Analisis Asuhan Keperawatan Pada Pasien Dengan Gangguan Sistem Endokrin Akibat Dyspnea E.C Kad Dengan Penerapan Intervensi Closed Suction Ett Terhadap Tingkat Saturasi Oksigen Di Ruang Icu Rsud Cibabat Tahun 2025

Authors

  • Yunika Salwa Ramdhani Institus Kesehatan Rajawali

DOI:

https://doi.org/10.31004/joecy.v6i1.8777

Keywords:

Ketoasidosis Diabetik, Closed Suction, Saturasi Oksigen, ICU, Ventilator.

Abstract

Ketoasidosis Diabetik (KAD) merupakan komplikasi akut diabetes melitus yang serius, sering kali membutuhkan perawatan intensif dan bantuan ventilator mekanik karena gagal napas atau dyspnea berat. Masalah utama pada pasien dengan ventilator adalah bersihan jalan napas tidak efektif akibat penumpukan sekret, yang memerlukan tindakan suction. Namun, prosedur suction berisiko menurunkan saturasi oksigen (SpO2). Studi kasus ini bertujuan menganalisis asuhan keperawatan pada Tn. A (18 tahun) dengan KAD melalui penerapan closed suction ETT untuk menjaga stabilitas SpO2. Metode yang digunakan adalah deskriptif analitik dengan pendekatan studi kasus di ICU RSUD Cibabat. Hasil menunjukkan bahwa tindakan closed suction yang didahului hiperoksigenasi 100% mampu meminimalkan penurunan saturasi oksigen secara signifikan dibandingkan teknik open suction. Evaluasi selama perawatan menunjukkan SpO2 pasien dapat dipertahankan pada rentang 92-94% setelah tindakan, meskipun kondisi metabolik pasien masih memerlukan pemantauan ketat.

References

Black, J. M., & Hawks, J. H. (2014). Keperawatan Medikal Bedah. Jakarta: Salemba Emban Patria

Corwin, E. J. (2009). Buku saku patofisiologi. EGC.

Haryono, R. & Maria, P. (2019). Keperawatan Medikal Bedah II. Yogyakarta: Pusatka Baru Press

Hudak & Gallo. (2010). Keperawatan kritis Pendekatan Holistik Volume 1. Jakarta: Penerbit Buku kedokteran EGC.

Mustafida, N. I., Kep, M., & Kep, S. (2025). Asuhan Keperawatan Pada

Pasien Gangguan Sistem Endokrin.

Rohmah, M., Septimar, Z. M., Nurbiantoro, D. A., Dewi, A. K., Setiawati, A.,

Dermawan, T., ... & Syarifudin, I. R. (2023). Asuhan Keperawatan Pada Pasien Diabetes Melitus Tipe Ii Dengan Pemberian Intervensi Manajemen Hipoglikemia Di Ruang Igd Rsud Kota Tangerang. Nusantara Hasana Journal, 3(3), 62-68.

Septiani, V. (2025). Asuhan Keperawatan Gangguan Pertukaran

Gas Berhubungan Dengan Oedema Pulmonal Pada Pasien Dm Tipe 2+ End Stage Renal Disease (Esrd) Di Ruang Intensive Care Unit Rumah Sakit Umum Daerah Cibabat (Doctoral dissertation, UniversitasAisyiyah Bandung).

Pravana, N. E., & Febriani, P. (2019). Analisis Praktek Klinis Keperawatan pada

Pasien Tn. N dengan Meningocephalitis dengan Intervensi Inovasi Tindakan Close Suction dan Hiperoksigenasi Terhadap Perubahan Saturasi Oksigen si Ruang ICU RSUD Abdul Wahab Sjahranie Samarinda Tahun 2019.

FEBRIANSYAH, W. I. (2022). Asuhan Keperawatan Pada Ny. S Dengan Diagnosa Medis Diabetes Mellitus Penyerta Penurunan Kesadaran Dengan Ventilator Di Ruang Icu Anastesi Rumkital Dr. Ramelan Surabaya (Doctoral Dissertation, Stikes Hang Tuah Surabaya).

