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Gaspar L, Reis N, Sousa P, Silva APE, Cardoso A, Brito A, Bastos F, Campos J, Parente P, Pereira F, Machado N. Nursing Process Related to the Nursing Focus "Airway Clearance": A Scoping Review. NURSING REPORTS 2024; 14:1871-1896. [PMID: 39189270 PMCID: PMC11348224 DOI: 10.3390/nursrep14030140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2024] [Revised: 07/25/2024] [Accepted: 07/26/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND Airway clearance impairment has a significant impact on self-care and quality of life. Identifying clinical data, nursing diagnoses, and nursing interventions is essential to clinical reasoning and enhancing nursing care. This study aims to map the existing evidence on clinical data, nursing diagnoses, and nursing interventions addressing the nursing focus on "airway clearance". METHODS Research was conducted based on Joanna Briggs's Scoping Review Methodology. We searched four databases for published studies until December 2023. RESULTS From the initial 1854 studies identified, 123 were included in the review. The findings highlighted two areas of nursing attention: one related to signs and symptom management, and the other related to education and coping strategies. The data that led to nursing diagnoses were divided into cognitive and clinical data. The nursing diagnoses were mostly related to secretion retention, excessive mucus production, and airway obstruction. The most commonly identified nursing interventions were educational interventions assembled into predesigned education programs rather than patient-tailored programs. CONCLUSIONS Findings can add substantial value for systematizing the nursing process related to "airway clearance", improving nursing decision-making and care quality. This study was prospectively registered with the Open Science Framework (OSF) on 02 December 2022, with the registration number wx5ze.
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Affiliation(s)
- Luís Gaspar
- Faculty of Health Sciences and Nursing, Universidade Universidade Católica Portuguesa, 4169-005 Porto, Portugal;
| | - Neuza Reis
- Faculty of Health Sciences and Nursing, Universidade Universidade Católica Portuguesa, 4169-005 Porto, Portugal;
| | - Paula Sousa
- Porto School of Nursing, Escola Superior de Enfermagem do Porto, 4200-072 Porto, Portugal; (P.S.); (A.P.e.S.); (A.C.); (A.B.); (F.B.); (J.C.); (P.P.); (F.P.); (N.M.)
| | - Abel Paiva e Silva
- Porto School of Nursing, Escola Superior de Enfermagem do Porto, 4200-072 Porto, Portugal; (P.S.); (A.P.e.S.); (A.C.); (A.B.); (F.B.); (J.C.); (P.P.); (F.P.); (N.M.)
| | - Alexandrina Cardoso
- Porto School of Nursing, Escola Superior de Enfermagem do Porto, 4200-072 Porto, Portugal; (P.S.); (A.P.e.S.); (A.C.); (A.B.); (F.B.); (J.C.); (P.P.); (F.P.); (N.M.)
| | - Alice Brito
- Porto School of Nursing, Escola Superior de Enfermagem do Porto, 4200-072 Porto, Portugal; (P.S.); (A.P.e.S.); (A.C.); (A.B.); (F.B.); (J.C.); (P.P.); (F.P.); (N.M.)
| | - Fernanda Bastos
- Porto School of Nursing, Escola Superior de Enfermagem do Porto, 4200-072 Porto, Portugal; (P.S.); (A.P.e.S.); (A.C.); (A.B.); (F.B.); (J.C.); (P.P.); (F.P.); (N.M.)
| | - Joana Campos
- Porto School of Nursing, Escola Superior de Enfermagem do Porto, 4200-072 Porto, Portugal; (P.S.); (A.P.e.S.); (A.C.); (A.B.); (F.B.); (J.C.); (P.P.); (F.P.); (N.M.)
| | - Paulo Parente
- Porto School of Nursing, Escola Superior de Enfermagem do Porto, 4200-072 Porto, Portugal; (P.S.); (A.P.e.S.); (A.C.); (A.B.); (F.B.); (J.C.); (P.P.); (F.P.); (N.M.)
| | - Filipe Pereira
- Porto School of Nursing, Escola Superior de Enfermagem do Porto, 4200-072 Porto, Portugal; (P.S.); (A.P.e.S.); (A.C.); (A.B.); (F.B.); (J.C.); (P.P.); (F.P.); (N.M.)
| | - Natália Machado
- Porto School of Nursing, Escola Superior de Enfermagem do Porto, 4200-072 Porto, Portugal; (P.S.); (A.P.e.S.); (A.C.); (A.B.); (F.B.); (J.C.); (P.P.); (F.P.); (N.M.)
