Application of Hand Held Fan Therapy and Orthopneic Position to Reduce  Dyspnea in Congestive Heart Failure (CHF) Patients: Case Report

Sausan Zahrah Salwa Salsabilla; Hesti Platini; Eka Afrima Sari

doi:10.24198/jnc.v8i2.63827

Application of Hand Held Fan Therapy and Orthopneic Position to Reduce Dyspnea in Congestive Heart Failure (CHF) Patients: Case Report

Sausan Zahrah Salwa Salsabilla, Hesti Platini, Eka Afrima Sari

Abstract

Introduction: Congestive Heart Failure (CHF) is a condition in which the heart is unable to pump blood effectively to meet the body’s needs, resulting in decreased cardiac output. This leads to fluid accumulation in the lungs due to increased pulmonary venous pressure, which subsequently triggers pulmonary edema. Pulmonary edema causes impaired oxygen diffusion in the alveoli, resulting in dyspnea as the primary complaint in CHF patients. The main nursing problem that arises is impaired gas exchange, indicated by an increased respiratory rate, decreased oxygen saturation, and the use of accessory respiratory muscles. To help address impaired gas exchange in CHF patients, non-pharmacological therapies such as the use of a hand-held fan and the implementation of an upright sitting position (orthopnea position) can be utilized. Purpose: To evaluate the effectiveness of the hand-held fan and orthopneic position interventions in CHF patients experiencing shortness of breath. Methods: This study employed a case study approach based on observation, interviews, and medical record reviews. The interventions hand-held fan and orthopneic position were administered over three days, with each session lasting 5 minutes. Results: Following the interventions, respiratory rate decreased from 30 breaths per minute to 25 breaths per minute, and oxygen saturation increased from 95% to 98%. The patient reported feeling more relieved, comfortable during breathing, and able to sleep more easily, although occasional shortness of breath persisted. Discussion: The interventions are physiologically beneficial: the orthopneic position helps reduce venous return to the heart, thereby lowering pulmonary pressure, while hand-held fan therapy alleviates the perception of breathlessness through sensory stimulation of the face, which activates the V2 branch of the trigeminal nerve. Conclusion: The combination of hand-held fan therapy and the orthopneic position is effective in relieving dyspnea, reducing respiratory rate, and improving oxygen saturation in patients with congestive heart failure

Keywords

Congestive Heart Failure (CHF), Dyspnea, Hand Held Fan, Orthopneic Position

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References

Agussalim, A. (2014). The Effects of High Fowler and Orthopneic Position in Lung Ventilation: A Quantitative-Experimental Study. In Article in International Journal of Science and Research. www.ijsr.net

Aulia Anita, E., Sarwono, B., Ari Murti Widigdo, D., Keperawatan, J., & Kesehatan Kementerian Kesehatan Semarang, P. (2021). Studi Kasus: Asuhan Keperawatan pada Pasien dengan Gagal Jantung Kongestif. Jurnal Skala Husada: The Journal Of Health, 18(1), 5. https://ejournal.poltekkes-denpasar.ac.id/index.php/JSH

Budhwar, N., & Syed, Z. (2020). Chronic Dyspnea: Diagnosis and Evaluation. American Family Physician, 101(9), 751–764. https://doi.org/10.1007/978-3-030-66049-9_44

Guyton, A. C., & Hall, J. E. (2014). Guyton and Hall Textbook f Medical Physiology (12th ed.). Elsevier.

Indra, R. L. (2017). Penggunaan Kipas Angin Untuk Mengurangi Dispnea Pada Pasien Kanker. Jurnal Keperawatan Adurrab, 1(1), 10–17.

Khasanah, S., Yudono, D. T., & Surtiningsih. (2019). Perbedaan Saturasi Oksigen dan Respiratory Rate Pasien CHF pada Perubahan Posisi. Jurnal Ilmu Keperawatan Medikal Bedah, 2(1), 1–13.

Kocatepe, V., Can, G., & Oruç, Ö. (2021). Lung Cancer–Related Dyspnea The effects of a handheld fan on management of symptoms. Clinical Journal of Oncology Nursing, 25(6), 655–661. https://doi.org/10.1188/21.CJON.655-661

Kusuma, A. J., Dewi, N. R., Ayubbana, S., Dharma, A. K., & Metro, W. (2021). Pengaruh Penerapan Teknik Hand Fan Untuk Masalah Sesak Nafas Pada Pasien Congestife Heart Failure (Chf) Di Kota Metro The Effect Of Application Of Hand Fan Techniques For Breath Problems In Congestife Patients Heart Failure (Chf) In The City Metro. Jurnal Cendikia Muda, 1(3).

