Yazdannik Ahmad R, Haghighat Somayeh, Saghaei Mahmoud, Eghbali Maryam
Department of Critical Care Nursing, Faculty of Nursing and Midwifery, Isfahan, Iran.
Iran J Nurs Midwifery Res. 2013 Mar;18(2):117-22.
Endotracheal suctioning (ETS) is one of the most common supportive measures in intensive care units (ICU). ETS may be associated with complications including hypoxia and tachycardia. Closed system suctioning (CSS) decreases the rate of cardiorespiratory complication mainly due to continuation of ventilatory support and oxygenation during procedure. CSS has questionable efficacy, therefore higher values of negative pressure has been recommended to enhance the efficacy of CSS. This study was designed to evaluate the effects on gas exchange of 200 mmHg suctioning pressure compared with 100 mmHg in CSS.
Fifty mechanically ventilated (MV) ICU patients were selected for the study. Two consecutive ten seconds CSS using suction pressures of 100 and 200 mmHg, in random order applied in each subject with the two hours wash out period. Effects of two levels of suction pressure on gas exchange were measured by recording the SPo2 values at 4 times.
Repeated measure analysis of variance didn't show any significant difference between two levels of pressure (P = 0.315), but within each groups (100 and 200 mmHg) SPO2 changes was significant (P = 0.000). There was a mild but significant and transient increase in heart rate following both suction pressures, but no significant difference between two groups.
The results show that CSS with suction pressure 200 mmHg has no detrimental effect on cardiorespiratory function of MV ICU patients. Since the safety of 200 mmHg suctioning pressure was approved, using 200 mmHg suction pressures is recommended for ETS of MV patients.
气管内吸痰（ETS）是重症监护病房（ICU）最常见的支持性措施之一。ETS可能会引发包括缺氧和心动过速在内的并发症。封闭式吸痰（CSS）主要通过在操作过程中持续进行通气支持和氧合来降低心肺并发症的发生率。CSS的疗效存在疑问，因此有人建议使用更高的负压值来提高CSS的疗效。本研究旨在评估在CSS中，200mmHg吸痰压力与100mmHg吸痰压力相比对气体交换的影响。
选择50例接受机械通气（MV）的ICU患者进行研究。对每个受试者以随机顺序连续进行两次十秒的CSS，分别使用100mmHg和200mmHg的吸痰压力，两次操作之间间隔两小时的洗脱期。通过记录4个时间点的SPo2值来测量两种吸痰压力水平对气体交换的影响。
重复测量方差分析显示两种压力水平之间无显著差异（P = 0.315），但每组（100mmHg和200mmHg）内SPO2变化显著（P = 0.000）。两种吸痰压力后心率均有轻度但显著且短暂的升高，但两组之间无显著差异。
结果表明，200mmHg吸痰压力的CSS对MV ICU患者的心肺功能没有不利影响。由于200mmHg吸痰压力的安全性得到认可，建议对MV患者进行ETS时使用200mmHg的吸痰压力。
