Applied Research Of Closed Endotracheal Suctioning On Patients With Pulmonary Infection

ObjectiveClosed endotracheal suctioning(CES) and open endotracheal suctioning(OES) were compared inthree aspects as their safety, effectiveness and economical efficiency. The change of heart rates(HR), mean arterial pressure(MAP) and oxygen saturation(SPO2) were investigated to evaluate the safety of both suction practices. Suctioning effectiveness was assessed by its efficacy and frequency, while economical efficacy was determined by material costs and nurse’s workload.This study aimed to provide reliable evidence for choosing the suctioning methods on the premise of assuring the safety of the patients’ body signs, in order to further improve the efficacy of suctioning, reduce the medical costs, enhance patient satisfaction, and promote high quality nursing. Methods130 patients of tracheal intubation via oral cavity, who were cured in the intensive care unit, Tianjin medical university general hospital between July 2014 and February 2015, were randomly assigned to OES Group and CES Group. OES Group(n=62, sum to 127 bronchoscope sputum suctions) were suctioned in OES method by normal suction tubes. CES Group(n=68, sum to 111 bronchoscope sputum suctions) were suctioned in CES method by closed endotracheal suction tubes. We collected the change in HR, MAP, SPO2 from pre-suction baseline, meanwhile recorded sputum volume of this suctioning and the sputum volume in large airway and mucosa condition by bronchoscope sputum suction which was conductedfollowing the suctioning. Thus, the clinical application of ECS could be evaluated in ways of its safety,effectiveness and the economical efficacy, which mayprovide reliable evidence for the choice of different suctioning methods. ResultsCES Group have no obvious change in HR, MAP, SPO2 after suctioning(p>0.05). CES Group also have no obvious change in body signs(p>0.05). But there are 20 items ended sputum head of time for the change of body signs in OES Group, only 7 items in CES Group. CES Group can suction less sputum volume than OES Group(p<0.05). CES Group’s remaining sputum volume in large airway by bronchoscope were obvious more than OES Group’s(p<0.05).Total sputum volume of the two groups have no difference(p>0.05). The all-in cost of suctioning was obvious reduced by CES method in the 7 days after establishing artificial airway. ConclusionCES conducts low influence to body signs, but effectiveness of suctioning is low in sputumviscosity of two degree, if we do not consider the correlation factors ofmechanical ventilation. CES will not increase the cost in suctioning. It is a more economical method if we use CES method in early stage of infection, and change to OES method in restoration stage. This research cannot make sure the relationship of the rate of secondary pulmonary infection and the choice of suctioning methods. In clinical, people should synthesize the material costs and suctioning effectiveness of CES and OES, and choose the best suctioning method overall.