Mesquita Montes, A., Tam, C., Crasto, C., Argel de Melo, C., Carvalho, P., Santos, R., Vilarinho, R., & Vilas-Boas, J. P. (2018). Forward trunk lean with arm support affects the activity of accessory respiratory muscles and thoracoabdominal movement in healthy individuals. Human Movement Science, 61, 167–176. https://doi.org/10.1016/j.humov.2018.07.011

Milwati, S., Indarti, E., Putro, D., Leniwati, H., Subandiyo, Sianigan, Y., Widiyanti, J., Maula, D., Putri, N., & Susilawati. (2024). Buku Ajar Keperawatan Medikal Bedah. In Nuansa Fajar Cemerlang (p. 319). Nuansa Fajar Cemerlang. https://repository.nuansafajarcemerlang.com/publications/585463/buku-ajar-keperawatan-medikal-bedah

Morrow, B., Brink, J., Grace, S., Pritchard, L., & Lupton-Smith, A. (2016). The effect of positioning and diaphragmatic breathing exercises on respiratory muscle activity in people with chronic obstructive pulmonary disease. South African Journal of Physiotherapy, 72(1). https://doi.org/10.4102/sajp.v72i1.315

Niman, S., Ziliwu, Y. S., & Susilowati, Y. A. (2021). Pengaruh Dukungan Edukasi Perawat Terhadap Self Care Pasien Congestive Heart Failure : Studi Literatur. BIMIKI (Berkala Ilmiah Mahasiswa Ilmu Keperawatan Indonesia), 9(2), 64–73. https://doi.org/10.53345/bimiki.v9i2.192

PERKI. (2022). Panduan Prevensi Penyakit Kardiovaskular Arterosklerosis. In Perhimpunan Dokter Spesialis Kardiovaskular Indonesia 2022 (1st ed.).

Purba, L., Susyanti, D., & Pamungkas, P. (2016). Studi Kasus Pemenuhan Kebutuhan Oksigenasi Dengan Teknik Relaksasi Nafas Dalam Pada Pasien Congestive Heart Failure Di Rumah Sakit Tk Ii Putri Hijau Medan Tahun 2016. Jurnal Riset Hesti Medan Akper Kesdam I/BB Medan, 1(2), 118. https://doi.org/10.34008/jurhesti.v1i2.75

Puspawati, N. L., Sitorus, R., & Herawati, T. (2017). Hand-held fan airflow stimulation relieves dyspnea in lung cancer patients. Asia-Pacific Journal of Oncology Nursing, 4(2), 162–167. https://doi.org/10.4103/apjon.apjon_14_17

Ratna Sari, F., Inayati, A., Risa Dewi, N., & Keperawatan Dharma Wacana Metro, A. (2023). Implementation Of Hand-Held Fan On Dyspnea Patients Of Heart Failure In The Heart Room Of Rsud Jend.

Ahmad Yani Metro City. Jurnal Cendikia Muda, 3(3).

Riset Kesehatan Dasar (Riskesdas). (2018). Laporan Riskesdas 2018 Nasional. In Lembaga Penerbit Balitbangkes (p. hal 156). https://repository.badankebijakan.kemkes.go.id/id/eprint/3514/1/Laporan Riskesdas 2018 Nasional.pdf

Ritianingsih, N., Irawaty, D., & Handiyani, H. (2015). Peningkatan Fungsi Ventilasi Paru Pada Klien Penyakit Paru Obstruksi Kronis Dengan Posisi High Fowler Dan Orthopneic. Jurnal Keperawatan Indonesia.

Santoso, K. B., Andarmoyo, S., & Sari, R. M. (2020). Studi Literatur: Pemberian Posisi Semi Fowler Pada Pasien Tb Paru Dengan Masalah Keperawatan Ketidakefektifan Pola Nafas. Health Sciences Journal, 4(2), 38. https://doi.org/10.24269/hsj.v4i2.512

Sepdianto. (2020). Peningkatan Saturasi Oksigen Melalui Latihan Diapragmatic Breathing Pada Pasien Gagal Jantung. Malang : Poltekes Kemenkes. Jurnal Ilmu Keperawatan Dan Kebidanan, 5(1).

Siregar, M. A., Tarigan, A. P., & Ariani, Y. (2021). The Effects Of Combination Orthopneic Position And Pursed Lips Breathing On Respiratory Status Of Copd Patients. European Journal of Molecular & Clinical Medicine, 08(03), 4106–4111.

Swan, F., Newey, A., Bland, M., Allgar, V., Booth, S., Bausewein, C., Yorke, J., & Johnson, M. (2019). Airflow relieves chronic breathlessness in people with advanced disease: An exploratory systematic review and meta-analyses. In Palliative Medicine (Vol. 33, Issue 6, pp. 618–633). SAGE Publications Ltd. https://doi.org/10.1177/0269216319835393

Syapitri, H., Barus, D. J., Sijabat, F., Aramita4, N., Farmasi, F., & Keperawatan, I. (2023). Efektifitas Posisi Orthopnea Terhadap Penurunan Sesak Nafas Pada Pasien Tb Paru. Jurnal Keperawatan Priority, 6(1).

Yusrina Ammazida. (2023). Implementasi Teknik Hand Held Fan Terhadap Penurunan Sesak Nafas pada Pasien dengan Congestive Heart Failure. Informasi Dan Promosi Kesehatan, 2(1), 35–42. https://doi.org/10.58439/ipk.v2i1.92

DOI: https://doi.org/10.24198/jnc.v8i2.63827