Endotracheal Suctioning May or May Not Have an Impact, But It Does Depend on What You Measure!

Ntoumenopoulos, George

doi:10.4187/respcare.02745

Cited by 8 publications

(4 citation statements)

References 27 publications

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“…Although tracheal suction is an indispensable requirement for airway patency, it can bring about many undesired conditions. In the literature, endotracheal suction, an invasive intervention, has been shown to cause several complications such as discomfort, pain, hemorrhage, infection, bronchospasm, cardiovascular instability, hypoxia / hypoxemia [12][13][14][15][16] . However, selection of an appropriate and effective suction technique can reduce the incidence of acute complications 17 .…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of the Closed Suction Applied To Patients In Intensive Care Units with Different Techniques: A Nonrandomized Controlled Trial

Gülsoy

Karagözoğlu

2020

Cumhuriyet Medical Journal

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The present study was conducted to investigate the effects of the closed suction system and different suction techniques in which oxygen and saline instillation were administered individually or in combination on the efficacy of suction, cardiopulmonary indicators, feelings and pain experienced by patients after suction. Method: This study was planned as an experimental and cross-sectional one. The study had a single group, and a pre-and post-test design (n=43). This study was planned as a single blind in line with the Transparent Reporting of Evaluations with Nonrandomized Designs (TREND). The study data were collected using the Data Collection Form aiming to assess hemodynamics, cardiopulmonary indicators and comfort and the Visual Analog Scale for Pain to assess pain. Parameters were measured before, during and at the 1 st ,3 rd ,5 th ,7 th and 10 th minutes after suction using different techniques, and the patients were asked how they felt during the suction. Although the processes were implemented by the researcher, data were recorded not by the researcher but by the other two nurses who voluntarily worked at the clinic. Results: It was found that the standard suction technique could be better tolerated. The administration of oxygen and saline instillation before suction individually or in combination caused anxiety in patients and affected study parameters statistically significantly. Conclusions: There was a statistically significant difference between aspiration with SI and other aspiration methods, but this difference was still within normal limits. The patients drew attention to relaxation after suction despite the discomfort they experienced during suction, it can be said that tracheal suction has a vital importance in ensuring the maintenance of airway patency and oxygenation, even though it is a discomforting and painful procedure.

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Section: Introductionmentioning

confidence: 99%

“…The materials were disposed appropriately. 16. The procedure was recorded.…”

mentioning

confidence: 99%

Efficacy of the Closed Suction Applied To Patients In Intensive Care Units with Different Techniques: A Nonrandomized Controlled Trial

Gülsoy

Karagözoğlu

2020

Cumhuriyet Medical Journal

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“…16,32,33 However, other studies suggest the evaluation of the need for hyperoxygenation with F IO 2 ¼ 1.0, considering that the delivery of low or no oxygen was able to prevent hypoxemia during open endotracheal suctioning. 11,[34][35][36][37][38][39] Although O 2 was delivered for a short period of time, it is known that exposure to F IO 2 ¼ 1.0 in humans produces toxic effects that can occur by reabsorption atelectasis, hyperoxic hypercapnia, bronchial and epithelial damage, decreased effectiveness of the ciliary epithelium, and bactericidal bronchial function. 40 Respiratory markers of oxidative stress were observed in healthy volunteers, 41 while hyperoxygenation with 28% above baseline was delivered for 30 min.…”

Section: Introductionmentioning

confidence: 99%

Effects of 0 PEEP and < 1.0 F_IO₂ on S_pO₂ and P_ETCO₂ During Open Endotracheal Suctioning

