Raymond S J
Department of Veterans Affairs Medical Center, Boston, Mass, USA.
Am J Crit Care. 1995 Jul;4(4):267-71.
This research utilization paper reviews the body of published literature on the practice of normal saline instillation before endotracheal suctioning of mechanically ventilated adult patients. Although normal saline instillation before suctioning is a common clinical practice, the research literature does not demonstrate any physiologic benefit to this procedure. Moreover, normal saline instillation may decrease oxygen saturation values (via pulse oximetry) after suctioning. The relevant research studies have been inconsistent and inconclusive because of limitations in sample size and research methodology. Further research studies using larger, more diverse samples, adhering strictly to recommended guidelines for endotracheal suctioning, and examining additional physiologic parameters of oxygenation are necessary. In addition, long-term outcomes of normal saline instillation such as respiratory infection and complications, as well as atelectasis, should be evaluated. Until scientific data can be presented to support the physiologic benefit of this practice, normal saline instillation should be discontinued as a routine or standard practice.
本研究应用论文回顾了已发表的关于对机械通气成年患者进行气管内吸痰前滴注生理盐水做法的文献。尽管吸痰前滴注生理盐水是一种常见的临床操作，但研究文献并未证明该操作有任何生理益处。此外，吸痰后滴注生理盐水可能会降低（通过脉搏血氧饱和度测定的）血氧饱和度值。由于样本量和研究方法的局限性，相关研究一直存在不一致且无定论的情况。有必要开展进一步的研究，使用更大、更多样化的样本，严格遵循气管内吸痰的推荐指南，并检查更多的氧合生理参数。此外，还应评估滴注生理盐水的长期后果，如呼吸道感染和并发症以及肺不张。在能够提供科学数据支持该操作的生理益处之前，应停止将滴注生理盐水作为常规或标准操作。
