Giakoumidakis Konstantinos, Kostaki Zoi, Patelarou Evridiki, Baltopoulos George, Brokalaki Hero
Cardiac - Surgery Intensive care Unit, 'Evangelismos' General Hospital of Athens, Greece.
Br J Nurs. 2011;20(21):1344-51. doi: 10.12968/bjon.2011.20.21.1344.
Endotracheal suctioning is a common aspect of nursing care to mechanically-ventilated patients. The aim of this study was to investigate the effects of two suctioning techniques on oxygen saturation (SaO2) and the amount of drained secretions. A quasi-experimental study of 103 mechanically-ventilated patients was conducted from two tertiary hospitals in Greece. Two suctioning techniques were applied to each patient: with normal saline instillation and without. Normal saline instillation was associated with increased secretions' weight (p<0.001) and no significant differences in SaO2 values compared with no instillation. In examining each suctioning technique separately, the use of normal saline instillation was associated with a decrease in SaO2 levels 1 minute (p<0.001) and 15 minutes (p=0.002) after this procedure. In addition, suctioning without normal saline instillation was associated with a decrease in SaO2 1 minute (p<0.001) after the suction. In conclusion, normal saline instillation is related with a negative outcome on patient oxygenation for a prolonged period after the suction and causes the removal of a greater amount of secretions than the applied technique with no instillation. Comparing the two techniques, none is superior to the other resulting from the statistically insignificant comparative differences in SaO2 values.
气管内吸痰是机械通气患者护理中的常见操作。本研究旨在探讨两种吸痰技术对氧饱和度(SaO2)和吸出分泌物量的影响。对来自希腊两家三级医院的103例机械通气患者进行了一项准实验研究。对每位患者应用两种吸痰技术:生理盐水滴注和不使用生理盐水滴注。与不滴注相比,生理盐水滴注与分泌物重量增加相关(p<0.001),且SaO2值无显著差异。分别检查每种吸痰技术时,生理盐水滴注的使用与该操作后1分钟(p<0.001)和15分钟(p=0.002)时SaO2水平下降相关。此外,不使用生理盐水滴注吸痰与吸痰后1分钟SaO2下降相关(p<0.001)。总之,生理盐水滴注在吸痰后较长时间内对患者氧合有负面影响,并且比不滴注的应用技术能吸出更多量的分泌物。比较这两种技术,由于SaO2值的比较差异无统计学意义,因此两者均不优于对方。