Med Second Ed. 2021;4(January):185–97.
2. WHO recommendations for management of serious bacterial infections in infants aged 0–59 days. 2024.
3. Kondo W, Taula S, Wahyudin B, Hariadi A, Pembahasan H. Karakteristik Pneumonia Pada Balita Di RSUD Labuang Baji Makassar Tahun 2021 - 2022 Characteristics of Pneumonia in Toddler at Labuang Baji Hospital Makassar in 2021 - Pendahuluan Metode Penelitian. 2024;2(1):29–33.
4. Yovi I, Safari D, Syah NA, Anggraini D, Hanifah ZN, Shapira VZ, et al. Bacterial Profile and Antimicrobial Resistance Patterns of Pleural Empyema in Pekanbaru Hospitals. J Respirologi Indones. 2024;44(1):36–44.
5. Vina Chintia Pariama. Pneumonia Bilateral. Kia Vina Dan Well. 2024;3(3):166–73.
6. Intan Daryaswanti P; dkk. Buku Ajar Medikal Bedah : Sistem Respirasi dan Sistem Kardiovaskuler. Cetakan Pe. Intan Daryaswanti P; E, editor. Jambi: PT Sonpedia Publishing Indonesia; 2024. 18 p.
7. Penyami Y, Firdaus SN, Wijayanti M, Rahmawati I, Hartono M, Inayah M. Studi Kasus: Implementasi Manajemen Jalan Napas Pada Anak Dengan Pneumonia. J Lintas Keperawatan. 2024;5(1):334–45.
8. Modjo D, Sudirman AA, Ibrahim SD. Analisis Asuhan Keperawatan Bersihan Jalan Napas Tidak Efektif Pada Anak Bronkopneumonia Dengan Tindakan Kolaborasi Pemberian Nebulizer Di Ruang Picu Rsud Prof. Dr. H. Aloei Saboe. J Rumpun Ilmu Kesehat. 2023;3(2):119–28.
9. Moy JM, Santoso SDRP, Paju W. Implementasi Fisioterapi Dada terhadap Masalah Bersihan Jalan Nafas Tidak Efektif pada Pasien Pneumonia. J Keperawatan Sumba. 2024;2(2):58–69.
10. Karima N, Hendarto GS, Biokimia B, Molekuler B, Kedokteran F, Lampung U. Dinamika dan Fungsi Mikrobioma Paru Dynamics and Functions of the Lung Microbiome. 2024;8:175–8.
11. Syafiati N, Nurhayati S. Penerapan Fisioterapi Dada Dalam Mengatasi Bersihan Jalan Nafas Tidak Efektif Pada Anak Pneumonia Usia Toddler (3-6 Tahun) the Implementation of Chest Physiotherapy in Resolve the Ineffective Airway Clearance in Toddler (3-6 Years) With Pneumonia. J Cendikia Muda. 2021;1(1):103–8.
12. Wardiyah AW, Wandini RW, Rahmawati RP. Implementasi Fisioterapi Dada Untuk Pasien Dengan Masalah Bersihan Jalan Napas Di Desa Mulyojati Kota Metro. J Kreat Pengabdi Kpd Masy. 2022;5(8):2348–62.
13. Sahrudi S, Ameilia NA. Pengaruh Pemberian Oksigen Menggunakan Nasal Kanul Terhadap Saturasi Oksigen pada Pasien PPOK di IGD RS TK II Moh Ridwan Meuraksa. Malahayati Nurs J. 2024;6(1):141–51.
14. Oktaviani V, Nugroho SA. Studi Literatur: Pengaruh Fisioterapi Dada Pada Pasien Pneumonia. J Keperawatan Prof. 2022;10(1):56–71.
15. Kusuma, W & Soetijono RR. Jurnal Studi Keperawatan Asuhan Keperawatan pada Anak Pneumonia dengan Fokus Studi Pengelolaan Pemenuhan. J Stud Keperawatan. 2021;2(1).
