Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 4 Issue 2.
August 2024, pp 248-256 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435 Effectiveness of Compression Therapy on Lower Extremity Oedema in Heart Failure Patients: A Case Study Irdina Batrisyia1 .
Jon Hafan Sutawardana2* .
Muhamad Zulfatul AAola2 .
Iwan Setiawan3 1 Faculty of Nursing.
Universitas Jember.
Indonesia 2 Department of Medical Surgical Nursing.
Faculty of Nursing.
Universitas Jember.
Indonesia 3 dr.
Soebandi Regional Hospital of Jember.
Indonesia Article History Submitted: 25-06-2024 Revised: 28-07-2024 Accepted: 10-08-2024 org/10.
58545/jkki.
Copyright .
2024 Authors This is an open-access article under the CC-BY-SA License.
Abstract Background: Heart Failure is a condition that the heart can not pump enough blood to meet the circulatory needs used in the body's metabolic Patients with heart failure disease may experience swelling .
in certain parts of the body, especially the lower extremities.
Oedema that is not treated will exacerbate damage to the circulatory One of the treatments for lower extremity oedema in heart failure patients can be done by giving compression therapy.
Purpose:
The purpose of this study is to determine the effectiveness of compression therapy on lower extremity oedema in heart failure Method: This research is a case study that managed one patient with heart failure disease who has lower extremity oedema.
Data collection was carried out by observation, interview and provision of interventions carried out for 4 days using moderate pressure .
-30 mmH.
This research use compression stocking for 18 hours within 24 Compression therapy is given once a day that the stocking is used 00 WIB and removed at 08.
00 WIB on the following day.
The instrument used in this study was the pitting oedema observation sheet.
Result: The results of this study were a decrease in the degree of pitting oedema in patients from a value of 3 with a depth of 5 mm in a return time of 65 seconds to a value of 1 with a depth of 1 mm in a return time of 2 seconds.
Conclusion: Compression therapy is effective in reducing the degree of pitting oedema in patients with heart failure.
Compression therapy has optimal effectiveness on the third day of intervention.
Therefore, this therapy is highly recommended to be applied in the inpatient room, especially in patients with heart failure who have oedema in lower extremity.
Keywords: Heart Failure.
Oedema.
Compression Therapy Correspondence Jon Hafan Sutawardana Faculty of Nursing.
Universitas Jember Jl.
Kalimantan No.
Sumbersari.
Kabupaten Jember.
East Java 68121 Indonesia Email: hafan@unej.
How to cite:
Batrisyia.
Sutawardana.
AAola.
& Setiawan.
Effectiveness of Compression Therapy on Lower Extremity Oedema in Heart Failure Patients: A Case Study.
Jurnal Kesehatan Komunitas Indonesia, 4.
, 248-256.
https://doi.
org/10.
58545/jkki.
BACKGROUND
cannot pump enough blood to meet the Heart Failure is a serious disease in needs of circulation used in the body's the world.
Heart failure is when the heart metabolic processes (Dewi et al.
, 2.
Effectiveness of Compression Therapy on Lower Extremity Oedema in Heart Failure Patients Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 4 Issue 2.
August 2024, pp 248-256 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435 The most common symptom in patients The fluid accumulation in the veins causes with heart failure is leg oedema, with the the fluid to escape from the veins into the percentage of incidence reaching 80% of interstitial space, causing oedema.
total HF patients.
In addition, other signs.
Management of leg oedema in such as orthopnea, have a percentage of patients with heart failure is essential.
71%, and dyspnea has a percentage of 52% Oedema that is not treated will exacerbate (Karson & Engkartini, 2.
Based on this damage to the circulatory system.
This is percentage, it can be seen that the most caused by the heart working very hard for a common symptom in patients with heart long time.
This circulation damage will also failure is leg oedema.
increase the work of other organs and cause The prevalence of heart failure several other symptoms, such as shortness of breath, chest pain, or even worsening of According to the World the patient's condition.
One of the Health Organization (WHO) shows that treatments for lower extremity oedema in the prevalence of heart failure in the United heart failure patients can be done with States reaches 550,000 cases/ year with a non-pharmacological therapy, namely by mortality rate of 375,000 people (Lumi et giving compression therapy.
, 2.
