Penatalaksanaan Fisioterapi Komprehensif Pada Kasus Pasca Coronary Artery By Pass Grafting Et Causa Coronary Artery Disease Involving 3 Vessels (CAD3VD): Case Report

Coronary heart disease is a malfunctioning of the heart caused by stenosis of the heart blood vessels which can affect one or more arteries. In these cases the patient had Triple Vessels Disease (3-VD), where there was ≥50-70% stenosis in most of the main branches of the heart blood vessels, then the patient underwent a revascularization operation Coronary Artery Bypass Grafting (CABG) with a postoperative condition, namely pain. in the sternum and lower right leg, accumulation of pulmonary sputum, decreased thoracic expansion, shortness of breath, decreased activity and functional ability. The management of physiotherapy that is given is chest physiotherapy and active and passive exercises in extremity. After 3 times of therapy, the results obtained from the degree of shortness of T0: 5 to T3: 3, the decrease in pain T0: 6 to T3: 3, then tenderness T0: 6 to T3: 3 and silent pain T0: 4 to T3: 3 increased the difference in thoracic expansion in the axilla T0: 1 cm becomes T3: 2 cm, at ICS T0: 1 cm changes to T3: 2 cm and there has been no increase in the xypoideus process, by 2 cm at T0 and T3. Activity and functional abilities were calculated using the Barthel index on T0 of the total dependency category, changing to T3: weight dependence. Chest physiotherapy and active-passive exercises in extremity can alleviate problems in post-CABG surgery.Keywords: Coronary Artery Bypass Grafting, Chest Physiotherapy, active and pasive exercise in extremity

Penerapan Fisioterapi Dada dan Batuk Efektif Terhadap Ketidakefektifan Bersihan Jalan Nafas Pada Pasien Tuberculosis Paru

Pulmonary tuberculosis is a chronic bacterial infection by the bacillus Myobacterium tuberculosis. This disease causes the patient to cough with phlegm or coghing up blood, shortness of breath, chest pain, night sweats and decreased appetite. The purpose of this scientific paper is ti describe nursing care for pulmonary tuberculosis patients with ineffective airway clearance problems. This research uses a descriptive case study method with the subject of two pulmonary tuberculosis patients who experience ineffective airway clearance problems in Pelutan Pemalang Village. The chest physiotherapy and effetive coughing actions were carried out for three days, twice a day, morning and evening. The results showed that the effective chest physiotherapy and coughing were able to overcome the ineffectiveness of airway clearance. Therefore, it can be concluded that the effective chest and cough physiotherapy is considered effective against ineffective airway clearance in pulmonary tuberculosis patients. For this reason, nurses are expected to be able to provide effective chest and cough physiotherapy therapy to help overcome the ineffectiveness of airway clearance in pulmonary tuberculosis patients.Keywords: Effective Cough and Chest Physiotherapy, Ineffective Airway Clearing AbstrakTuberculosis paru merupakan penyakit infeksi bakteri menahun yang disebabkan oleh basil myobacterium tuberculosis. Penyakit ini menyebabkan pasien batuk disertai dahak atau batuk berdarah, sesak nafas, nyeri pada daerah dada, keringat pada malam hari dan penurunan nafsu makan. Tujuan dari Karya Tulis Ilmiah ini untuk menggambarkan asuhan keperawatan pada pasien tuberculosis paru dengan masalah ketidakefektifan bersihan jalan nafas. Rancangan Karya Tulis Ilmiah ini menggunakan metode studi kasus deskriptif dengan subjek dua pasien tuberculosis paru yang mengalami masalah ketidakefektifan bersihan jalan nafas di Kelurahan Pelutan Pemalang, dilakukan tindakan fisioterapi dada dan batuk efektif dilakukan selama tiga hari dikerjakan dua kali sehari pagi dan sore. Hasil pemberian fisioterapi dada dan batuk efektif berhasil mampu mengatasi ketidakefektifan bersihan jalan nafas. Kesimpulan : fisioterapi dada dan batuk efektif dinilai efektif terhadap ketidakefektifan bersihan jalan nafas pada pasien tuberculosis paru. Untuk itu diharapkan perawat dapat memberikan terapi fisioterapi dada dan batuk efektif untuk membantu mengatasi ketidakefektifan bersihan jalan nafas pada pasien tuberculosis paru.Kata kunci: Fisioterapi Dada dan Batuk Efektif, Ketidakefektifan Bersihan Jalan Nafas