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Yılmaz İ, Özden D. The effects of open and closed system endotracheal suctioning methods on suctioning frequency, amount of secretion, and haemodynamics: A single-blind, randomised, 2 × 2 crossover trial. Aust Crit Care 2024; 37:25-33. [PMID: 37833132 DOI: 10.1016/j.aucc.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 08/28/2023] [Accepted: 09/02/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Several studies have revealed that clinicians cannot suction all available secretion in the trachea and perform more frequent suctioning with a closed suctioning system (CSS) than with an open suctioning system (OSS). There are also studies claiming that the CSS is as effective as the OSS, based on either the amount of secretion, the frequency of suctioning, or haemodynamic parameters alone. However, there is no study examining all at once. OBJECTIVES This study aims to determine whether the CSS is as effective for secretion removal, suctioning frequency, tidal volume (VT), and peripheral oxygen saturation (SpO2) as the OSS. METHODS The study used a single-blind, randomised, 2 × 2 crossover (2-method, 2-arm, 2-period) design. One hundred intubated patients were randomly assigned to two study arms. Thirty-four were randomised to the CSS on the first day and the OSS on the second day (AB arm), and 35 were randomised to the OSS on the first day and the CSS on the second day (BA arm). A 12-h washout period was set between them. Haemodynamic parameters were measured just before suctioning and in the 5th minute after suctioning. The secretions obtained after suctioning were weighed, and the frequency of suctioning was recorded. RESULTS There were no effects of method, period, or carryover on suctioning frequency and amount of secretion in the 2 × 2 crossover design t-test (p > 0.05). In the OSS, there was a weak, linear, and negative correlation between the amount of secretion and SpO2, and between VT and SpO2 measured before and after suctioning (p < 0.05 for all). CONCLUSIONS Open and closed suctioning systems were similar in terms of haemodynamic alterations, amounts of secretion, and frequency of suctioning. The CSS was as effective as the OSS. REGISTRATION NUMBER NCT04053751.
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Affiliation(s)
- İlkin Yılmaz
- Dokuz Eylül University Faculty of Nursing, 35340, Izmir, Turkey.
| | - Dilek Özden
- Dokuz Eylül University Faculty of Nursing, 35340, Izmir, Turkey
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Ramírez-Torres CA, Rivera-Sanz F, Sufrate-Sorzano T, Pedraz-Marcos A, Santolalla-Arnedo I. Closed Endotracheal Suction Systems for COVID-19: Rapid Review. Interact J Med Res 2023; 12:e42549. [PMID: 36548950 PMCID: PMC9874988 DOI: 10.2196/42549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The increase in admissions to intensive care units (ICUs) in 2020 and the morbidity and mortality associated with SARS-CoV-2 infection pose a challenge to the analysis of evidence of health interventions carried out in ICUs. One of the most common interventions in patients infected with the virus and admitted to ICUs is endotracheal aspiration. Endotracheal suctioning has also been considered one of the most contaminating interventions. OBJECTIVE This review aims to analyze the benefits and risks of endotracheal suctioning using closed suction systems (CSS) in COVID-19 patients. METHODS A rapid review was carried out using the following databases: PubMed, MEDLINE, CINAHL, LILACS, the Cochrane Library, and IBECS. The data search included articles in English and Spanish, published between 2010 and 2020, concerning adult patients, and using the key words "endotracheal," "suction," and "closed system." RESULTS A total of 15 articles were included. The benefits and risks were divided into 3 categories: patient, care, and organization. Relating to the patient, we found differences in cardiorespiratory variables and changes in the ventilator, for example, improvement in patients with elevated positive and end-expiratory pressure due to maladaptation and alveolar collapse. Relating to care, we found a shorter suctioning time, by up to 1 minute. Relating to organization, we found fewer microorganisms on staff gloves. Other conflicting results between studies were related to ventilator-associated pneumonia, bacterial colonization, or mortality. CONCLUSIONS Aside from the need for quality research comparing open suction systems and CSS as used to treat COVID-19 patients, closed endotracheal suctioning has benefits in terms of shorter stay in the ICU and reduced environmental contamination, preventing ventilator disconnection from the patient, reducing the suctioning time-though it does produce the greatest number of mucosal occlusions-and preventing interpatient and patient-staff environmental contamination. New evidence in the context of the SARS-CoV-2 virus is required in order to compare results and establish new guidelines.
