Lu Kang, Wu Weizhou, Jin Gaomei, Yang Haixia, Cai Xiaowei, Li Lin, Chen Zanchao, Ren Lin, Guo Baoshuan, Xue Qing-Feng
Cadre Ward Department, The 985th Hospital of the Joint Logistics Support Force, Taiyuan, China.
Neurology Department, The 985th Hospital of the Joint Logistics Support Force, Taiyuan, China.
Crit Care Res Pract. 2023 Dec 31;2023:9927819. doi: 10.1155/2023/9927819. eCollection 2023.
To explore the clinical application of a new type of protective sputum suction device (PSSD) in patients with tracheotomy or tracheal intubation and to evaluate the protective effect of PSSD against cross-infection between medical staffs and patients.
A novel PSSD was designed which can assist closed sputum suction operation without disconnecting the ventilator. 32 patients with tracheotomy were included to study the protective effect and safety of this device. Patients' vital signs including heart rate, respiratory rate, mean arterial pressure, and blood oxygen saturation were recorded to compare the influence of open suction and closed suction (performed with this novel device). To verify the antisplash effect of this device on airway secretions, bacterial samples were collected from the hands of the suction operators and the environment near the endotracheal tube orifice before and after the two suction processes. In addition, the satisfaction of the two suction methods was compared through the questionnaire of suction staff. Finally, with the assistance of this device, an attempt was made to complete the bronchoscopy without weaning of ventilator.
Compared with open sputum suction, closed sputum suction has a smaller decrease in patients' blood oxygen saturation ( < 0.05), and no significant differences in other vital signs. Compared with open sputum suction, bacteria from the hands of suction staffs and the surrounding environment of the endotracheal tube were barely detected in closed suction. A questionnaire survey of sputum suction nurses suggested that the satisfaction with use and protective effect of the closed suction were better than open suction. In addition, bronchoscopy can be successfully completed with the assistance of this device, which is not possible for other breathing tubes.
This closed sputum suction device has little effect on the oxygen saturation of patients but has excellent protective effects for medical staff against cross-infection. It has a unique advantage that can assist in completing the fiberoptic bronchoscopy with continuous ventilator-assisted breathing.
探讨新型保护性吸痰装置（PSSD）在气管切开或气管插管患者中的临床应用，并评估该装置对医护人员与患者之间交叉感染的防护效果。
设计一种新型PSSD，可在不脱开呼吸机的情况下辅助进行密闭式吸痰操作。纳入32例气管切开患者，研究该装置的防护效果及安全性。记录患者的心率、呼吸频率、平均动脉压和血氧饱和度等生命体征，以比较开放式吸痰和使用该新型装置进行的密闭式吸痰的影响。为验证该装置对气道分泌物的防溅效果，在两种吸痰操作前后，从吸痰操作人员的手部以及气管导管口附近环境采集细菌样本。此外，通过吸痰工作人员的问卷比较两种吸痰方法的满意度。最后，在该装置的辅助下，尝试在不脱机的情况下完成支气管镜检查。
与开放式吸痰相比，密闭式吸痰患者的血氧饱和度下降幅度较小（<0.05），其他生命体征无显著差异。与开放式吸痰相比，密闭式吸痰时吸痰工作人员手部及气管导管周围环境中几乎未检测到细菌。对吸痰护士的问卷调查表明，对密闭式吸痰的使用满意度和防护效果优于开放式吸痰。此外，借助该装置可成功完成支气管镜检查，而其他呼吸导管则无法做到。
这种密闭式吸痰装置对患者的血氧饱和度影响较小，但对医护人员预防交叉感染具有出色的防护效果。它具有独特优势，可在持续呼吸机辅助呼吸的情况下协助完成纤维支气管镜检查。
