Chest Physiotherapy to Manage Respiratory Rate In Patients with Bronchopneumonia: A Literature Review

Purpose: Knowing the application of chest physiotherapy techniques can manage respiratory rates in children with bronchopneumonia. Methods: This review uses the literature review method. Searches were conducted in PubMed, Garuda


Introduction:
Bronchopneumonia is an infection that affects the airways into the lungs.Mainly caused by bacterial infections, it can also be caused by viral and fungal infections.It is life-threatening in children, older adults, and other chronic immune compromised patients.Bronchopneumonia is more common in infants and young children.This is because their immune response is still not well developed.The most common bacteria in infants and The coverage of pneumonia among children under five years old in Indonesia has fluctuated over the past 11 years.The highest was in 2016 at 65.3%.In 2015-2019, there was a change in the estimated number of cases from 10% to 3.55%, which led to high coverage in that year.In 2021, the national coverage of pneumonia in children under five was 31.4%, and the province has not yet reached the 65% discohidyavery target.The provinces with the highest under-five pneumonia coverage were East Java (50%), Banten (46.2%), and Lampung (40.6%) (Kemenkes RI, 2022).
The standard treatment that can be given to patients with pneumonia is chest physiotherapy.Chest physiotherapy can mobilize tracheobronchial secretions based on clinical parameters such as respiratory frequency and oxygen saturation (Oktaviani & Nugroho, 2022).Chest physiotherapy is divided into two, first by patting the chest wall or back with hands shaped like a bowl called percussion technique.
Second, with manual compression and vibration techniques on the chest wall during the exhalation phase of breathing called vibration techniques (Musniati & Badrin, 2020).

Material and Methods:
This research uses the method literature study or literature review.The type in this study uses quasi-experimental type research and case studies whose data sources in this study are secondary data.International & National books, articles, and journals in the form of printed and nonprinted data.
Literature search was conducted in 2018 -2023.Literature search in this literature review using three databases with search engines namely Google Scholar, PubMed, and Garuda.Research journals that are found in accordance with the next words screen the titles and abstracts of the articles that have been obtained.Then, read the full text of the article and observe the articles to meet the inclusion and exclusion criteria.The inclusion criteria for this review were quasi-experimental research design or case study, sample age of children.The exclusion criteria for this review are articles that cannot be accessed, not full text, and articles with a literature review design.
Then, researchers created a special folder in Mendeley to store the articles obtained.Researchers filtered duplicate articles obtained from three databases.After the duplicate articles were removed, reviewers took steps to select the articles.The article search uses keywords and boolean operators (AND, OR, NOT) which are used to expand or limit the search.The keywords in this literature review are adjusted to the Medical Subject Heading (MeSH) consisting of:

Findings/Result
Figure 3 describes the process of selecting articles according to the Preferred Reporting Systematic Reviews and Meta-analysis (PRISMA) guidelines (Page et al., 2021).The initial search obtained articles with a total of 573 articles.After checking and removing duplicate articles, a total of 2 articles were obtained.Then, 571 articles were filtered.Furthermore, 551 articles were excluded because they did not match the title and abstract.After that, matching the title and abstract obtained 16 articles.Then checking again there were 8 articles that were excluded because they did not match the inclusion criteria of the researchers.Selected 8 articles that are eligible for inclusion in the review.

Discussions
A review of 8 articles showed that the application of chest physiotherapy to children with pneumonia and bronchopneumonia with ineffective airway clearance was shown to reduce the incidence of coughing, relieve sputum discharge, make respiratory frequency, pulse frequency, and oxygen saturation increase within normal limits.
Chest physiotherapy is the action of postural drainage, percussion and vibration on the chest which is a way to enlarge client efforts and improve lung function (Astuti & Dewi, 2020).The purpose of this therapy is to clean the airway, mechanically release secretions attached to the bronchial wall and maintain the function of the respiratory muscles (Marini, 2020).Chest physiotherapy is very useful for children with lung disease both acute and chronic, very effective in removing secretions and improving ventilation in clients with impaired lung function (Nurhayati et al., 2022).
According to research Tehupeiory & Sitorus (2022) Chest physiotherapy was given to the three patients and given for 3 x 24 hours and each action was carried out for approximately 10 -15 minutes.Patients 1 and 3 experienced significant changes after being given chest physiotherapy, namely secretions easily came out so that there was no more sputum production and accumulation of secretions.In patient 2 there were no significant changes, because the intensity of chest physiotherapy was not continuous, and the patient was not cooperative.This is in line with research

Limitations and Future Research
In this review, there is no mention of effective chest physiotherapy and there is not much discussion on bronchopneumonia.In the future, it is hoped that future researchers can conduct research related to chest physiotherapy in bronchopneumonia cases and the amount of time needed to achieve effective chest physiotherapy so that airway clearance is resolved, and respiratory status improves.

Conclusion
Based on the review of several articles that have been reviewed, it can be concluded that the application of chest physiotherapy in children with bronchopneumonia or pneumonia is proven to stabilize hemodynamic status such as pulse frequency, respiratory rate frequency, oxygen saturation within normal limits, and can remove secretions, sputum, and reduce cough frequency.
children are Streptococcus Pneumoniae and Haemophilus Influenzae (Putri & Amalia, 2023).The prevalence of bronchopneumonia is estimated to be nearly one-fifth of child deaths worldwide, with approximately 2 million children under five dying each year from pneumonia, mostly in Africa and Southeast Asia.The incidence of pneumonia in developing countries is 30-45% per 1000 children under 5 years of age, 16-22% per Chest Physiotherapy to Manage Respiratory Rate In Patients with Bronchopneumonia: A Literature Review journal home page: https://goicare.web.id/index.php/JNJBriefly write the runnind head of your research.Yudha et al.Java Nursing Journal, Vol. 1, No. 1, 2023, ISSN: 2988-4152 30 1000 children aged 5-9 years, and 7-16% per 1000 older children (Dicky & Wulan, 2017).

Briefly write the runnind head of your research. Yudha et al. Java Nursing Journal, Vol. 1, No. 1, 2023, ISSN: 2988-4152 35
In line with research Turochman & Nuhan (2022) chest physiotherapy is effective and beneficial in improving airway clearance in pre-school children with pneumonia cases.