Akgül Sevim, Akyolcu Neriman
Florence Nightingale College of Nursing, Istanbul University, Istanbul, Turkey.
J Clin Nurs. 2002 Nov;11(6):826-30. doi: 10.1046/j.1365-2702.2002.00655.x.
This study was designed to determine the effects of saline solution administered prior to endotracheal suctioning by nurses working in intensive care on oxygenation, heart rate and long-term pulmonary hygiene. The study was carried out on an experimental basis in the Intensive Care Unit of a university hospital in Turkey. A total of 20 patients were included, who were mechanically ventilated because of pulmonary or cardiovascular problems or trauma. Data were collected using a data form. Each patient was monitored for 5 minutes following suctioning with or without saline solution and findings of heart rate, SpO2, and blood gas measurements were recorded. Data were analysed using percentage calculations, the student's t-test and the Friedman test. The study showed that most of the patients were between 60 and 69 years and were intubated because of respiratory insufficiency. Evaluation of blood gases following suctioning with or without saline solution showed partial decreases in pO2, pCO2, HCO3, and oxygen saturation (SaO2), which did not reach a significant level. No significant difference was found between pH levels recorded prior to and 5 minutes after suctioning without saline solution; however, the increase in pH following suctioning with saline solution was significant. Patients undergoing suctioning with saline solution exhibited significantly increased heart rates in the fourth and fifth minutes, whereas no increases were detected in these undergoing suctioning without saline solution. SpO2 values obtained by pulse oxymeter did not show significant differences. Saline solution administered with suctioning resulted in undesirable, although not significant, alterations in oxygen saturation and arterial blood gas levels.
本研究旨在确定重症监护病房护士在气管内吸痰前给予生理盐水对氧合、心率和长期肺部清洁的影响。该研究在土耳其一所大学医院的重症监护病房进行了实验。总共纳入了20名因肺部或心血管问题或创伤而接受机械通气的患者。使用数据表格收集数据。在有或没有生理盐水的情况下,对每位患者吸痰后监测5分钟,并记录心率、血氧饱和度(SpO2)和血气测量结果。使用百分比计算、学生t检验和弗里德曼检验对数据进行分析。研究表明,大多数患者年龄在60至69岁之间,因呼吸功能不全而插管。在有或没有生理盐水的情况下吸痰后的血气评估显示,氧分压(pO2)、二氧化碳分压(pCO2)、碳酸氢根(HCO3)和氧饱和度(SaO2)部分下降,但未达到显著水平。在没有生理盐水的情况下吸痰前和吸痰后5分钟记录的pH值之间没有发现显著差异;然而,用生理盐水吸痰后pH值的升高是显著的。用生理盐水吸痰的患者在第四和第五分钟心率显著增加,而在没有生理盐水吸痰的患者中未检测到心率增加。通过脉搏血氧仪获得的SpO2值没有显示出显著差异。吸痰时给予生理盐水导致氧饱和度和动脉血气水平出现不良但不显著的变化。