Demir Fatma, Dramali Alev
School of Nursing, Ege University, Izmir, Turkey.
J Adv Nurs. 2005 Aug;51(3):245-51. doi: 10.1111/j.1365-2648.2005.03500.x.
This paper reports an experimental study to determine whether giving 100% oxygen for 1 minute before and after closed suctioning is required.
Some studies suggest that patients receiving closed suction do not require preoxygenation to minimize desaturation.
The study was conducted in 2002, with 30 patients receiving mechanical ventilation who had various positive end-expiratory levels. Two suctioning methods were used for each patient: one involving administration of 100% oxygen for 1 minute before and after suctioning and the other without hyperoxygenation. Samples of arterial blood gases were taken before and after suctioning. Heart rate, arterial oxygen saturation and mean arterial pressure measures were documented before, immediately after, 30 and 60 seconds after suctioning.
Levels of partial oxygen pressure, arterial oxygen saturation and mean arterial pressure were significantly higher in patients who received 100% oxygen for 1 minute before and after suction, whereas partial carbon dioxide pressure and heart rate were similar in the two groups.
In patients who did not receive 100% oxygen before and after closed suctioning, no significant falls in partial oxygen pressure and oxygen saturation were seen. A small number of patients were hypoxaemic before suctioning, and not [corrected] giving 100% oxygen might be deleterious for this category.
本文报告一项实验研究，以确定在密闭吸痰前后给予1分钟100%氧气是否必要。
一些研究表明，接受密闭吸痰的患者不需要预充氧来尽量减少血氧饱和度下降。
该研究于2002年进行，纳入30例接受机械通气且具有不同呼气末正压水平的患者。对每位患者采用两种吸痰方法：一种是在吸痰前后给予1分钟100%氧气，另一种不进行高氧通气。在吸痰前后采集动脉血气样本。记录吸痰前、吸痰后即刻、吸痰后30秒和60秒时的心率、动脉血氧饱和度和平均动脉压测量值。
在吸痰前后给予1分钟100%氧气的患者中，氧分压、动脉血氧饱和度和平均动脉压水平显著更高，而两组的二氧化碳分压和心率相似。
在密闭吸痰前后未给予100%氧气的患者中，未观察到氧分压和血氧饱和度显著下降。少数患者在吸痰前存在低氧血症，不对这类患者给予100%氧气可能有害。
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