In Indonesia, according to The cases in this study were taken research by the Ministry of Health, there from patients diagnosed with heart failure.
was an increase in the prevalence of heart The patient also had a history of disease in 2018 (Utami & Pratiwi, 2.
hypertension and diabetes mellitus.
Of the According to Basic Health Research several typical signs of heart failure (Riskesda.
data in 2018, the prevalence of patients, one physical sign appears in this heart failure was 229,696 people or 0.
Namely, the patient has edema in the (Riskesdas, 2.
The Leg edema is an accumulation of fluid admitted on 16 June 2024 until 24 June in the feet and legs caused by interstitial The patient had lower extremity oedema with a value of 3 with a depth of 5 extracellular volume (Dewi et al.
, 2.
mm in a return time of 65 seconds.
The Patients with heart failure can experience patient received diuretic therapy on 22 swelling .
of the lower extremities June 2024, on the third day of intervention.
because the heart disturbs blood pumping.
Batrisyia .
Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 4 Issue 2.
August 2024, pp 248-256 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435 In addition, a fluid restriction program was also imposed on the patient.
Measurement patient's vital signs and measurement of the degree of pitting oedema before and METHODS The method used in this research is a case study on heart failure patients who after the intervention will be recorded on the observation sheet every day.
have lower extremity oedema in the Researchers also provide nursing Lavender room of dr.
Soebandi Hospital.
care to solve the patient's problems.
Some The sample used in this study was one nursing problems in patients are decreased patient, namely Mrs.
E, who had met the cardiac output, hypervolemia, activity research criteria, namely aged> 18 years, intolerance, instability of blood glucose class II-i heart failure patients, heart failure patients with stable conditions disturbed sleep patterns.
From the nursing .
lood pressure, pulse, oxygen saturation, problems that arise, researchers apply appropriate interventions to achieve the temperatur.
, patients who did not have desired nursing outcomes.
This case study leg wounds/infections and patients who is one part of the researcher's nursing care were not undergoing hemodialysis.
This study was conducted for four days, starting June 20-24, 2024.
The intervention used in this study was RESULTS One of the nursing problems is that the patient has a decrease in cardiac installation of compression stockings in output, so the patient is diagnosed with heart failure patients with leg oedema for heart failure.
In addition, the patient also 18 hours within 24 hours.
Compression has one of the significant symptoms and therapy is given once a day, and the signs in the diagnosis of decreased cardiac stocking is used at 14.
00 WIB and removed output, namely oedema.
The researcher 00 WIB on the following day.
The then conducted a cardiac care intervention, data used in this study were obtained from and one of the therapeutic actions of the interviews and direct measurements of intervention was to compress the patient's patients' condition and degree of pitting oedema using an elastic stocking.
The The instruments used in this study Effectiveness of Compression Therapy on Lower Extremity Oedema in Heart Failure Patients Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 4 Issue 2.
August 2024, pp 248-256 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435 intervention for four consecutive days.
This allowed us to note a decrease in the degree After providing compression therapy for 4 days, meticulous observation of the effectiveness of the intervention.
degree of pitting oedema in the patient was Table 1.
Result of Pitting Oedema Date/Time of Use Stocking 20 June 2024 / 00 pm 21 June 2024/ 00 pm 22 June 2024/ 00 pm 23 June 2024/ 00 pm Day Pitting Oedema Pre 3 .
mm depth in 65 seconds return tim.
mm depth in 60 seconds return tim.
mm depth in 15 seconds return tim.
mm depth in 3 seconds return tim.
Date/Time of Remove Stocking 21 June 2024/ 08.
00 am 22 June 2024/ 08.
00 am 23 June 2024/ 08.
00 am 24 June 2024/ 08.
00 am Pitting Oedema Post 3 .
mm depth in 60 seconds return tim.
mm depth in 15 seconds return tim.
mm depth in 3 seconds return tim.
mm depth in 2 seconds return tim.
Table 1 shows that compression installation was delivered to the patient therapy was implemented for the Patient and family.
This ensures that patients or for four days with a frequency of 1 time a day with a pressure of 20-30 mmHg stockings within the specified hours.
oderate Compression addition, pitting oedema measurement was stockings are installed for 18 hours and 6 also carried out on the Patient's vital signs, hours of relaxation within 24 hours.
including blood pressure, heart rate.