A study to assess the effectiveness of nebulization followed by chest physiotherapy among patients with respiratory problem, admitted in era hospital at Lucknow

Acute respiratory infections are a major cause of morbidity and mortality in young adults worldwide. T hey account for nearly 3.9 million deaths every year globally. Chest physiotherapy plays an import ant role by promoting drainage and ensuring normal lung expansion in parenchymal lung diseases and pleural diseases. Hence I was keen to evaluate the effectiveness of nebulisation with chest physiotherapy on respiratory status among adults patients with selected respiratory disorders like bronchitis, bronchiolitis, asthma, COPD and pneumonia. It was a quantit ative approach , Quasi experimental study design used (30) with respiratory disorders within the age group of 20-35 above years receiving nebulisation with chest physiotherapy using purposive sampling technique. Respiratory status assessment of clinical parameters (Rating Scale) and Bio physiological measurements(BPM) was done. For experimental group nebulisation with chest physiotherapy for 6 minutes in 10 positions. For control group nebulisation alone given both morning and evening for 2days. Mean, standard deviation, t -test , pearson chisquare test is used for statistical analysis. In experiment al group the respiratory disorder patients are reduced their clinical parameter distress score from 11.33 t o 4.17 . They are able to reduce 7.16 score from base line score. In control group 11.33 t o 7.90 t hey are able to reduce 3.27 score from base line score. Regarding bio physiological parameter, the reduction is statistically significant (P=0.001***) in both groups. Thus the author concludes that Improvement in respiratory status seen in children who receive nebulisation along with chest physiotherapy . Thus patients with respiratory diseases will benefit from the intervention in improving their respiratory status by clearing the secretions.

Chest Physiotherapy for Mechanically Ventilated Children: A Systematic Review

The aim of this study was to appraise and summarize the effects of chest physiotherapy in mechanically ventilated children. A systematic review was completed by searching Medline, Embase, Cinahl Plus, PEDro, and Web of Science from inception to February 9, 2021. Studies investigating chest physiotherapy for mechanically ventilated children (0–18 years), in a pediatric intensive care unit were included. Chest physiotherapy was defined as any intervention performed by a qualified physiotherapist. Measurements of effectiveness and safety were included. Exclusion criteria included preterm infants, children requiring noninvasive ventilation, and those in a nonacute setting. Thirteen studies met the inclusion criteria: two randomized controlled trials, three randomized crossover trials, and eight observational studies. The Cochrane risk of bias and the Critical Appraisal Skills Program tools were used for quality assessment. Oxygen saturations decreased after physiotherapy involving manual hyperinflations (MHI) and chest wall vibrations (CWV). Although statistically significant, these results were not of clinical importance. In contrast, oxygen saturations improved after the expiratory flow increase technique; however, this was not clinically significant. An increase in expiratory tidal volume was demonstrated 30 minutes after MHI and CWV. There was no sustained change in tidal volume following a physiotherapy-led recruitment maneuver. Respiratory compliance and dead-space increased immediately after MHI and CWV. Atelectasis scores improved following intrapulmonary percussive ventilation, and MHI and CWV. Evidence to support chest physiotherapy in ventilated children remains inconclusive. There are few high-quality studies, with heterogeneity in interventions and populations. Future studies are required to investigate multiple physiotherapy interventions and the impact on long-term outcomes.