PENERAPAN MOBILISASI PROGRESIF TERHADAP STATUS HEMODINAMIK PASIEN INTENSIVE CARE UNIT RSUD PANDAN ARANG BOYOLALI

Abstrak

Latar Belakang: Pasien kritis yang dirawat di ICU umumnya mengalami imobilisasi yang dapat menyebabkan ketidakstabilan hemodinamik dan meningkatkan risiko komplikasi. Mobilisasi progresif menjadi intervensi keperawatan yang dilakukan secara bertahap, sesuai toleransi pasien. Pendekatan ini terbukti mampu menstimulasi sistem kardiovaskular secara fisiologis, meningkatkan venous return, memperbaiki curah jantung, serta mengoptimalkan perfusi jaringan sehingga berimplikasi langsung terhadap stabilitas hemodinamik pasien ICU.  Tujuan: Mengetahui perbaikan status hemodinamik setelah dilakukan mobilisasi progresif terhadap pasien ICU. Metode: Penelitian ini menggunakan metode deskriptif dengan pendekatan studi kasus melalui proses asuhan keperawatan. Subjek penelitian 2 pasien ICU RSUD Pandan Arang Boyolali. Pengukuran dilakukan terhadap parameter hemodinamik meliputi TD, MAP, nadi, RR, dan SpO₂ sebelum dan sesudah penerapan mobilisasi progresif yang dilakukan 2x sehari 15 menit selama 3 hari. Hasil: Terdapat perbaikan status hemodinamik. Pada Ny. D TD menjadi 125/76 mmHg, MAP 92 mmHg, nadi 87 kali/menit, RR 22 kali/menit, dan SpO₂ 99%. Pada Tn. K TD menjadi 113/59 mmHg, MAP 77 mmHg, nadi 69 kali/menit, RR 22 kali/menit, dan SpO₂ 100%. Kesimpulan: Mobilisasi progresif menujukkan perbaikan terhadap status hemodinamik pasien ICU dapat dilihat dengan penurunan tekanan darah, penurunan nilai Mean Arterial Pressure (MAP), stabilisasi frekuensi nadi, serta peningkatan saturasi oksigen.

Background: Critically ill patients in the Intensive Care Unit (ICU) often experience immobilization, which may lead to hemodynamic instability and increased risk of complications. Progressive mobilization, performed in stages according to patient tolerance, can physiologically stimulate the cardiovascular system, enhance venous return, improve cardiac output, and optimize tissue perfusion, thereby supporting hemodynamic stability. Objective: To determine the effectiveness of progressive mobilization on the hemodynamic status of ICU patients. Methods: This study used a descriptive method with a case study approach through the nursing care process. The subjects were two ICU patients at RSUD Pandan Arang Boyolali. Hemodynamic parameters, including blood pressure (BP), Mean Arterial Pressure (MAP), heart rate (HR), respiratory rate (RR), and oxygen saturation (SpO₂), were measured before and after progressive mobilization, which was conducted twice daily for 15 minutes over three days. Results: Hemodynamic status improved in both patients. Mrs. D showed BP 125/76 mmHg, MAP 92 mmHg, HR 87 beats/minute, RR 22 breaths/minute, and SpO₂ 99%. Mr. K showed BP 113/59 mmHg, MAP 77 mmHg, HR 69 beats/minute, RR 22 breaths/minute, and SpO₂ 100%. Conclusion: Progressive mobilization improved hemodynamic status, indicated by reduced BP and MAP, stabilized HR, and increased oxygen saturation.