Sitorus, D., & Firdaus, R. (2025). Asuhan Keperawatan Pada Pasien Diabetes Melitus Tipe II Dengan Masalah Keperawatan Ketidakstabilan Kadar Glukosa Darah Di Ruang Punai 3 Rsud Aji Muhammad Parikesit Tenggarong (Doctoral dissertation, Poltekkes Kemenkes Kaltim).

Talpur, A. S., Sridhar, K. K., Shabbir, K., Amba-Ambaiowei, E. E., Hasan, R. M.,

Douedari, Z., ... & Hafizyar, F. (2022). Restrictive pulmonary disease in diabetes mellitus type II patients. Cureus, 14(4).

Klein, O. L., Flores, F., Samee, M., Brenkley, J., & Tate, D. (2007). Dyspnea in

diabetics is due to restrictive lung pattern, rather than diastolic dysfunction. Chest, 132(4), 616A.

Wibawa, K., Kuhuwael, F. V., Putra, C. R. J., Widiastuti, S. U., & Suciadi, L. P.

(2021). Euglycemic diabetic ketoacidosis associated with empagliflozin in patients hospitalized with acute pulmonary embolism. Clinical Diabetology, 10(2), 204-208.

Restika, I., Sulfikar, A., Wijayaningsih, K. S., & Tawil, S. (2023). Long-Suffering

of Diabetes Mellitus and Hospital Readmission among Adult with Type 2 Diabetes Mellitus: A Multicenter Study. International Journal of Nursing and Health Services (IJNHS), 6(5), 316-322.

Satriawibawa, I. W. E., & Saraswati, M. R. (2012). Prevalensi komplikasi akut dan

kronis pasien diabetes melitus tipe 2 di poliklinik penyakit dalam rsup sanglah periode januari 2011-Mei 2012. HOSPITAL.

Yasa, K. D., Nilawati, G. A. P., Mahakrishna, B. N., & Setiyawan, I. M. K. (2024).

Hemodialisis pada ketoasidosis diabetik dengan Acute Kidney Injury Stage Failure: Case Series dari Bali, Indonesia. Medicina, 55(1), 5-10.

Huang, I. Case Report Patofisiologi dan Diagnosis Penurunan Kesadaran pada

Penderita Diabetes Mellitus.

Kusuma, G. A., Nurdin, H., Salam, S. H., & Palinrungi, A. S. (2023). Renal

Replacement Therapy sebagai Intervensi Dini pada Tatalaksana Ketoasidosis Diabetik. UMI Medical Journal, 8(1), 14-25.

TRIYANI, T., Yuliano, N. A., MM, N. A. Y., & Fitari, N. A. (2019). Penerapan

perawatan ett pada ny. p dengan penurunan kesadaran pada kad diruang icu rsud h. hanafie tahun 2019 (Doctoral dissertation, STIKes PERINTIS PADANG).

Faisal, F., Adelaine, A. T., & Nurhayati, T. (2020). Hubungan Derajat Ketoasidosis

Diabetik dengan Kadar Kalium pada Pasien Anak di Rumah Sakit Dr. Hasan Sadikin Periode Tahun 2014-2019. Sari Pediatri, 22(2), 71-5.

Fardanesh, A., Stavropoulou-Tatla, S., Grassby, O., & Elliott, S. (2021). Improving

rehabilitation information-giving to intensive care unit survivors to aid in physical and psychological recovery. Cureus.

Iida, Y., Watanabe, S., Yanagita, Y., Shinohara, A., Morisawa, T., Obata, K., Kozu,

R., Inoue, S., Nishida, O., & Network, F. T. R. (2025). Hospital-acquired disability as a predictor of functional decline in ICU survivors: A multicenter prospective cohort study in japan. Journal of Clinical Medicine.

Khaliq, H., Minhas, M., & Ahmed, M. A. A. (2025). Post-intensive care syndrome

(PICS): A call for continuity beyond discharge. Anaesthesia, Pain &Amp; Intensive Care.

