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"Applying mechanical ventilation principles to patient care, this title helps you provide safe, appropriate, and compassionate care for patients requiring ventilatory support. It features chapters on"

"ABSTRAKKesulitan berkomunikasi merupakan stressor yang paling berat bagi pasien yang menggunakan ventilasi mekanis. Ketidakmampuan berkomunikasi karena penggunaan alat bantu nafas dapat menyebabkan ansietas. Komunikasi efektif dapat membantu menurunkan ansietas dan kesulitan berkomunikasi. Tujuan penelitian ini untuk mengetahui perbandingan efektifitas writing board dan communication board dalam menurunkan ansietas dan kesulitan berkomunikasi pasien dengan ventilasi mekanis. Desain penelitian menggunakan quasi eksperimen dengan pre-post test without control grup pada 24 pasien yang menggunakan ventilasi mekanis di ruang rawat intensif. Hasil penelitian menunjukkan pengaruh yang signifikan pada penurunan ansietas dan kesulitan berkomunikasi sebelum dan sesudah intervensi baik pada kelompok writing board maupun communication board p value < 0,05 , namun tidak ada perbedaan penurunan ansietas dan kesulitan berkomunikasi antara kedua kelompok tersebut p value > 0,05 . Hasil penelitian ini menunjukkan bahwa writing board dan communication board dapat direkomendasikan menjadi alternatif metode komunikasi yang efektif digunakan pada pasien yang menggunakan ventilasi mekanis di ICU.

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ABSTRACTCommunication difficulties is the most severe stressor for patients receiving mechanical ventilation. Inability to communicate due to the use of ventilatory support can cause anxiety. Effective communication can help reduce anxiety and communication difficulties. This study aimed to compare the effectiveness of writing board and communication board in lowering anxiety and communication difficulties in patients receiving mechanical ventilation. A total of 24 intensive care patients receiving mechanical ventilation, were included in this quasi experimental study that involved pre and post test without control group. The results showed a significant effect on the reduction of anxiety and communication difficulties before and after intervention in both communication board and writing board group p value 0.05 . This study results showed that writing board and communication board could be recommended as an effective alternative method of communication used in intensive care patients receiving mechanical ventilation "

"ABSTRAKPasien yang terpasang ventilator mengalami kesulitan berbicara sehingga mengalami gangguan dalam berkomunikasi dan menggunakan suatu metode dalam berkomunikasi. Penelitian ini menggunakan desain crossectional dengan sampel 45 responden dan tekhnik pengumpulan data purposive sampling. Hasil penelitian menunjukkan metode komunikasi yang digunakan pasien yaitu menunjuk atau membuat isyarat dengan tangan yang digunakan 100% responden, menulis atau menggambar yang digunakan 40% responden, menggerakkan bibir atau mencoba untuk berbisik yang digunakan 91% responden, ekspresi wajah yang digunakan 84% responden, dan menggerakkan kepala, ya atau tidak yang digunakan 93% responden. Metode komunikasi lain yang digunakan adalah mengetuk tempat tidur. Perawat diharapkan mengetahui metode komunikasi yang digunakan pasien yang terpasang ventilator sehingga dapat memberikan penjelasan tentang pilihan metode komunikasi sesuai keadaan pasien serta menyediakan media sesuai metode komunikasi yang dipilih.

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ABSTRAKPatients who have difficulty speaking with mechanical ventilation so that impaired communication and uses a method of communicating. This study used crosssectional design with a sample of 45 respondents and data collection purposive sampling technique. The results showed that method of communication used by patients to refer or make a gesture with the hand were used 100% by the respondents, writing or drawing were used 40% by respondents, moving his lips or trying to whisper were used 91% by respondents, the facial expression were used 84% by respondents, and move his head, yes or not were used 93% by respondents. Another communication method which was used by the patient is knocking on the bed. Nurses are expected to know the method of communication used by patients with mechanical ventilation in order to provide an explanation of the preferred method of communication according to the situation of patients and provide appropriate media communication method selected."

