Faraji Azam, Khatony Alireza, Moradi Gholamreza, Abdi Alireza, Rezaei Mansour
Kermanshah School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Crit Care Res Pract. 2015;2015:470842. doi: 10.1155/2015/470842. Epub 2015 Sep 3.
Aim. This study was aimed at comparing the effects of the open and closed suctioning techniques on the arterial blood gas values in patients undergoing open-heart surgery. Methods. In a clinical trial, we recruited 42 patients after open-heart surgery in an educational hospital. Each patient randomly underwent both open and closed suctioning. ABGs, PaO2, SaO2, PaCO2, were analyzed before and one, five, and fifteen minutes after each suctioning episode. Results. At first the pressure of oxygen in arterial blood increased; however, this increase in the open technique was greater than that of the closed system (P < 0.001). The pressure of oxygen decreased five and fifteen minutes after both suctioning techniques (P < 0.05). The trends of carbon dioxide variations after the open and closed techniques were upward and downward, respectively. Moreover, the decrease in the level of oxygen saturation five and fifteen minutes after the open suctioning was greater than that of the closed suctioning technique (P < 0.05). Conclusion. Arterial blood gas disturbances in the closed suctioning technique were less than those of the open technique. Therefore, to eliminate the unwanted effects of endotracheal suctioning on the arterial blood gases, the closed suctioning technique is recommended.
目的。本研究旨在比较开放式和封闭式吸痰技术对心脏直视手术患者动脉血气值的影响。方法。在一项临床试验中，我们在一家教学医院招募了42名心脏直视手术后的患者。每位患者随机接受开放式和封闭式吸痰。在每次吸痰前以及吸痰后1分钟、5分钟和15分钟分析动脉血气、动脉血氧分压（PaO2）、动脉血氧饱和度（SaO2）、动脉血二氧化碳分压（PaCO2）。结果。起初动脉血氧压力升高；然而，开放式技术的这种升高幅度大于封闭式系统（P < 0.001）。两种吸痰技术在吸痰后5分钟和15分钟时氧压力均下降（P < 0.05）。开放式和封闭式技术后二氧化碳变化趋势分别为上升和下降。此外，开放式吸痰后5分钟和15分钟时血氧饱和度水平的下降幅度大于封闭式吸痰技术（P < 0.05）。结论。封闭式吸痰技术引起的动脉血气紊乱少于开放式技术。因此，为消除气管内吸痰对动脉血气的不良影响，推荐使用封闭式吸痰技术。