Vianna

Lorenzo

Simões³

et al. 2020

Respir Care

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BACKGROUND: Hyperoxygenation and hyperinflation, preferably with a mechanical ventilator, is the most commonly used technique to prevent the adverse effects of open endotracheal suctioning on arterial oxygenation and pulmonary volume. However, limited data are available on the effects of oxygen concentrations < 100% and PEEP with zero end-expiratory pressure (0 PEEP) to improve oxygenation and to maintain adequate ventilation during open endotracheal suctioning. The aim of this study was to analyze the behavior of S pO 2 and end-tidal CO 2 pressure (P ETCO 2) in open endotracheal suctioning using the 0 PEEP technique with baseline F IO 2 (0 PEEP baseline F IO 2) and 0 PEEP + hyperoxygenation of 20% above the baseline value (0 PEEP F IO 2 + 0.20) in critically ill subjects receiving mechanical ventilation. METHODS: This was a prospective, randomized, single-blind crossover study, for which 48 subjects with various clinical and surgical conditions were selected; of these, 38 subjects completed the study. The subjects were randomized for 2 interventions: 0 PEEP baseline F IO 2 and 0 PEEP F IO 2 + 0.20 during the open endotracheal suctioning procedure. Oxygenation was assessed via oxygen saturation as measured with pulse oximetry (S pO 2), and changes in lung were monitored via P ETCO 2 using volumetric capnography. RESULTS: In the intragroup analysis with 0 PEEP baseline F IO 2 , there was no significant increase after open endotracheal suctioning in either S pO 2 (P 5 .63) or P ETCO 2 (P 5 .11). With 0 PEEP F IO 2 + 0.20, there was a significant increase in S pO 2 (P < .001), with no significant changes in P ETCO 2 (P 5 .55). In the intergroup comparisons, there was a significant increase compared to the basal values only with the 0 PEEP + 0.20 method at 1 min after hyperoxygenation (P < .001), post-immediately (P < .001), at 1 min after (P < .001), and at 2 min after open endotracheal suctioning (P < .001). CONCLUSIONS: The appropriate indication of the hyperinflation strategy via mechanical ventilation using 0 PEEP with or without hyperoxygenation proved to be efficient to maintain S pO 2 and P ETCO 2 levels. These results suggest that the technique can minimize the loss of lung volume due to open endotracheal suctioning. (ClinicalTrials.gov registration NCT02440919).

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“…Therefore, suctioning of secretions accumulated in the airway according to the patient's needs becomes an inevitable requirement. 4,5 It is reported in the literature that endotracheal suctioning, which is an invasive procedure, may result in many complications such as discomfort, pain, bleeding, infection, bronchospasm, cardiovascular instability, hypoxia/hypoxemia, tracheal or bronchial mucosa damage, changes in the cerebral blood flow, an increase in intracranial pressure, a decrease in dynamic lung compliance and residual capacity, atelectasis, hypotension, and hypertension in patients. [6][7][8][9] In the literature, endotracheal suctioning is defined as a painful and uncomfortable intervention for patients.…”

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confidence: 99%

DCCN on the Web

2024

Dimens Crit Care Nurs

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Endotracheal Suctioning May or May Not Have an Impact, But It Does Depend on What You Measure!

Cited by 8 publications

References 27 publications

Efficacy of the Closed Suction Applied To Patients In Intensive Care Units with Different Techniques: A Nonrandomized Controlled Trial

Efficacy of the Closed Suction Applied To Patients In Intensive Care Units with Different Techniques: A Nonrandomized Controlled Trial

Effects of 0 PEEP and < 1.0 F_IO₂ on S_pO₂ and P_ETCO₂ During Open Endotracheal Suctioning

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Endotracheal Suctioning May or May Not Have an Impact, But It Does Depend on What You Measure!

Cited by 8 publications

References 27 publications

Efficacy of the Closed Suction Applied To Patients In Intensive Care Units with Different Techniques: A Nonrandomized Controlled Trial

Efficacy of the Closed Suction Applied To Patients In Intensive Care Units with Different Techniques: A Nonrandomized Controlled Trial

Effects of 0 PEEP and < 1.0 FIO2 on SpO2 and PETCO2 During Open Endotracheal Suctioning

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Effects of 0 PEEP and < 1.0 F_IO₂ on S_pO₂ and P_ETCO₂ During Open Endotracheal Suctioning