SpO2.
Compression stockings are installed every respiration rate, and temperature.
The 00 WIB, and removal is done at 08.
following were the results of monitoring WIB the patient's vital signs (TTV) for four days Before implementation, the procedure for the before implementation.
Table 2.
Observation of Vital Signs (Pre-Interventio.
Date
20/06/24
21/06/24
22/06/24
23/06/24
130/80 120/70 130/80 110/80 MAP .
Vital Signs SpO2 (Per minute.
(Per minute.
Temperature Batrisyia .
Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 4 Issue 2.
August 2024, pp 248-256 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435 Based on Table 2, the vital signs can be pulse 83 times/min.
SpO2 97%.
RR 22 seen before compression therapy during times/min and temperature 36.
8o C.
Before the four days.
The patient's condition was giving compression therapy on the third On the first day before compression day, vital signs were measured on PatientAos therapy, the Patient's blood pressure and the results were obtained blood results were 130/80 mmHg.
MAP: 96.
pressure 130/80 mmHg.
MAP: 96.
6 mmHg, mmHg, pulse 90 times/min.
SpO2 98%.
RR pulse 103 x/min.
SpO2 98%.
RR 21 20 times/min, and temperature 36.
5o C.
times/min and temperature 36.
5o C.
On the the second day before the intervention, last day of the intervention, the Patient's vital signs were measured.
The results blood pressure was 110/80 mmHg.
MAP: 90 showed that the Patient's blood pressure mmHg, pulse 87 x/min.
SpO2 99%.
RR 20 was 120/70 mmHg.
MAP: 86.
6 mmHg, times/min, and temperature 36.
7o C.
Table 3.
Observation of Vital Signs (Pre-Interventio.
Vital Signs Date
20/06/24
21/06/24
22/06/24
23/06/24
120/80 110/70 130/70 120/70 MAP .
(Per minute.
SpO2 (Per minute.
Temperature Based on Table 3, it can be seen the On the third day after giving compression vital signs after compression therapy therapy, the vital signs were measured during the four days.
On the first day, vital again and the results obtained were blood signs were checked again and the results pressure 130/70 mmHg.
MAP: 90 mmHg, showed that Patient's blood pressure was pulse 96 times/min.
SpO2 98%.
RR 21 120/80 mmHg.
MAP: 93.
3 mmHg, pulse 85 times/min and temperature 36.
7o C.
On the times/min.
SpO2 98%.
RR 22 times/min last day after the therapy was given, vital and temperature 36.
6o C.
After the second signs were measured again and the results day of intervention, vital signs were measured again and the results obtained pressure was 120/70 mmHg.
MAP: 86.
were blood pressure 110/70 mmHg.
MAP:
mmHg, pulse 84 times/min.
SpO2 99%.
RR 3 mmHg, pulse 97 times/min.
SpO2 99%, 20 times/min and temperature 36.
6o C.
Patient's RR 21 times/min and temperature 36.
5o C.
Effectiveness of Compression Therapy on Lower Extremity Oedema in Heart Failure Patients Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 4 Issue 2.
August 2024, pp 248-256 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435 Figure 1.
Pitting Oedema Changes In the pre-test on the first day on June of 3 seconds.
During the fourth day of 20, 2024 at 14.
00 WIB, the degree of pitting installation on June 23, 2024 at 2:00 pm oedema 3 with a depth of 5 mm in a return WIB, it was found that the degree of pitting time of 65 seconds.
On the first day post- oedema was 1 with a depth of 1 mm in a test on June 21, 2024 at 08.
00 WIB, pitting return time of 3 seconds.
At the final oedema 3 with a depth of 4 mm in a return evaluation on June 24, 2024 at 08.
00 am, it time of 60 seconds.
On the second day pre- was found that the degree of pitting test on June 21, 2024 at 2.
00 pm pitting oedema was 1 with a depth of 1 mm in a oedema 3 with a depth of 4 mm in a return return time of 2 seconds.
time of 60 seconds.
While on the secondday post-test on June 22, 2024 at 08.
DISCUSSION
WIB, the degree of pitting oedema 2 with Based a depth of 3 mm was obtained in a return implementation of compression therapy time of 15 seconds.