Lee, H., Lee, B., Youn, H. J., Cho, C. H., Lee, J. H., & Kim, S. W. (2025). Clinical

frailty scale at ICU discharge predicts ICU readmission and post-ICU mortality: A retrospective single-center study. Medicine.

Liebzeit, D., Kumar, A., Hein, M., Perkhounkova, Y., & Krupp, A. (2025). Sepsis

survivors” functional recovery and symptom experience following intensive care unit hospitalization. Professional Case Management.

O”Neill, B., Mcauley, D., Clarke, R., Duncan, S., Firshman, P., Terblanche, E.,

Bruce, J., Costley, J., Connolly, B. A., & Bradley, J. M. (2025). Development of a patient centred, structured, individually tailored, multi-component intervention to promote rehabilitation and recovery after critical illness: Content, theory, and construction. NIHR Open Research.

Perfetti, A. R., Jacoby, S. F., Buddai, S., Kaplan, L., & Lane-Fall, M. B. (2022).

Improving post-injury care: Key family caregiver perspectives of critical illness after injury. Critical Care Explorations.

Sevin, C., & Jackson, J. (2019). Post-ICU clinics should be staffed by ICU clinicians. Critical Care Medicine.

Tanna, K., Vala, G., & Khatri, S. (2024). A road map to recovery of a hypertensive

covid-19 positive patient with tailor made physiotherapy intervention and yoga nidra: A case study. International Journal of Recent Innovations in Medicine and Clinical Research.

You, H., Docherty, S. L., Ashana, D., Pan, W., Cox, C. E., & Oyesanya, T. (2025).

Nurses” role in transitional care during intensive care unit family meetings for patients with prolonged mechanical ventilation. Journal of Advanced Nursing.

Abdolalipur, M., Janani, R., Mahalleii, M., Hoseini, M. B., & Mohammadzadeh,

M. (2017). 32: CLINICAL GUIDELINE OF NURSING CARE FOR NEONATAL AIRWAYS. BMJ Open.

Dexter, A., & Scott, J. B. (2019). Airway management and ventilator-associated

events. American Association for Respiratory Care.

Dunger, D. B., Sperling, M. A., Acerini, C. L., Bohn, D., Daneman, D., Danne, T.,

Glaser, N., Hans, R., Hintz, R. L., Levitsky, L. L., Savage, M. O., Tasker, R. C., & Wolfsdorf, J. I. (2004). European society for paediatric endocrinology/lawson wilkins pediatric endocrine society consensus statement on diabetic ketoacidosis in children and adolescents. American Academy of Pediatrics.

Jaleel, I. H., & Dawood, H. (2025). Effect of open and closed endotracheal suction

systems on cardiopulmonary parameters among mechanically ventilated patients: A comparative study. Anaesthesia, Pain &Amp; Intensive Care.

Kartikasari, D., & Mas”ut, I. (2024). Penerapan suctioning terhadap perubahan

saturasi oksigen pasien gagal nafas yang terpasang ventilator di ICU RSI PKU muhammadiyah pekajangan. MAHESA Malahayati Health Student Journal.

Mwakanyanga, E. T., Masika, G. M., & Tarimo, E. (2018). Intensive care nurses

knowledge and practice on endotracheal suctioning of the intubated patient: A quantitative cross-sectional observational study. Public Library of Science.

Overend, T. J., Anderson, C. M., Brooks, D., Cicutto, L., Keim, M. A., McAuslan,

D., & Nonoyama, M. (2009). Updating the evidence base for suctioning adult patients: A systematic review. Pulsus Group.

RamrezTorres, C. A., Rivera-Sanz, F., SufrateSorzano, T., Marcos, A. P., &

SantolallaArnedo, I. (2022). Closed endotracheal suction systems for COVID-19: Rapid review. JMIR Publications.

Rocha, G., Soares, P., Gonalves, A., Silva, A. I., Almeida, D., Figueiredo, S.,

Pissarra, S., Costa, S., Soares, H., Flr-de-Lima, F., & Guimares, H. (2018). Respiratory care for the ventilated neonate. Pulsus Group.

