Afshari Ali, Safari Mahmoud, Oshvandi Khodayar, Soltanian Ali Reza
Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, IR Iran.
Research Center for Maternal and Child Care, Hamadan University of Medical Sciences, Hamadan, IR Iran.
Nurs Midwifery Stud. 2014 Jun;3(2):e14097. Epub 2014 Jun 15.
One of the measures to keep the airway open is suctioning of endotracheal tube in patients under ventilation. This procedure can be accompanied with some complications. Selection of appropriate method of suctioning can prevent incidence of acute complications.
This study aimed to compare the effects of the open and closed system suctioning methods on blood pressure, mean arterial pressure, heart rate, percentage of arterial oxygen saturation, time, and costs in patients under mechanical ventilation.
This clinical trial study was conducted on 40 patients in ICU. Patients' blood pressure, heart rate, arterial oxygen saturation, related costs, and length of suctioning procedure were measured and recorded immediately before and one, five, ten, and fifteen minutes after suctioning. Data were analyzed using paired t test and repeated measure analysis of variance.
No significant differences were observed between the two suctioning methods in terms of mean systolic blood pressure (P = 0.075), diastolic blood pressure (P = 0.405), and mean arterial pressure (P = 0.257) in the five consecutive measurements. However, significant changes were observed in heart rate (P = 0.025) and percentage of arterial oxygen saturation (P < 0.001). The mean lengths of time in open and closed suctioning methods were 5.59 ± 0.211 and 4.34 ± 0.039 seconds, respectively (P < 0.001). The cost of the closed system was lower than the open method for the patients who were admitted to ICU for longer than two days.
Closed suction caused fewer disturbances in patients' hemodynamic condition, took shorter time, and is more economical. Therefore, this method can replace open suction method in caring of severely critically ill patients.
保持气道通畅的措施之一是对通气患者进行气管内吸痰。该操作可能会伴随一些并发症。选择合适的吸痰方法可预防急性并发症的发生。
本研究旨在比较开放系统和密闭系统吸痰方法对机械通气患者血压、平均动脉压、心率、动脉血氧饱和度、时间及费用的影响。
本临床试验研究在40例重症监护病房患者中进行。在吸痰前及吸痰后1分钟、5分钟、10分钟和15分钟，测量并记录患者的血压、心率、动脉血氧饱和度、相关费用及吸痰操作时间。数据采用配对t检验和重复测量方差分析进行分析。
在连续5次测量中，两种吸痰方法在平均收缩压（P = 0.075）、舒张压（P = 0.405）和平均动脉压（P = 0.257）方面均未观察到显著差异。然而，在心率（P = 0.02）和动脉血氧饱和度百分比（P < 0.001）方面观察到显著变化。开放吸痰法和密闭吸痰法的平均时间分别为5.59±0.211秒和4.34±0.03秒（P < 0.001）。对于入住重症监护病房超过两天的患者，密闭系统的费用低于开放系统。
密闭吸痰对患者血流动力学状况的干扰较小，所需时间较短，且更经济。因此，在护理重症患者时，该方法可替代开放吸痰法。
