The Analysis Of Aspiration Complications And The Effect Of Different Depth Of Aspiration In ICU Artificial Airway Patients

ObjectiveThis study aimed to survey the rates of sputum suction related complications of department of neurology and neurosurgery ICU patients in Xijing hospital from 2015 to 2016,then identified the influence factors of sputum suction related complications,and explored the sputum suction effects by different depth of sputum suction and the influence of the related complications,providing scientific and reliable theoretical basis for safe and effective clinical sputum suction.Methods1.The first part of this study used retrospective study method to collect the data of the critically patients in department of neurology and neurosurgical ICU in Xijing hospital,from January 2015 to June 2015.Cases in this study were collected by the inclusion and exclusion criteria.Based on related article review,the author used the homemade application of “The questionnaire of influencing factors in sputum suction related complications”.After the experts’ argument,the clinical data was collected.Using Epidata 3.1 software to input the data,and adopting SPSS19.0 statistical software to analyze data,χ² test for categorical data,and t test for measurement data.The significant statistical difference was identified with P < 0.05.2.The second part adopted randomized controlled research method.According to the different depth of sputum suction,150 patients with mechanical ventilation in the hospital of neurosurgical ICU from May 2015 to December 2016 were divided into three groups.In the group A,sputum suction tube insertion depth and endotracheal intubation scale was consistent.In the group B,sputum suction tube was inserted into the trachea intubation deep,then raised 1-2 cm if it was blocked.In the group C,tube insertion depth of endotracheal intubation for sputum suction was 1-2 cm further after calibration.By sputum suction time of 0 min,3 min,6 min,and 9 min,patients’ sputum suction frequency,change of sputum amount and rale,choking cough frequency,mucosal damage and the change of SpO₂,blood pressure and heart rate were respectively observed.The influence of different depth of sputum suction on sputum suction effectiveness and the related complications were compared.Using SPSS19.0 statistical analysis software,taking χ² to test enumeration data,describing measurement data,analyzing variance in view of the independent samples using single factor,comparing different groups using LSD-t test,the difference of data was significant with P < 0.05.Results1.The rate of critical patients with sputum suction related complications and influence factors in the hospital.The study collected a total of 300 patients,include 185 males and115 females with an average age of 47.47 years,average intubation time of 13.01 days and ICU treatment time of 14.6 days.Cerebral infarction,brain tumor surgery and postoperative cerebral hemorrhage patients with higher complication of aspiration of sputum.The incidence of complications related to aspiration of sputum was hypoxemia（41.0%）,bucking（31.7%）and mucosal injury（21.3%）.The intubation time,aspiration,the number of sputum and sputum viscosity had a significant relationship with the suction complication（P<0.05）.2.The influence of different depth of sputum suction of sputum suction effect,and the related complicationsEffectiveness of 24 h sputum suction include frequency,amount of sputum and wheezy phlegm improvement status.There existed significant differences between group B,C and group A with P < 0.05,while there was no statistical significance between B and C（P > 0.05）.Sputum suction related complications include choke to cough and airway mucosa damage,group B with A and C groups had significant difference（P<0.05）,but no statistical significance between group A and C（P > 0.05）.Vital signs changed including heart rate,blood pressure and SpO2,there was no statistical significance among A,B and C group（P>0.05）.Group C and A had statistically significant difference with group B in 3min,6min,9min after Sputum suction（P < 0.05）.After 3min and 6min,group A had a significant statistical difference among group A,B and C（P > 0.05）.Conclusion1.The rate of sputum suction complications in the hospital is relatively high,including hypoxemia,choking cough and mucosa damage.These should be taken as a key point in the process of sputum suction operation to prevent complications.The influencing factors of sputum suction related complications included the intubation time,aspiration,the number of sputum and sputum viscosity.The clinical nursing staff should be given the corresponding prevention measures from the above several aspects to reduce the patients’ sputum suction related complications.2.The results of this study showed that the sputum suction effect in group A is not good,but the rate of the related complication was low.The sputum suction effect in group B is relatively well,but the rate of the related complications is also higher.The effect in group C is the best,and the depth is better than the other two kinds of sputum suction with efficient sputum suction,minimize the related complications and the change of patients’ vital signs.Therefore,make it 1-2 cm further after the sputum suction tube was inserted to the depth scale of endotracheal intubation,could effectively remove more airway secretions of patients,reduce sputum suction frequency,reduce the patients’ discomfort,and improve the efficiency of the nursing staff,which can benefit patients by recover earlier.This method could be applied in critically patients who need sputum suction during the nursing procedures.