Oxygenation and Semi-Fowler Position to Improve Breathing Patterns in Clients with Acute Decompensated Heart Failure (ADHF)
DOI:
https://doi.org/10.56127/jukeke.v5i1.2398Keywords:
ADHF, nasal cannula, oxygenation, ineffective breathing pattern, semi-fowler positionAbstract
Acute Decompensated Heart Failure (ADHF) is a cardiovascular emergency commonly characterized by dyspnea, orthopnea, use of accessory muscles, and reduced oxygen saturation. These manifestations arise from increased left ventricular pressure and pulmonary congestion, which lead to an ineffective breathing pattern. This study aimed to evaluate the effectiveness of combining oxygen therapy using a nasal cannula and the Semi-Fowler position in improving the breathing pattern of patients with ADHF. A case study design was applied to three patients admitted to the ICCU of Kanjuruhan Hospital, Malang. The intervention consisted of administering oxygen at 4 L/min via nasal cannula along with positioning patients in Semi-Fowler at 30–45°, delivered consistently over three days. Respiratory parameters observed included dyspnea, orthopnea, use of accessory muscles, respiratory rate, and oxygen saturation. The results demonstrated significant improvement beginning on the second day, marked by reduced dyspnea and orthopnea, absence of accessory muscle use, decreased respiratory rate toward the normal range, and increased oxygen saturation above 94%. On the third day, all patients achieved optimal improvement across all respiratory indicators. The combined intervention effectively reduced respiratory workload, enhanced lung expansion, and optimized ventilation–perfusion mechanisms. These findings indicate that simple and non-invasive measures, such as oxygen therapy and Semi-Fowler positioning, can serve as an effective standard nursing strategy for managing ineffective breathing patterns in ADHF patients in intensive care settings.
References
Ahmad Muzaki, C. P. (2022). Penerapan pemberian terapi oksigen dan posisi semi Fowler dalam mengatasi masalah pola napas tidak efektif di IGD. Nursing Science Journal (NSJ), 4(2), 223–229.
Annisha, A., Amir, H., Wahidah, N., & Karepesina, N. (2023). Application of oxygen therapy and deep diaphragmatic breathing to overcome shortness of breath with acute decompensated heart failure. An Idea Health Journal, 3(2), 61–64. https://doi.org/10.53690/ihj.v3i02.173
Antika, F. N., Hudiyawati, D., & Widiastuti, A. (2025). Asuhan keperawatan pada pasien acute decompensated heart failure (ADHF) dengan intervensi utama pemberian posisi semi Fowler (30°–45°): Studi kasus. Jurnal Ners, 2(7), 2828–2834. https://doi.org/10.55681/sentri.v2i7.1222
Ardiansyah, F., Nurachmah, E., Adam, M., Anjarwati, N., Hardika, R., & Baedlawi, A. (2022). Penerapan konservasi energi Myra Levine pada pasien acute decompensated heart failure (ADHF). Jurnal Kesehatan Mercusuar, 5(1), 42–55. https://doi.org/10.36984/jkm.v5i1.279
Ardiyanto, M. M. A. S., Zulfatul, A. M., Gunarto, S. T., & Zainur, A. (2024). Asuhan keperawatan pada penurunan curah jantung dengan intervensi posisi semi Fowler: Studi kasus pada pasien acute decompensated heart failure (ADHF) di ruang intensive cardiac care unit (ICCU). Jurnal Ilmiah Ners Indonesia, 1(1), 1–7.
Aulia, N., & Daryaman, U. (2023). Asuhan keperawatan pada Ny. Y dengan pemberian hand-held fan therapy dengan masalah keperawatan pola napas tidak efektif dan diagnosis medis acute decompensated heart failure (ADHF) di ruang HCCU Aglonema RSUP Dr. Hasan Sadikin Bandung.
Ayuningtyas, N., Martani, H. R., & Setyawan, S. (2023). Pengelolaan masalah pernapasan pada pasien dengan heart decompensation di IGD RSA Universitas Gadjah Mada: Case report. Clinical and Community Nursing Journal, 7(1), 50. https://doi.org/10.22146/jkkk.77411
Basrah, M. J., Majid, A., & Ningra, S. (2024). Pembatasan cairan dan pemberian diuretik untuk mengurangi edema pada pasien acute decompensated heart failure (ADHF) tipe wet and warm di pusat jantung terpadu. Politeknik Kesehatan Makassar, 15(1), 2087–2122.
Kusuma, H. M., & Kurniawan, S. T. (2020). Asuhan keperawatan pada pasien acute decompensated heart failure dalam pemenuhan kebutuhan istirahat tidur. Program Studi D3 Keperawatan Fakultas Ilmu Kesehatan Universitas Kusuma Husada Surakarta.
Laksono, S., Oktaverina, D., & Kusharsamita, H. (2023). Manajemen gagal jantung akut di instalasi gawat darurat: Sebuah tinjauan pustaka. Jurnal Kedokteran Unram, 12(2), 195–209.
Miranda, F., Halimuddin, & Aklima. (2022). Perawatan pasien acute decompensated heart failure di ICCU: Suatu studi kasus. JIM FKep, 1, 116–120.
Nisa Nirmala, & Nurhakim, F. (2023). Asuhan keperawatan pada pasien acute decompensated heart failure dengan intervensi utama pemberian oksigenasi: Studi kasus. Sentri: Jurnal Riset Ilmiah, 2(7), 2828–2834.
Pangukir Rahayu, L. (2020). Manajemen pengoptimalan kebutuhan oksigen pada pasien gagal jantung di unit perawatan intensif: A literature review. Jurnal Berita Ilmu Keperawatan, 13(2), 84–92.
Putra, I. G. A. G. W., Yundari, A. I. D. H., & Saraswati, N. L. G. I. (2025). Pengaruh latihan deep diaphragm breathing terhadap saturasi oksigen pasien acute decompensated heart failure (ADHF). Jurnal Insan Cendekia, 12(2), 119–134.
Riska, E. E., Amni, R., & Syarif, H. (2025). Karakteristik pasien acute decompensated heart failure (ADHF) di RSUD dr. Zainoel Abidin Banda Aceh. Jurnal Assyifa’ Ilmu Kesehatan, 10(1), 69–78.
Supardi, Widiyanto, A., Sawitri, E., Mawardi, Elsera, Chori, Zukhri, & Saifudin. (2021). Pasien acute decompensated heart failure di unit gawat darurat RSUP Dr. Soeradji Tirtonegoro Klaten. The 2nd Conference of Health and Social Humaniora, 162–172.
Tarfi Budiadari, Y., Darliana, D., & Tim. (2024). Asuhan keperawatan pada pasien dengan acute decompensated heart failure (ADHF) di Ruang Raudhah 1 RSUD dr. Zainoel Abidin Banda Aceh. Journal of Healthcare Technology and Medicine, 10(2), 2615–2619.
Tazkirah, R., Kamal, A., & Safuni, N. (2023). Asuhan keperawatan pada pasien acute decompensated heart failure (ADHF): Suatu studi kasus. JIM FKep, 7, 26–32. https://jim.usk.ac.id/FKep/article/viewFile/23553/11431
Utami, M., & Afni, A. C. N. (2023). Penerapan pemberian terapi oksigen dan posisi semi Fowler dalam mengatasi masalah pola napas tidak efektif pada pasien congestive heart failure (CHF). Universitas Sukuma Husada Sukarta.
Zikrina, Nurhidayah, I., & Amni, R. (2022). Asuhan keperawatan acute decompensated heart failure (ADHF) di intensive cardiac care unit: Studi kasus. JIM FKep, 1, 1–7.