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Affiliation(s)
- Carmen Amaia Ramírez-Torres
- Health and Care Research Group, University of La Rioja, Logroño, Spain
- Research Unit on Health System Sustainability, Biomedical Center of La Rioja, Logroño, Spain
| | | | - Teresa Sufrate-Sorzano
- Health and Care Research Group, University of La Rioja, Logroño, Spain
- Research Unit on Health System Sustainability, Biomedical Center of La Rioja, Logroño, Spain
| | | | - Ivan Santolalla-Arnedo
- Health and Care Research Group, University of La Rioja, Logroño, Spain
- Research Unit on Health System Sustainability, Biomedical Center of La Rioja, Logroño, Spain
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Effect of deep and superficial endotracheal suctioning on hemodynamic parameters and pain in neurosurgical intensive care patients. MARMARA MEDICAL JOURNAL 2022. [DOI: 10.5472/marumj.1121846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Çam Yanık T, Altun Uğraş G. Effects of endotracheal tube fixation methods on haemodynamic parameters during endotracheal suction: A single-blind non-randomized clinical trial study. Int J Nurs Pract 2021; 28:e13007. [PMID: 34390084 DOI: 10.1111/ijn.13007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 07/28/2021] [Accepted: 07/28/2021] [Indexed: 11/28/2022]
Abstract
AIM This study aimed to determine the effect of the methods used in endotracheal tube fixation on haemodynamic parameters (systolic and diastolic blood pressure, heart rate and oxygen saturation) during endotracheal suction. METHODS The sample of this prospective, parallel two-armed, single-blind non-randomized clinical trial study included 86 intubated patients treated in the cardiovascular surgery intensive care unit between September 2016 and December 2017. The endotracheal tube was fixed with tube holders in the intervention group (n = 43), whereas the endotracheal tube was fixed with plasters in the control group (n = 43). The patients' haemodynamic parameters were measured before, during, at the end of suction, and 5 and 15 min after suction. RESULTS In comparison with the patients with plasters, patients with tube holders had significantly lower systolic blood pressure 15 min after endotracheal suction and significantly lower diastolic blood pressure during and at the end of endotracheal suction. Oxygen saturation of the patients with tube holder during, at the end, and following 5 min after endotracheal suction were higher than patients with plaster. Heart rate was not affected during endotracheal suction in both groups. CONCLUSION The study showed the tube holder affected the haemodynamic parameters during endotracheal suction less than the plaster.
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Affiliation(s)
- Tuğba Çam Yanık
- Faculty of Nursing, Department of Surgical Nursing, Mersin University, Mersin, Turkey
| | - Gülay Altun Uğraş
- Faculty of Nursing, Department of Surgical Nursing, Mersin University, Mersin, Turkey
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Khayer F, Ghafari S, Saghaei M, Yazdannik A, Atashi V. Effects of Open and Closed Tracheal Suctioning on Pain in Mechanically Ventilated Patients. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2020; 25:426-430. [PMID: 33344215 PMCID: PMC7737833 DOI: 10.4103/ijnmr.ijnmr_135_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 05/11/2020] [Accepted: 06/08/2020] [Indexed: 11/19/2022]
Abstract
Background: Painful care procedures are the most common cause of stress in patients admitted to Intensive Care Units (ICUs). Tracheal suctioning is the most painful experience for ICU patients. The present study was conducted to compare open and closed endotracheal suctioning in terms of their effect in pain in mechanically ventilated patients. Materials and Methods: The present clinical trial recruited 70 mechanically ventilated patients with tracheostomy in 2019. The eligible patients were randomly divided into open and closed suctioning groups. The pain was measured in the patients using the Critical Pain Observational Tool (CPOT) before and during suctioning as well as 10 and 30 min later. The data were analyzed using the repeated measures Analysis Of Variance (ANOVA), paired t-test, and Chi-squared test. Results: The pain score was significantly higher in the open suctioning group during (t = 2.59, p = 0.01) and 10 min after suctioning (t = 3.02, p = 0.004). No significant differences were observed in the pain score between the two groups 30 min after suctioning (t = 0.32, p = 0.75). The post hoc Least Significant Difference (LSD) test showed that the CPOT scores 10 min after suctioning was significantly higher than that before suctioning and significantly lower than that during suctioning (p = 0.001). The CPOT score 30 min after suctioning was also significantly lower than that 10 min after suctioning (p < 0.001). Conclusions: The present findings suggested a lower pain in the patients with closed suctioning compared to those with open suctioning.
