Krüger Lars, Mannebach Thomas, Wefer Franziska, Lohmeier Sarah, Stork Vanessa, Gosmann Evelin, Kaltwasser Arnold
Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland.
Stabsstelle Projekt- und Wissensmanagement/Pflegeentwicklung Intensivpflege, Pflegedirektion, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Georgstraße 11, 32345, Bad Oeynhausen, Deutschland.
Anaesthesiologie. 2024 May;73(5):340-347. doi: 10.1007/s00101-024-01400-w.
Endotracheal suctioning in intubated or tracheotomized critically ill patients is a daily task of various professional groups in intensive and emergency medicine; however, a German language summary of current evidence is lacking.
The aim is to develop a narrative overview of current evidence on endotracheal suctioning of intubated or tracheotomized patients in the clinical setting.
A literature search was conducted in the databases Cinahl, Cochrane Library, Livivo, and Medline via PubMed by nurses with an academic degree. In addition, a hand search and applying the snowball principle were performed. Following a successful critical appraisal, all English and German language publications addressing endotracheal suctioning in the context of hospital care were included.
A total of 23 full texts were included. After developing 6 main topics on endotracheal suction 19 articles were considered in the reporting. The results showed, among others, that routine deep suctioning once per shift is contraindicated and that the catheter should be advanced no more than 0.5-1 cm beyond the distal end of the tube or tracheal cannula. Closed suction catheters offer advantages, especially for staff protection, although studies are heterogeneous. Further training of staff is obligatory.
Few conclusive studies on endotracheal suction could be found; however, with the available evidence initial conclusions can be drawn which should be considered in, for example, internal standard operating procedures. Further research is needed.
对插管或气管切开的重症患者进行气管内吸痰是重症医学和急诊医学中各专业团队的日常工作；然而，目前缺乏德语的证据总结。
旨在对临床环境中插管或气管切开患者气管内吸痰的现有证据进行叙述性综述。
由具有学术学位的护士在Cinahl、Cochrane图书馆、Livivo和通过PubMed的Medline数据库中进行文献检索。此外，还进行了手工检索并应用了滚雪球原则。在成功进行批判性评价后，纳入了所有在医院护理背景下涉及气管内吸痰的英文和德文出版物。
共纳入23篇全文。在确定了关于气管内吸痰的6个主要主题后，报告中考虑了19篇文章。结果显示，除其他外，每班常规深度吸痰是禁忌的，并且导管推进不应超过气管导管或气管套管远端0.5 - 1厘米。封闭式吸痰导管具有优势，特别是对工作人员的保护，尽管研究存在异质性。工作人员必须接受进一步培训。
关于气管内吸痰的确定性研究很少；然而，根据现有证据可以得出初步结论，例如在内部标准操作程序中应予以考虑。还需要进一步研究。