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Acute Respiratory Distress Syndrome (ARDS) merupakan kondisi paru yang memicu respon inflamasi sistemik dengan etiologi yang berbeda yang memiliki ciri-ciri klinis patologis khas. Penelitian ini menganalisis tentang pemberian posisi prone dan reverse trendelenburg 30 derajat sebagai terapi suportif untuk meningkatkan status oksigenasi pada pasien ARDS serta bagaimana dampaknya terhadap komplikasi edema wajah dan Gastric Residual Volume (GRV). Tujuan penelitian untuk mengetahui pengaruh pemberian posisi prone dan reverse trendelenburg 30 derajat terhadap parameter oksigenasi, edema wajah dan GRV. Desain penelitian dengan menggunakan quasi experiment design melalui pendekatan crossover trial design dengan 11 responden. Analisis data menggunakan uji independent t-test pada data terdistribusi normal dan Mann Whitney pada data terdistribusi tidak normal dan jenis data kategorik. Tidak terdapat perbedaan rata-rata yang signifikan pada parameter oksigenasi; saturasi oksigen (p value 0,685), PaO2/FiO2 rasio (p value 0,358), SpO2/FiO2 rasio (p value 0,850), maupun EtCO2 (p value 0,409) dan edema wajah (p value 0,403) antar kelompok prone dengan kelompok prone dan reverse trendelenburg 30 derajat, namun terdapat perbedaan rata-rata yang signifikan pada variabel GRV antara kelompok prone dengan kelompok prone dan reverse trendelenburg 30 derajat (p value 0,035). Kesimpulan: baik posisi prone maupun posisi prone dengan reverse trendelenburg 30 derajat sama-sama memberikan dampak yang positif pada parameter oksigenasi. Namun kedua posisi ini juga memberikan dampak yang patut diwaspadai terkait kejadian edema wajah dan peningkatan GRV, dengan angka kejadian yang lebih rendah pada pemberian posisi prone dengan reverse trendelenburg 30 derajat.

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Acute Respiratory Distress Syndrome (ARDS) is a pulmonary condition that triggers a systemic inflammatory response with different etiologies that has typical pathological clinical characteristics. This study analyzes the provision of 30 degrees prone and reverse Trendelenburg positions as supportive therapy to improve oxygenation status in ARDS patients and its impact on complications of facial edema and Gastric Residual Volume Gastric Residual Volume (GRV). The aim of the research is to determine the effect of 30 degrees prone and reverse trendelenburg positions on oxygenation parameters, facial edema and GRV. The research design used a quasi experimental design using a crossover trial design approach with 11 respondents. Data analysis used the independent t test on normally distributed data and Mann Whitney on non-normally distributed data and categorical data types. There were no significant average differences in oxygenation parameters; oxygen saturation (p value 0.685), PaO2/FiO2 ratio (p value 0.358), SpO2/FiO2 ratio (p value 0.850), as well as EtCO2 (p value 0.409) and facial edema (p value 0.403) between the prone group and the prone group and reverse trendelenburg, there is a significant average difference in the GRV variable between the prone group and the prone and reverse trendelenburg 30 degrees groups (p value 0.035). Conclusion: the prone position and the prone position with reverse trendelenburg 30 degrees both have a positive impact on oxygenation parameters. However, these two positions also have an impact that is worth paying attention to regarding the incidence of facial edema and increased GRV, with a lower incidence rate in the prone position with reverse Trendelenburg 30 degrees.

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"This trusted guide is written from the perspective of authors who have more than seventy-five years' experience as clinicians, educators, researchers, and authors. Featuring chapters that are concise, focused, and practical, this book is unique. Unlike other references on the topic, this resource is about mechanical ventilation rather than mechanical ventilators. It is written to provide a solid understanding of the general principles and essential foundational knowledge of mechanical ventilation as required by respiratory therapists and critical care physicians. To make it clinically relevant, Essentials of Mechanical Ventilation includes disease-specific chapters related to mechanical ventilation in these conditions"--Publisher's description"