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Affiliation(s)
- Fatemeh Khayer
- MSc Student in Critical Care Nursing, department of nursing, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Somayeh Ghafari
- Assistant Professor, Nursing and Midwifery Care, Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahmoud Saghaei
- Professor of Anesthesiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmadreza Yazdannik
- Assistant Professor, Department of Critical Care Nursing, Nursing and Midwifery School, Nursing and Midwifery Care Research Center, Isfahan University of Medical Science, Isfahan, Iran
| | - Vajihe Atashi
- PHD of Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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Pinto HJ, D'silva F, Sanil TS. Knowledge and Practices of Endotracheal Suctioning amongst Nursing Professionals: A Systematic Review. Indian J Crit Care Med 2020; 24:23-32. [PMID: 32148345 PMCID: PMC7050166 DOI: 10.5005/jp-journals-10071-23326] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction Ventilator-associated pneumonia, a common cause of mortality and morbidity, is commonly seen among patients with endotracheal intubation due to unsafe suctioning practices by health professionals. Objective A systematic review was conducted to explore the gaps in the existing practices of nurses and thus proposing comprehensive guidelines for safe practice. Materials and methods A two-phase strategy was adopted to identify the studies through a comprehensive electronic search in PubMed, Google Scholar, ProQuest, Ovid, and Helinet Summon by using predefined keywords within a year limit of 2002–2016. The quality of studies was reviewed using tools endorsed by Joanna Briggs Institute. This review was conducted according to the guidelines described in the preferred reporting items for systematic reviews and meta-analyses (PRISMA). Qualitative data were described through the process of metasynthesis. Quantitative analysis was performed to combine the competent quantitative evidences to identify knowledge and practices of endotracheal suctioning (ETS). Results Thirty studies had been subjected for metasynthesis, among which six provided relevant information for quantitative analysis. Quantitative analysis of the studies reported that only 36% of the nurses had assessed patients prior to suctioning and had knowledge about the size of the suction catheter while only 46% were aware of the appropriate suction pressure to be used for ETS. Handwashing compliance prior to suctioning was observed in only 62% of the nurses. It is reported that, despite the awareness on possible complications, nurses fail to adhere to the recommended practice guidelines. Conclusion The current review would explore the best evidence-based practices (EBPs) among nurses related to ETS, which would ensure quality care to critically ill patients. How to cite this article Pinto HJ, D'silva F, Sanil TS. Knowledge and Practices of Endotracheal Suctioning amongst Nursing Professionals: A Systematic Review. Indian J Crit Care Med 2020;24(1):23–32.
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Affiliation(s)
- Halita J Pinto
- Department of Medical Surgical Nursing, Nitte Usha Institute of Nursing Sciences, Nitte University, Mangaluru, Karnataka, India
| | - Fatima D'silva
- Department of Medical Surgical Nursing, Nitte Usha Institute of Nursing Sciences, Nitte University, Mangaluru, Karnataka, India
| | - Thankappan S Sanil
- Department of Biostatistics, KSHEMA, Nitte University, Mangaluru, Karnataka, India
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Seyedhejazi M, Sheikhzade D, Aliakbari Sharabiani B, Abri R, Sadeghian M. Evaluating the Effects of Post-Intubation Endotracheal Suctioning Before Surgery on Respiratory Parameters in Children with Airway Secretion. Anesth Pain Med 2019; 9:e86486. [PMID: 31497517 PMCID: PMC6712427 DOI: 10.5812/aapm.86486] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 06/01/2019] [Accepted: 06/09/2019] [Indexed: 11/16/2022] Open
Abstract
Background Endotracheal suctioning (ETS) is a common procedure in intubated patients for the clearance of secretions and improvement of oxygenation. Objectives Owing to the controversies in previous studies, we studied the effects of open ETS before surgery on respiratory parameters in children with pulmonary crackles. Methods In this clinical trial, 100 children with pulmonary crackles, candidates for surgery were randomly assigned into two groups. After intubation, in the group A (n = 50), deep and open suction was done until the crackle was cleared and in the group B (n = 50), anesthesia without suctioning was continued. Hemodynamic and respiratory parameters were compared. Results The patients in group A had higher oxygen saturation with a statistically significant difference in 15th to 75th minutes of the operation (P < 0.001) and in post-anesthetic care unit (P = 0.004). After suction, before and after extubation, there was a statistically significant reduction of crackles in the group A in comparison to the group B (P < 0.001). There was no statistically significant difference in the end-tidal CO2, airway pressure and respiratory rate between the two groups (P > 0.05). Relevant complications and the emergence of anesthesia time were statistically lower in the group A (P < 0.001). There was no statistically significant change in terms of blood pressure in the two groups (P > 0.05). The heart rate in the 15th, 30th, and 45th minutes of surgery was statistically lower in the group B (P < 0.05). Conclusions This study indicates positive effects of open and deep suction in improving oxygen saturation and reducing complications and emergence time. Pulmonary auscultation of the group A before and after weaning was statistically better than group B. However, this study found no positive effect of ETS on airway pressure, ETCO2, blood pressure, and respiratory rate. Meanwhile, increased heart rate in the group A might introduce the potential risk of dysrhythmia and hemodynamic instability.
