Effectiveness of Diaphragmatic Breathing Exercises in Enhancing Pulmonary Recovery and Expediting Water Seal Drainage (WSD) Removal in Pleural Effusion Patients at Persahabatan Hospital
DOI:
https://doi.org/10.33755/jkk.v11i1.798Keywords:
Diaphragmatic breathing exercises, pleural effusion, pulmonary recovery, respiratory rehabilitation,water seal drainageAbstract
Aims: Pleural effusion, characterized by the abnormal accumulation of pleural fluid, poses significant health risks and often necessitates interventions such as water seal drainage (WSD) placement. Diaphragmatic breathing exercises (DBE) are non-invasive techniques that may enhance pulmonary recovery and expedite WSD removal by optimizing respiratory mechanics. Despite the potential benefits, limited research has explored their effectiveness in patients with pleural effusion.
Objective: This study aimed to evaluate the effectiveness of diaphragmatic breathing exercises in enhancing pulmonary recovery and expediting WSD removal in pleural effusion patients at Persahabatan Hospital, Jakarta, Indonesia.
Methods: A quasi-experimental, single-group pretest-posttest design was employed. Seventeen adult patients diagnosed with pleural effusion undergoing WSD placement were recruited through purposive sampling. Participants performed DBE twice daily for 15 minutes over seven days. Pulmonary recovery and WSD outcomes were assessed using a validated Pulmonary Recovery Assessment Questionnaire. Data were analyzed using paired t-tests, with statistical significance set at p < 0.05.
Results: The mean age of participants was 51.71 years (±10.12), with 64.7% female. Peak current respiration significantly improved from 103.53 L/min (±36.22) pre-intervention to 165.52 L/min (±75.28) post-intervention (p = 0.000). DBE also reduced the duration of WSD placement, indicating enhanced pulmonary recovery. Participants reported high feasibility and acceptability of the intervention.
Conclusion: Diaphragmatic breathing exercises significantly improve pulmonary recovery and expedite WSD removal in pleural effusion patients. These findings highlight the potential of DBE as a cost-effective, non-invasive adjunct in respiratory rehabilitation. Further research with larger sample sizes and long-term follow-up is recommended to validate these results.
References
Krishna R, Antoine MH, Alahmadi MH, Rudrappa M. Pleural effusion. In: StatPearls [Internet]. StatPearls Publishing; 2024.
Rosalina R, Sukarno S, Yudanari YG. Perbedaan Kecepatan Pengembangan Paru Sebelum dan Sesudah Latihan Pernapasan Diafragma dalam Upaya Mempercepat Pelepasan Water Seal Drainage (WSD). Indonesian Journal of Nursing Research (IJNR). 2019;2(1).
Liam C, Lim K, Wong CM. Causes of pleural exudates in a region with a high incidence of tuberculosis. Respirology. 2000;5(1):33–8.
Valdes L, Alvarez D, Valle JM, Pose A, San José E. The etiology of pleural effusions in an area with high incidence of tuberculosis. Chest. 1996;109(1):158–62.
Muruganandan S, Azzopardi M, Thomas R, Fitzgerald DB, Kuok YJ, Cheah HM, et al. The Pleural Effusion And Symptom Evaluation (PLEASE) study of breathlessness in patients with a symptomatic pleural effusion. European Respiratory Journal. 2020;55(5).
Jany B, Welte T. Pleural effusion in adults—etiology, diagnosis, and treatment. Dtsch Arztebl Int. 2019;116(21):377.
McGrath EE, Anderson PB. Diagnosis of pleural effusion: a systematic approach. American Journal of Critical Care. 2011;20(2):119–28.
Thomas R, Jenkins S, Eastwood PR, Lee YCG, Singh B. Physiology of breathlessness associated with pleural effusions. Curr Opin Pulm Med. 2015;21(4):338–45.
Junaidin J, Sartika D, Hasliani H, Fitriani F, Ramli R, Nugrawati N, et al. Comparison of training pursed lip breathing and balloon blowing on the increasing of respiratory muscle strength, respiratory rate and the increasing of oxygen saturation in COPD at the Makassar community lung health center. Int J Health Sci (Qassim). 2019;(II):4134–47.
Bellemare F, Jeanneret A, Couture J. Sex differences in thoracic dimensions and configuration. Am J Respir Crit Care Med. 2003;168(3):305–12.
Loring SH, Mead J, Griscom NT. Dependence of diaphragmatic length on lung volume and thoracoabdominal configuration. J Appl Physiol. 1985;59(6):1961–70.
Douglas KE, Alasia DD. Evaluation of Peak Expiratory Flow rates (PEFR) of Workers in a Cerment Factory in Port Harcout South-South, Nigeria. The Nigerian Health Journal. 2012;12(4):97–101.
Kim HS, Cho SH. Correlation between lung function and functional movement in healthy adults. In: Healthcare. MDPI; 2020. p. 276.
de Souza Francisco D, Peruzzolo CC, Moecke DP, Yamaguti WP, Kunzler DH, Paulin E. Influence of mild pulmonary congestion on diaphragmatic mobility and activities of daily living in chronic kidney disease: An experimental and clinical study. nefrologia. 2023;43(1):81–90.
Ubolnuar N, Tantisuwat A, Thaveeratitham P, Lertmaharit S, Kruapanich C, Mathiyakom W. Effects of breathing exercises in patients with chronic obstructive pulmonary disease: systematic review and meta-analysis. Ann Rehabil Med. 2019;43(4):509–23.
Eltonsy AM, Amlani K, Schleicher M, McCurry KR, Mehta AC. Diaphragmatic palsy following lung transplantation. European Respiratory Review. 2024;33(173).
Cao Y, Li P, Wang Y, Liu X, Wu W. Diaphragm dysfunction and rehabilitation strategy in patients with chronic obstructive pulmonary disease. Front Physiol. 2022;13:872277.
Loring SH, Mead J, Griscom NT. Dependence of diaphragmatic length on lung volume and thoracoabdominal configuration. J Appl Physiol. 1985;59(6):1961–70.
Mao X, Hu F, Peng J, Zhao Y, Gu A, Fang W, et al. Expert consensus on multi-disciplinary treatment, whole-course pulmonary rehabilitation management in patients with lung cancer and chronic obstructive lung disease. Ann Palliat Med. 2022;11(5):1601623–5623.
Jany B, Welte T. Pleural effusion in adults—etiology, diagnosis, and treatment. Dtsch Arztebl Int. 2019;116(21):377.
Karkhanis VS, Joshi JM. Pleural effusion: diagnosis, treatment, and management. Open access emergency medicine. 2012;31–52.
