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145 154 PDF
145 154 PDF
Ani Widiastuti
Program Studi Ilmu Keperawatan, FIKES, UPN ”Veteran” Jakarta
Jl. RS. Fatmawati, Pondok Labu, Jakarta Selatan - 12450
Telp/HP. 021 7656971
Abstract
Coronary Artery Bypass Graft (CABG) is one of the common methods of revascularization
in patients with atherosclerosis or coronary heart disease with 3 or more blockages in the coronary
arteries or significant blockage in the Left Main Artery Coroner (Chulay & Burns, 2006). As a last
alternative management of coronary heart disease, CABG have little complications for the patient
for example hypovolemia, bleeding, cardiac tamponade, pneumonia, atelectasis and even failure
of the ventilator weaning process can occur due to complications. Prevention of complication should
be done early so that patients avoid new problems that can making late the healing process.
Necessary to prevent post-operative complications. Post-CABG patients will use breathing ascesories
and use tube or WSD (water sail drainage) to evacuate postoperative intrathoracic fluid. One of
the preventive measures that can be done to prevent complications is to train the patient's airway
in the respiratory muscles training. Breathing exercises is an effort to help maximize lung function
through-diaphragm abdominal breathing and lip-purse breathing (LPB), while the respiratory muscles
exercises with breathing diaphragm is a breathing technique using diafrahma movement so that
movement and use of accessory respiratory muscles may be either because it can reduce the
workload when breathing. The aim of this intervention is increase lung expansion while improving
oxygenation to the heart muscle. Research that have done by Westerdahl, 2005, mentions that train
regularly breathing in patients post CABG with mechanical ventilation can result in a significant
increase in lung volume capacity and improve gas exchange value in post-CABG patients (p <0.0001).
METODE PENELITIAN
Intervensi keperawatan berbasis bukti
(evidence based nursing practice) ini
Gambar 1. Ekspansi dada saat bernafas menggunakan pendekatan quasi eksperiment
pretest posttest without control group, yang
Pada saat pernafasan diafragma, diafragma sampelnya diambil secara random. Pengukuran
datar selama inspirasi, meningkatkan fungsi paru menggunakan cara manual atau secara
pengembangan rongga dada dan ekspansi paru- klinis pasien, antara lain frekuensi bernafas,
paru. Pernapasan diafragma-abdominal telah saturasi oksigen, serta indicator fisiologis lainnya
lama dilakukan untuk meningkatkan meliputi tekanan darah dan frerkuensi jantung.
pengembangan paru dan dada. Pernapasan Pasien post operasi CABG yang telah
diafrahma-abdominal dan PLB (purse lip dilepas dari alat bantu pernafasan diberikan
breathing) dilakukan bersama- sama untuk intervensi keperawatan berupa latihan otot-otot
efisiensi pernapasan yang lebih maksimal. Latihan pernafasan dan nafas dalam, dan dinilai beberapa
ini akan meningkatkan pernapasan dan ventilasi indicator ekspansi dada dan paru sebelum dan
paru. Pernapasan melalui penggunaan pergerakan sesudah intervensi dilakukan.
diafrahma lebih baik dari pada menggunakan Pada saat post operatif, pasien diingatkan