Effect of level of lung injury on HR, MAP and SaO2 changes during suctioning

Glass, C; Corley, Mary C.; Creekmore, Susan; Mellott, Karen G.; Howard, C; Grap, Mary Jo

doi:10.1016/0964-3397(94)90017-5

Cited by 13 publications

(4 citation statements)

References 5 publications

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“…18, 43, 44 In contrast, however, in this study, changes in physiologic responses (HR, RR or SPO 2 ) from baseline were not found and changes were not modified by sedation level. More recent studies of pain in the critically ill have found that physiologic responses (HR, RR, SPO 2 ) may not be good or consistent markers of pain nor, potentially, of stress, and should be considered with caution.…”

Section: Discussioncontrasting

confidence: 87%

“…2, 15-17 However, noxious experiences such as endotracheal tube suctioning 18-22 may produce stressful stimuli, even in the presence of sedation, resulting in increases in both beta-endorphin 23 and catecholamine blood levels, tachycardia and hypertension. 24 Although noxious experiences may be unavoidable in critical care, whether sedation ameliorates their negative effects has not been well examined and identification of strategies to reduce the stress response to critical illness is a priority.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Responses to noxious stimuli in sedated mechanically ventilated adults

Grap¹,

Munro²,

Wetzel³

et al. 2014

Heart & Lung

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Section: Discussioncontrasting

confidence: 87%

mentioning

confidence: 99%

Responses to noxious stimuli in sedated mechanically ventilated adults

Grap¹,

Munro²,

Wetzel³

et al. 2014

Heart & Lung

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“…We found that level of lung injury did not correlate significantly with changes from baseline in heart rate, oxygen saturation, or mean arterial pressure. 10 However, heart rate and mean arterial pressure increased significantly but returned to baseline 5 minutes after suctioning. Patients' oxygen saturation did not change significantly during the procedure or up to 15 minutes afterwards.…”

Section: Airway Management Practicesmentioning

confidence: 90%

“…Patients' oxygen saturation did not change significantly during the procedure or up to 15 minutes afterwards. In that study, 10 patients with lung injury were able to be suctioned safely while maintaining adequate oxygenation.…”

Section: Airway Management Practicesmentioning

confidence: 99%

Not-so-Trivial Pursuit: Mechanical Ventilation Risk Reduction

Grap

2009

American Journal of Critical Care

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As many as half of critically ill patients require mechanical ventilation. In this article, a program of research focused on reduction of risk associated with mechanical ventilation is reviewed. Airway management practices can have profound effects on outcomes in these patients. How patients are suctioned, types of processes used, effects of suctioning in patients with lung injury, and open versus closed suctioning systems all have been examined to determine best practices. Pneumonia is a common complication of mechanical ventilation (ventilator-associated pneumonia), and use of higher backrest elevations reduces risk of pneumonia, although compliance with such recommendations varies. The studies reviewed here describe backrest elevation practices, factors that affect backrest elevation, and the effect of backrest elevation on ventilator-associated pneumonia. Oral care strategies also have been investigated to determine their effect on ventilator-associated pneumonia. Oral care practices are reported to hold a low care priority, vary widely across care providers, and differ in intubated versus nonintubated patients. However, in several studies, oral applications of chlorhexidine have reduced the occurrence of ventilator-associated pneumonia. Although ventilator patients require sedation, sedation is associated with significant risks. The overall goals of sedation are to provide physiological stability, to maintain ventilator synchrony, and to ensure patients' comfort–although methods to evaluate achievement of these goals are limited. Reducing risks associated with mechanical ventilation in critically ill patients is a complex and interdisciplinary process. Our understanding of the risks associated with mechanical ventilation is constantly changing, but care of these patients must be based on the best evidence.

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Feedback withdrawal and changing compliance during manual hyperinflation

Hila

Ellis

Holmes

2002

Physiotherapy Res Intl

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The availability of a pressure manometer negates the influence of respiratory compliance on the achievement of target peak airway pressures during manual hyperinflation in the laboratory environment, however these benefits are not retained when feedback is withdrawn. Therefore, it is recommended that a pressure manometer should be routinely available during manual hyperinflation in clinical practice to optimize treatment safety and effectiveness.

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Effect of level of lung injury on HR, MAP and SaO2 changes during suctioning

Cited by 13 publications

References 5 publications

Responses to noxious stimuli in sedated mechanically ventilated adults

Responses to noxious stimuli in sedated mechanically ventilated adults

Not-so-Trivial Pursuit: Mechanical Ventilation Risk Reduction

Feedback withdrawal and changing compliance during manual hyperinflation

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