Eid Mohamed H, Hambridge Kevin, Schofield Patricia, Latour Jos M
School of Nursing and Midwifery, Faculty of Health, University of Plymouth, United Kingdom; Critical Care and Emergency Nursing Department, Faculty of Nursing, Mansoura University, Egypt.
School of Nursing and Midwifery, Faculty of Health, University of Plymouth, United Kingdom.
Intensive Crit Care Nurs. 2025 Apr;87:103848. doi: 10.1016/j.iccn.2024.103848. Epub 2024 Oct 2.
Currently there is limited evidence of the frequency of using endotracheal suctioning catheters. Due to limited resources, many low- and middle-income countries still reuse single-use suction catheters multiple times during the length of a nursing shift. This scoping review was conducted to map the impact of reusing single-use endotracheal suctioning catheters practices on mechanically ventilated patients' outcomes.
The scoping review was conducted in accordance with the JBI methodology for scoping reviews. Four databases systematically searched using predefined keywords (CINAHL, EMBASE, MEDLINE, GLOBAL HEALTH). Key electronic journals were hand searched, while reference lists of included documents and grey literature sources were screened thoroughly. Two independent reviewers completed the study selection and data extraction. A third reviewer made the final decision on any disagreements disputed records.
In total 22 articles were identified, and 14 non-duplicate records were screened, and 8 articles were screened for full text. Six articles met the inclusion criteria and were included in this review. Differences were observed on the findings of included studies, two studies identified that reusing single-use suction catheter might increases the risk of respiratory infection, while two other studies identified no difference in contamination rate between single used or multiple-used catheters. One study indicated that reusing single-use catheters are a safe and cost-effective intervention and finally one study reported that reusing single-use catheters might reduce incidence of ventilator associated pneumonia if flushed with chlorhexidine after suctioning.
There is no strong evidence of the frequency of using endotracheal suction catheters. Further research is needed comparing single-used versus multiple-used endotracheal suction catheters in mechanically ventilated patients.
Nurses in resource-limited countries can follow their hospital policy regarding the changing frequency of endotracheal suction catheters due to lack of a robust evidence. Flushing suction circuits with chlorhexidine while reusing single-use catheters might reduce the risk of respiratory infections in these hospitals.
目前，关于气管内吸引导管使用频率的证据有限。由于资源有限，许多低收入和中等收入国家在一次护理轮班期间仍多次重复使用一次性吸引导管。本综述旨在梳理重复使用一次性气管内吸引导管的做法对机械通气患者预后的影响。
本综述按照循证卫生保健国际协作组织（JBI）的综述方法进行。使用预定义关键词（CINAHL、EMBASE、MEDLINE、全球健康）对四个数据库进行系统检索。对手检关键电子期刊，并对纳入文献的参考文献列表和灰色文献来源进行全面筛选。两名独立评审员完成研究筛选和数据提取。第三名评审员对任何有争议的记录做出最终决定。
共识别出22篇文章，筛选出14条非重复记录，8篇文章进行全文筛选。6篇文章符合纳入标准并纳入本综述。纳入研究的结果存在差异，两项研究发现重复使用一次性吸引导管可能会增加呼吸道感染风险，而另外两项研究发现一次性使用或多次使用的导管之间的污染率没有差异。一项研究表明，重复使用一次性导管是一种安全且具有成本效益的干预措施，最后一项研究报告称，如果在吸痰后用洗必泰冲洗，重复使用一次性导管可能会降低呼吸机相关性肺炎的发生率。
没有确凿证据表明气管内吸引导管的使用频率。需要进一步研究比较机械通气患者使用一次性与多次使用的气管内吸引导管的情况。
由于缺乏有力证据，资源有限国家的护士可遵循医院关于气管内吸引导管更换频率的政策。在重复使用一次性导管时用洗必泰冲洗吸引回路可能会降低这些医院呼吸道感染的风险。
