Effects of open and closed suction systems on the haemodynamic parameters in cardiac surgery patients

Abstract

Aims:This study was carried out to determine the effects of open and closed suction systems on haemodynamic parameters of the patients who underwent open heart surgery. Background: Nurses should work meticulously and carefully as many complications may develop if the method used to perform suctioning is not appropriate. Design: The quasi-experimental study design was used. Method: The study sample comprised 120 patients who underwent open heart surgery in the cardiovascular surgery intensive care unit of a state hospital in Turkey. Haemodynamic parameters were determined just before, right after, at the 5th and 15th minute after suctioning. The data were evaluated with the One-Way Analysis of Variance (ANOVA) for Repeated Measures, independent t-test and Bonferroni's test for further analysis (post hoc). Results:The difference between heart rate (HR) and mean blood pressure, mean PaO 2 and PaCO 2 , SaO 2 and pH values measured before, right after and at the 5th and 15th minute after suctioning was found to be significant in patients who underwent the open suctioning procedure. It was determined that the difference between mean PaO 2 values was not significant and that SaO 2 versus SpO 2 values increased in patients who underwent the closed suctioning procedure. When the open and closed suction systems were compared, statistically significant difference was determined in terms of MAP, SpO 2 . Conclusion: It was determined that HR, arterial blood pressure and arterial blood gases of the patients who underwent open heart surgery were negatively affected by the open suction system but did not increase significantly as soon as suctioning was over during the closed suctioning procedure. The data obtained indicate that closed system suctioning, compared with open system suctioning, can be used safely on this patient group. Relevance to clinical practice: The closed suction system is recommended since it contributes to the enhancement of patient safety and the quality of nursing care.

Effect of Application of Endotracheal Suction Guidelines on Cardiorespiratory Parameters of Mechanically Ventilated Patients

“…Parsons et al (36) evaluated the effect of hyperventilation at 100% O 2 followed by ES and found that MAP was significantly elevated above baseline. Ozden et al's (37) Concerning respiratory parameters, results of this study showed that RR decreased in the study group and increased in the control one with significant difference between them at immediate 1, and 10 min after suction. The result can be related to restlessness and suffering produced by ES technique.…”

“…Zahran et al (50) found significant increase in PaCO 2 after ES with normal saline instillation. However Caramez et al (8) found PaCO 2 elevations after ES with open and closed method, the Özden et al (37) and U˘gras et al (51) didn't In addition, Kelher et al (52) showed that some nurses performed ES without consideration to recommended steps so excellence of this nursing intervention was less than predicted. Additionally, Jongerden et al (3) performed a practical study evaluating ES in which the suctioning procedure was done during standard way as needed based on advices.…”

Comparison of the Effect of Open and Closed Endotracheal Suctioning Methods on Pain and Agitation in Medical ICU Patients: A Clinical Trial

“…It is well documented that the most important advantage of CSS is the eradication of any weak point due to the detachment of the mechanical ventilation device from the patient. Still, there is little information about the effect of CSS on hemodynamic parameters (30). The results of a study by Evans et al demonstrated that CS is done more often during the day and that nurses spend less time carrying out CS compared to OS.…”

What's in this Issue?

“…To address this, Özden and Görgülü (2015) using a quasi-experimental design, studied the effects of both approaches on a sample of 120 patients who underwent open heart surgery and evaluated changes in heart rate (HR), mean arterial blood pressure (MAP), Pa0 2 , PaC0 2 and Sa0 2 at four time intervals (prior to and after suctioning). For example, comparisons between open and closed suctioning manoeuvres in relation to lung dynamics and functioning have been studied; however, research on the effect on haemodynamic parameters is disputed.…”

“…For example, comparisons between open and closed suctioning manoeuvres in relation to lung dynamics and functioning have been studied; however, research on the effect on haemodynamic parameters is disputed. To address this, Özden and Görgülü (2015) using a quasi-experimental design, studied the effects of both approaches on a sample of 120 patients who underwent open heart surgery and evaluated changes in heart rate (HR), mean arterial blood pressure (MAP), Pa0 2 , PaC0 2 and Sa0 2 at four time intervals (prior to and after suctioning). One group (n = 60) had suctioning using the open system, the other (n = 60) had the closed endotracheal suctioning system.…”