Fardanesh, A., Stavropoulou-Tatla, S., Grassby, O., & Elliott, S. (2021). Improving

rehabilitation information-giving to intensive care unit survivors to aid in physical and psychological recovery. Cureus.

Fazial, N. S. B. M., Shudim, S. S., & Keong, S. C. (2025). DIABETIC

KETOACIDOSIS MANAGEMENT IN HOSPITAL SULTAN HAJI AHMAD SHAH (HOSHAS). Journal of the ASEAN Federation of Endocrine Societies.

Iida, Y., Watanabe, S., Yanagita, Y., Shinohara, A., Morisawa, T., Obata, K., Kozu,

R., Inoue, S., Nishida, O., & Network, F. T. R. (2025). Hospital-acquired disability as a predictor of functional decline in ICU survivors: A multicenter prospective cohort study in japan. Journal of Clinical Medicine.

Ji, H., & Hwang, S.-K. (2025). Risk factors for the readmission of patients with

diabetic ketoacidosis: A systematic review and meta-analysis. Journal of Korean Academy of Nursing.

Karajgikar, N., Manroa, P., Acharya, R., Codario, R., Reider, J. A., Donihi, A.,

Salata, R., & Korytkowski, M. (2019). ADDRESSING PITFALLS IN MANAGEMENT OF DIABETIC KETOACIDOSIS WITH a STANDARDIZED PROTOCOL. Endocrine Practice.

Khaliq, H., Minhas, M., & Ahmed, M. A. A. (2025). Post-intensive care syndrome

(PICS): A call for continuity beyond discharge. Anaesthesia, Pain &Amp; Intensive Care.

Kinoshita, I., Higashino, M., Taniuchi, M., Terada, T., Tochizawa, T., Kawata, R.,

& Haginomori, S. (2025). Factors and outcomes attributable to weaning and decannulation from ventilation after tracheostomy. JMA Journal.

Lee, H., Lee, B., Youn, H. J., Cho, C. H., Lee, J. H., & Kim, S. W. (2025). Clinical

frailty scale at ICU discharge predicts ICU readmission and post-ICU mortality: A retrospective single-center study. Medicine.

Liu, A., Carmichael, K., Schallom, M., & Arroyo, C. (2020). 1229-p: Clinical

characteristics and hospital care among patients with diabetic ketoacidosis. Diabetes.

Muhammad, Rahmawan, I., Rahmawan, M. I., al-afik, Rubidiyani, E., Klinik, P.,

Magelang, R. T., Brawijaya, Jl., Geblagan, Tamantirto, K., Kasihan, K., Bantul, Istimewa, D., Yogyakarta, Posisi, P., Untuk, S.-F., & Oksigen, M. S. (2024). Pemberian posisi semi-fowler untuk meningkatkan saturasi oksigen pasien congestive heart failure di ICU RSUD tidar magelang. Corona: Jurnal Ilmu Kesehatan Umum, Psikolog, Keperawatan Dan Kebidanan.

O”Neill, B., Mcauley, D., Clarke, R., Duncan, S., Firshman, P., Terblanche, E.,

Bruce, J., Costley, J., Connolly, B. A., & Bradley, J. M. (2025). Development of a patient centred, structured, individually tailored, multi-component intervention to promote rehabilitation and recovery after critical illness: Content, theory, and construction. NIHR Open Research

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Published

04-03-2026

How to Cite

Ramdhani, Y. S. . (2026). Analisis Asuhan Keperawatan Pada Pasien Dengan Gangguan Sistem Endokrin Akibat Dyspnea E.C Kad Dengan Penerapan Intervensi Closed Suction Ett Terhadap Tingkat Saturasi Oksigen Di Ruang Icu Rsud Cibabat Tahun 2025. Journal of Innovative and Creativity, 6(1), 15280–15291. https://doi.org/10.31004/joecy.v6i1.8777

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