On the third day pre- given to the Patient for four days show a test on June 22, 2023 at 14.
00 WIB, the decrease in lower limb oedema.
The results results showed that the degree of pitting of this study are also supported by other oedema was 2 with a depth of 3 mm in a research conducted by (Fadel et al.
, 2.
return time of 15 seconds.
After 18 hours of conducted on 29 patients with class II and installation, an evaluation was conducted i heart failure who have lower extremity in the third post-test on June 23, 2024 at The results in this study explain 00 WIB.
The implementation results that the provision of compression therapy showed that the degree of pitting oedema can reduce the degree of pitting oedema was 1 with a depth of 1 mm in a return time and shorten the use of diuresis therapy in Batrisyia .
Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 4 Issue 2.
August 2024, pp 248-256 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435 These results also follow the case therapy uses compression stockings placed study conducted by (Silalahi, 2.
, who on the feet for 18 hours/day within four conducted nursing care for patients at H.
Compression stockings will produce Hanafie Muara Bungo Hospital with the varying pressure on the foot.
the highest pressure is on the lower leg and ankle, and the higher the pressure, the looser.
Using The patient has edema of the the appropriate pressure will help blood in extremities on both legs, and fluid the veins return to the heart optimally so monitoring interventions and cardiac care that swelling .
does not occur are carried out, including intermittent (Urbanek et al.
, 2.
elastic or pneumatic stockings, according The compression therapy intervention After in this study was given to class II heart intervening for three days, the patient's failure patients who had a stable condition.
oedema decreased from a score of 3 If there is a decrease in the patient's .
to 5 .
condition, the provision of compression Oedema in heart failure patients can be non-pharmacological therapy will be stopped.
This is by the (SOP) Based measurement of vital signs before and after (Chloranyta et al.
, 2.
This compression the intervention, it was found that there therapy is carried out to press the area was no worsening of the patient's where buildup occurs to improve the These results also prove that body's circulation (Atkin & Byrom, 2.
compression therapy does not interfere The with other medical treatments or therapies compression therapy are applying constant given to patients.
Compression therapy can pressure to the tissue and providing also be used as a supporting therapy for the resistance to the calf muscles during use of diuretic drugs to accelerate the The constant pressure will process of reducing oedema in patients cause an increase in interstitial tissue because this therapy does not inhibit the pressure, which fights fluid leakage out of workings of diuresis drugs given to the capillary system.
The fluid that comes out will be reabsorbed or reabsorbed into Compression therapy has been widely the bloodstream (Webb et al.
, 2.
This used in Indonesia as one of the therapeutic Effectiveness of Compression Therapy on Lower Extremity Oedema in Heart Failure Patients Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 4 Issue 2.
August 2024, pp 248-256 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435
options to reduce oedema of the lower
CONFLICT OF INTEREST
Based on the compression therapy intervention that has been given to The authors declare no conflict of interest for this publication.
patient with heart failure disease, there is a change in pitting oedema.
Before the DATA AVAILABILITY STATEMENT intervention, the degree of pitting oedema The data that support the findings of was at a value of 3 with a depth of 5 mm in a return time of 65 seconds.
Meanwhile, corresponding author upon reasonable after the intervention, the degree of pitting oedema is at a value of 1 with a depth of 1 mm in a return time of 2 seconds.
REFERENCES
Atkin.
and Byrom.
The links CONCLUSION Based application of compression therapy on compression therapy.
, pp.
22Ae Patient with a diagnosis of heart failure for https://wounds-uk.
com/journal- four days, it can be seen that there is a articles/links-between-heart-failure- decrease in the degree of pitting oedema in and-leg-oedema-importance- So, it can be concluded that the compression-therapy/ application of compression therapy is practical for reducing lower extremity Chloranyta.
Widyantari.
, &
Dayani.
Penerapan oedema in patients with heart failure.
Balutan Kompresi Pada Ulkus Kaki:
Literature Review.
In Malahayati AUTHOR CONTRIBUTIONS The author contribute all research Nursing Journal (Vol.
Issue 3, pp.
activity such as conceptualization, data 601Ae.
Universitas Malahayati curation, analysis, writing & editing.
Bandar manuscript revisions.
https://doi.
org/10.
33024/mnj.
Lampung.
ACKNOWLEDGMENT