"Latar Belakang: Coronavirus Disease (COVID-19) adalah penyakit yang menjadi pandemi diseluruh dunia sejak awal tahun 2020 dengan memiliki angka kematian yang tinggi. Derajat klinis COVID-19 beragam dari mulai ringan hingga kritis. Pasien COVID-19 derajat kritis dengan kondisi sindrom gawat napas akut (ARDS) yang menggunakan ventilasi mekanis memiliki angka kematian yang tinggi. Penelitian yang berfokus kepada lama kesintasan pasien COVID-19 derajat kritis dengan ventilasi mekanis terutama di Indonesia masih belum banyak dilakukan.Metode Penelitian: Penelitian ini merupakan penelitian kohort retrospektif dengan analisis kesintasan pada pasien COVID-19 derajat kritis yang menggunakan ventilasi mekanis dalam rentang Maret 2020 sampai September 2020. Pengambilan sampel dilakukan secara consecutive sampling dan data subjek yang memenuhui kriteria inklusi diambil dari rekam medis. Hasil Penelitian: Terdapat 70 subjek, 51 subjek memiliki kelengkapan rekam medis dan sesuai dengan kriteria inklusi dan eksklusi. Mayoritas subjek merupakan laki-laki (58,8%), rerata usia subjek 55,98 tahun (+ 11,96) dengan median IMT 23,9 kg/m2(17-54). Median durasi penggunaan ventilasi mekanis 4 hari (1-20) dengan angka kesintasan 7,8% dan kematian 92,2%. Nilai median kadar PaO2/FiO2 72 mmHg (31-606) dengan mayoritas sindom gawat napas akut derajat berat (84,3%). Median kesintasan pasien COVID-19 derajat kritis dengan ventilasi mekanis adalah 4 hari (IK95% ; 3,139-4,861) dan rerata kesintasan 5,5 hari (IK95% ; 4,213-6,922). Median kesintasan subjek dengan sindrom gawat napas akut berat adalah 4 hari (IK95% ; 3,223-4,777). Median kesintasan subjek tanpa sindrom gawat napas akut berat adalah 6 hari (IK95% ; 2,799-9,201) HR 0,802 (IK95% ; 0,337-1,911) p = 0,619. Median kesintasan subjek dengan hiperkapnia adalah 2 hari (IK95% ; 0,00-4,006) HR 0,613 (IK95% ; 0,3030-1,242) dan p = 0,174. Median kesintasan subjek dengan hiponatremia adalah 3 hari (IK95% ; 2,157-3,843) HR 0,897 (IK95% ; 0,5-1,610) p = 0,716. Median kesintasan subjek dengan hiperkalemia adalah 2 hari (IK95% 2,0-2,0) HR 0,293 (IK95% ; 0,061-1,419) p = 0,127.Kesimpulan: Angka kesintasan pasien COVID-19 derajat kritis dengan ventilasi mekanis pada awal pandemi memiliki angka yang rendah dengan lama kesintasan selama 4 hari. Derajat sindrom gawat napas akut sebelum intubasi, hiperkapnia, hiperkalemia dan hiponatremia memengaruhi lama kesintasan.

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Background: The severity of Coronavirus Disease year 2019 (COVID-19) varies from mild to critical. Critically ill COVID-19 patients with acute respiratory distress syndrome (ARDS) receiving mechanical ventilation have a high mortality rate. Research that focuses on the survival time of critically ill COVID-19 patients receiving mechanical ventilationhas not been carried out especially in Indonesia.

Methods: This retrospective survival cohort analysis observed critically ill COVID-19 patients receiving mechanical ventilation treated at a national respiratory center in Jakarta, Indonesia, between March and September 2020. Sampling was carried out by consecutive sampling and data of subjects who met the study criteria were obtained from medical records.

Results: Among 70 subjects, 51 subjects had complete medical records and met the study criteria. Subjects were predominately male (58.8%), mean age 55.98+11.96 years and median BMI 23.9 (IQR17-54) kg/m2. The median duration of mechanical ventilation was 4 (IQR 1-20) days with a survival rate of 7.8%. The median PaO2/FiO2 ratio was 72 (IQR 31-606)as the most of the subjects suffered from severe ARDS (84.3%). The median survival of critically ill COVID-19 patients with mechanical ventilation was 4 days (95%CI;3.139-4.861) and the mean survival was 5.5 days (95%CI;4.213-6.922). The median survival of subjects with severe ARDS was 4 days (95% CI;3.223-4.777). Median survival of subjects without severe ARDS was 6 days (95%CI; 2.799-9.201) with HR=0.802 (95%CI;0.337-1.911, p=0.619). The median survival of subjects with hypercapnia was 2 days (95%CI;0.00-4.006) with HR=0.613 (95%CI;0.3030-1.242, p=0.174). Median survival of subjects with hyponatremia was 3 days (95%CI;2.157-3.843) with HR=0.897 (95%CI; 0.5-1.610, p=0.716). Median survival of subjects with hyperkalemia was 2 days (95%CI;2.0-2.0) with HR=0.293 (95% CI; 0.061-1.419, p=0.127).

Conclusion: The survival rate for critically ill COVID-19 patients with mechanical ventilation at the start of the pandemic was low with a survival period of 4 days. The severity of ARDS before intubation, hypercapnia, hyperkalemia and hyponatremia influence the survival rate."