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Affiliation(s)
- Mahin Seyedhejazi
- Department of Anesthesiology and Critical Care, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Dariush Sheikhzade
- Department of Anesthesiology and Critical Care, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Behzad Aliakbari Sharabiani
- Department of Anesthesiology and Critical Care, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reyhaneh Abri
- Department of Anesthesiology and Critical Care, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Corresponding Author: Assistant Professor, Department of Anesthesiology and Critical Care, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. Tel/Fax: +98-4133341994,
| | - Mahsa Sadeghian
- Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Effect of minimally invasive endotracheal tube suctioning on physiological indices in adult intubated patients: An open-labelled randomised controlled trial. Aust Crit Care 2019; 32:199-204. [DOI: 10.1016/j.aucc.2018.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 03/12/2018] [Accepted: 03/18/2018] [Indexed: 11/22/2022] Open
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Albarran JW. What's in this Issue? Nurs Crit Care 2016; 20:111-2. [PMID: 25854431 DOI: 10.1111/nicc.12179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Dastdadeh R, Ebadi A, Vahedian-Azimi A. Comparison of the Effect of Open and Closed Endotracheal Suctioning Methods on Pain and Agitation in Medical ICU Patients: A Clinical Trial. Anesth Pain Med 2016; 6:e38337. [PMID: 27847697 PMCID: PMC5101537 DOI: 10.5812/aapm.38337] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 06/05/2016] [Accepted: 06/23/2016] [Indexed: 11/24/2022] Open
Abstract
Background Endotracheal suctioning is a necessary procedure practiced by nurses in intensive care units to remove lung secretions. This procedure leads to higher oxygenation levels and reduced breathing difficulties. It also prevents atelectasis, pulmonary infections, and the accumulation of secretions. Objectives The present study aims to compare the effectiveness of open and closed endotracheal suction tube systems on pain and agitation in patients under mechanical ventilation. Methods A randomized controlled clinical trial was conducted in the general intensive care units of Khatam-ol-Anbia hospital and Sina hospital, Tehran, Iran, in 2015. In total, 60 patients who were qualified to be included in the study were randomly assigned to either the intervention group or the control group. When necessary, suction was carried out for each patient using the standard technique. The patients’ level of pain and agitation was measured in both groups at five stages (before, during, immediately after, 5 minutes after, and 15 minutes after the intervention) using the behavioral pain scale and the Richmond agitation sedation scale. Results Significant statistical differences in the pain and agitation at different times within each of the two groups were observed for both open and closed suction (P > 0.001). However, these changes at different times between the two groups was not significant (P < 0.05). Conclusions Although statistical differences were observed in the levels of pain and agitation in the two groups, the type of suction system did not have any effect on the level of pain and agitation of patients under mechanical ventilation. The researchers recommend that other studies with larger sample sizes should be carried out.
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Affiliation(s)
- Raziyeh Dastdadeh
- Student of Master Degree in Nursing, Tehran Medical Branch, Islamic Azad University, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Corresponding author: Abbas Ebadi, Behavioral Sciences Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran. Tel: +98-9122149019, Fax: +98-2126127237, E-mail:
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Open and Closed Endotracheal Suctioning and Arterial Blood Gas Values: A Single-Blind Crossover Randomized Clinical Trial. Crit Care Res Pract 2015; 2015:470842. [PMID: 26425366 PMCID: PMC4573878 DOI: 10.1155/2015/470842] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 08/26/2015] [Indexed: 02/02/2023] Open
Abstract
Aim. This study was aimed at comparing the effects of the open and closed suctioning techniques on the arterial blood gas values in patients undergoing open-heart surgery. Methods. In a clinical trial, we recruited 42 patients after open-heart surgery in an educational hospital. Each patient randomly underwent both open and closed suctioning. ABGs, PaO2, SaO2, PaCO2, were analyzed before and one, five, and fifteen minutes after each suctioning episode. Results. At first the pressure of oxygen in arterial blood increased; however, this increase in the open technique was greater than that of the closed system (P < 0.001). The pressure of oxygen decreased five and fifteen minutes after both suctioning techniques (P < 0.05). The trends of carbon dioxide variations after the open and closed techniques were upward and downward, respectively. Moreover, the decrease in the level of oxygen saturation five and fifteen minutes after the open suctioning was greater than that of the closed suctioning technique (P < 0.05). Conclusion. Arterial blood gas disturbances in the closed suctioning technique were less than those of the open technique. Therefore, to eliminate the unwanted effects of endotracheal suctioning on the arterial blood gases, the closed suctioning technique is recommended.
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