Level I Progressive Mobilization effected on Improvement Pulmonary Oxygenation Ventilation Function in Non Hemorrhagic Stroke Patients

Niken Setyaningrum, Mardiyono Mardiyono, Untung Sujianto


Immobilization in non-hemorrhagic stroke patients can lower lung expansion due to an accumulation of secretions resulting in impaired oxygenation ventilation function of the lungs, thus facilitating the growth of bacteria that cause pneumonia. Switching the patient's position every 2 hours allows the lung area to re-expand and to increase the transport of oxygen which will improve oxygenation ventilation function of the lungs. Various research results concluded that a measure to prevent changes in the oxygenation ventilation function of the lungs is to maintain the airway effective. This can be done by putting the patient in a sloping or semi-prone position, heightening the head of the bed to a 30- degree angle. Level I progressive mobilization is a preferred intervention that is safe to do to maintain the lung's oxygenation ventilation function. Objective: To evaluate the effect of progressive mobilization of level I on the pulmonary oxygenation ventilation function in non-hemorrhagic stroke patients. Methods: Design of experimental research. Sampling was done using random allocation with the number of samples that were 52 people, using the Wilcoxon and Man Whitney test analysis. The results showed that the measurement of the pulmonary oxygenation ventilation function using the peak flow meter seen in the intervention group had a significant increase in air volume, from before the intervention of 220 ± 78,9 to 263,65 ± 61.6 after 5 days of intervention, with p-value <0.001. While in the control group there was a significant decrease of air volume from 255 ± 58,94 to 225 ± 53,16 with p-value <0.001. The oxygenation ventilation function average increase in the intervention group was 43.65, higher than the increase in the control group, which decreased by -30. The Mann Whitney test result obtained p-value <0.001. In conclusion. there was a significant difference in the pulmonary oxygenation ventilation functions in the intervention and control groups after the level I progressive mobilization in non- hemorrhagic stroke patients at Dr.Adhyatma Semarang Hospital, which means that there was an impact of the level I mobilization on the lung oxygenation ventilation function on non-hemorrhagic stroke patients in Dr. Adhyatma Semarang Hospital. 



level I progressive mobilization; pulmonary oxygenation ventilation function; non hemorrhagic stroke

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Stephen J, Phee M, Ganong WF. Patofisiologi Penyakit: Pengantar Menuju Kedokteran Klinis. Jakarta: EGC; 2011.

Brunner & Suddarth’s. Medical-surgical Nursing, Volume 1. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2010. 1896 p.

Price S, Wilson L. Patofisiologi Konsep Klinis Proses-Proses Penyakit,. 6th ed. Jakarta: EGC; 2012.

Langhorne P, Stott DJ, Robertson L, Macdonald J, Jones L, Mcalpine C, et al. Medical Complications After Stroke. 2000.

Gallen OS, Nephrology B. 40 th Annual Meeting Swiss Society of Nephrology Société Suisse de Néphrologie Società Svizzera di Nefrologia. 2008.

Kozier B. Fundamental Of Nursing. Australia: Pearson Australia; 2010.

Jones FB. Perawatan Kritis seri panduan Klinis. Jakarta: Erlangga; 2009.

Guyton AC. Textbook of Medical Physiology. 11th ed. Philadelphia: USA: Elsevier Saunders; 2006.

Vollman KM. Introduction to Progressive Mobility. Crit Care Nurse [Internet]. 2010 Apr 1;30(2):S3–5. Available from: http://ccn.aacnjournals.org/cgi/doi/10.4037/ccn2010803

Berney S, Denehy L. The effect of physiotherapy treatment on oxygen consumption and haemodynamics in patients who are critically ill. Aust J Physiother [Internet]. 2003;49(2):99–105. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12775205

Genc A, Ozyurek S, Koca U, Gunerli A. Respiratory and hemodynamic responses to mobilization of critically ill obese patients. Cardiopulm Phys Ther J [Internet]. 2012 Mar;23(1):14–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22807650

Quanjer PH, Lebowitz MD, Gregg I, Miller MR, Pedersen OF. Peak expiratory flow: conclusions and recommendations of a Working Party of the European Respiratory Society. Eur Respir J Suppl [Internet]. 1997 Feb;24(March):2S–8S. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9098701

Pneumonia H. Guidelines for the Management of Adults with Hospital-acquired, Ventilator-associated, and Healthcare-associated Pneumonia. Am J Respir Crit Care Med [Internet]. 2005 Feb 15;171(4):388–416. Available from: http://www.atsjournals.org/doi/abs/10.1164/rccm.200405-644ST

Kementerian Kesehatan RI. Peningkatan kapasitas vital paru pada pasien ppok menggunakan metode pernapasan. Surakarta; 2011. 59-63 p.

Pedoto A. Lung Physiology and Obesity: Anesthetic Implications for Thoracic Procedures. Anesthesiol Res Pract [Internet]. 2012;2012:1–7. Available from: http://www.hindawi.com/journals/arp/2012/154208/

Putra DP, Rahmatullah P, Novitasari A. Hubungan Usia, Lama Kerja, dan Kebiasaan Merokok dengan Fungsi Paru pada Juru parker di Jalan Pandanaran Semarang. J Kedokt Muhammadiyah [Internet]. 2012;1(3):7–12. Available from: http://jurnal.unimus.ac.id/index.php/kedokteran/article/view/1340

Pujiastuti BE. Analisis faktor yang mempengaruhi kapasitas vital paru pada ibu hamil di RB Sri Lumintu jajar Laweyan surakarta. Universitas Muhammadiyah Surakarta; 2012.

Smeltzer, S. C. Bare, B. G. Hinkle, J. L & Cheever KH. Medical Surgical Nursing. 12th ed. Philadephia: Lippincott williams & Wilkins; 2010.

Muttaqin. Buku Ajar Asuhan Keperawatan Klien dengan Gangguan Sistem Pernapasan. Jakarta: Salemba medika; 2008.

Olviani Y. The Influence of First Level Progressive Mobilization Action to Non Invasive Hemodynamic Monitoring On Patient With Cerebral Injury At Intensive Care Unit Banjarmasin Ulin General Hospital Year 2015. Caring Vol 2 [Internet]. 2015;2(1):37–48. Available from: http://docplayer.info/30389545-Yurida- olviani-1- key-words- proggresive-mobilization- the-value- of-monitoring- hemodynamik-of- non-invative.html

Zakiyyah S. Pengaruh Mobilisasi Progresif Level I :Terhadap Risiko Dekubitus dan Perubahan saturasi oksigen pada pasien yang terpasang ventilator di Ruang ICU RSUD Dr. Moewardi Surakarta. Penelitian keperawatan. Universitas Diponegoro; 2014.

Titsworth WL, Hester J, Correia T, Reed R, Guin P, Archibald L, et al. The effect of increased mobility on morbidity in the neurointensive care unit. J Neurosurg [Internet]. 2012 Jun;116(6):1379–88. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22462507

Ainur. Pengaruh Mobilisasi Progresif Level I Pada Pasien KritisTerpasang Ventilator Terhadap Perubahan Hemodinamik Di Ruang GICCU RSHS. Universitas Padjadjaran; 2012.

Perme C, Chandrashekar R. Early Mobility and Walking Program for Patients in Intensive Care Units: Creating a Standard of Care. Am J Crit Care [Internet]. 2009 May 1;18(3):212–21. Available from: http://ajcc.aacnjournals.org/cgi/doi/10.4037/ajcc2009598

DOI: http://dx.doi.org/10.21927/jnki.2017.5(3).230-236


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