Effect of Endotracheal Suctioning with and without Normal Saline on Hemodynamic and Respiratory Parameters in Patients Undergoing Mechanical Ventilation in ICU of Hospitals Supervised by Guilan University of Medical Sciences

2014 ◽  
Vol 7 (2) ◽  
pp. 515-523 ◽  
Author(s):  
Masoomeh Adib ◽  
Atefeh Ghanbari ◽  
Cyrus Emir Alavi ◽  
Ehsan Kazemnezhad Leyli
Keyword(s):  
Mechanical Ventilation ◽  
Normal Saline ◽  
Medical Sciences ◽  
Endotracheal Suctioning ◽  
Respiratory Parameters

scholarly journals Predictors of post-extubation stridor in patients on mechanical ventilation: a prospective observational study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Aiko Tanaka ◽  
Akinori Uchiyama ◽  
Yu Horiguchi ◽  
Ryota Higeno ◽  
Ryota Sakaguchi ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Observational Study ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Prospective Observational Study ◽  
Spontaneous Breathing Trial ◽  
Leak Test ◽  
Endotracheal Suctioning ◽  
Cuff Leak ◽  
The Impact

AbstractThe cuff leak test (CLT) has been widely accepted as a simple and noninvasive method for predicting post-extubation stridor (PES). However, its accuracy and clinical impact remain uncertain. We aimed to evaluate the reliability of CLT and to assess the impact of pre-extubation variables on the incidence of PES. A prospective observational study was performed on adult critically ill patients who required mechanical ventilation for more than 24 h. Patients were extubated after the successful spontaneous breathing trial, and CLT was conducted before extubation. Of the 191 patients studied, 26 (13.6%) were deemed positive through CLT. PES developed in 19 patients (9.9%) and resulted in a higher reintubation rate (8.1% vs. 52.6%, p < 0.001) and longer intensive care unit stay (8 [4.5–14] vs. 12 [8–30.5] days, p = 0.01) than patients without PES. The incidence of PES and post-extubation outcomes were similar in patients with both positive and negative CLT results. Compared with patients without PES, patients with PES had longer durations of endotracheal intubation and required endotracheal suctioning more frequently during the 24-h period prior to extubation. After adjusting for confounding factors, frequent endotracheal suctioning more than 15 times per day was associated with an adjusted odds ratio of 2.97 (95% confidence interval, 1.01–8.77) for PES. In conclusion, frequent endotracheal suctioning before extubation was a significant PES predictor in critically ill patients. Further investigations of its impact on the incidence of PES and patient outcomes are warranted.

scholarly journals Evaluating the Effects of Post-Intubation Endotracheal Suctioning Before Surgery on Respiratory Parameters in Children with Airway Secretion

2019 ◽  
Vol 9 (3) ◽  
Author(s):  
Mahin Seyedhejazi ◽  
Dariush Sheikhzade ◽  
Behzad Aliakbari Sharabiani ◽  
Reyhaneh Abri ◽  
Mahsa Sadeghian
Keyword(s):  
Endotracheal Suctioning ◽  
Respiratory Parameters ◽  
Airway Secretion ◽  
Post Intubation

A survey of endotracheal suctioning with instillation of normal saline

1998 ◽  
Vol 7 (4) ◽  
pp. 255-260 ◽  
Author(s):  
D Schwenker ◽  
M Ferrin ◽  
AG Gift
Keyword(s):  
Adverse Effects ◽  
Normal Saline ◽  
Nursing Intervention ◽  
Educational Programs ◽  
University Teaching ◽  
Pulmonary Infections ◽  
Endotracheal Suctioning ◽  
Respiratory Therapists ◽  
Increased Risk ◽  
Saline Instillation

BACKGROUND: Instillation of normal saline before suctioning is a common nursing intervention although little research supports the practice. OBJECTIVES: To determine when and how often saline is used during suctioning and to assess the knowledge of nurses and respiratory therapists of the advantages and dangers of using saline during endotracheal suctioning. METHODS: A survey of nurses and respiratory therapists working in adult ICUs was conducted in a large university teaching hospital. RESULTS: Of the 187 respondents, 96 (51%) rarely instill saline before suctioning, whereas 61 (33%) frequently use saline. Fifty-five percent use saline to enhance retrieval of secretions, and 45% use it to stimulate a cough. Nurses and respiratory therapists differ in their use and understanding of saline instillation. Most nurses (64%) rarely use saline before suctioning, whereas most respiratory therapists (71%) frequently use saline. Respiratory therapists (57%) were more aware than were nurses (37%) of the benefit of using normal saline to stimulate a cough. Nurses indicated more adverse effects of instillation of normal saline, specifically oxygen desaturation and increased risk of pulmonary infections, than did respiratory therapists. CONCLUSION: The results of the survey helped determine target areas for educational programs for nurses and respiratory therapists. A protocol is being developed for use by all who do suctioning.

Endotracheal saline and suction catheters: sources of lower airway contamination

1994 ◽  
Vol 3 (6) ◽  
pp. 444-447 ◽  
Author(s):  
DA Hagler ◽  
GA Traver
Keyword(s):  
Critical Care ◽  
Normal Saline ◽  
Catheter Insertion ◽  
Lower Airway ◽  
Suction Catheter ◽  
Endotracheal Suctioning ◽  
Saline Irrigation ◽  
Endotracheal Tubes ◽  
Viable Bacteria ◽  
Saline Instillation

BACKGROUND. Normal saline instillation prior to endotracheal suctioning is a critical care ritual that persists despite a lack of demonstrated benefit. Saline instillation may dislodge viable bacteria from a colonized endotracheal tube into the lower airway, overwhelming the defense mechanism of immunocompromised patients. OBJECTIVE. To determine the extent to which normal saline irrigation and suction catheter insertion dislodge viable bacteria from endotracheal tubes. METHODS. Endotracheal tubes from 10 critical care patients intubated for at least 48 hours were obtained immediately after extubation. Each tube was used in random order for both saline instillation and suction catheter insertion. Dislodged material was cultured for quantitative analysis. RESULTS. Suction catheter insertion dislodged up to 60,000 viable bacterial colonies. A 5-mL saline instillation dislodged up to 310,000 viable bacterial colonies. CONCLUSIONS. The potential for infection caused by dislodging bacteria into the lower airway is additional evidence that routine use of saline during suctioning procedures should be abandoned.

Normal saline instillation before suctioning: helpful or harmful? A review of the literature

1995 ◽  
Vol 4 (4) ◽  
pp. 267-271 ◽  
Author(s):  
SJ Raymond
Keyword(s):  
Normal Saline ◽  
Research Utilization ◽  
Research Literature ◽  
Scientific Data ◽  
The Body ◽  
Endotracheal Suctioning ◽  
Common Clinical Practice ◽  
Saline Instillation ◽  
Recommended Guidelines ◽  
Research Studies

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.

Relief of Procedural Pain in Critically Ill Patients by Music Therapy: A Randomized Controlled Trial

2019 ◽  
Vol 26 (3) ◽  
pp. 156-165 ◽  
Author(s):  
Yeşim Yaman Aktaş ◽  
Neziha Karabulut
Keyword(s):  
Mechanical Ventilation ◽  
Music Therapy ◽  
Controlled Trial ◽  
Pain Scale ◽  
Procedural Pain ◽  
Control Group ◽  
Endotracheal Suctioning ◽  
Randomized Controlled ◽  
Pain Scores ◽  
Behavioral Pain Scale

Background: This study aimed to determine the effectiveness of music listening for procedural pain relief using two different observational pain tools during endotracheal suctioning. Materials and Methods: This study was a randomized controlled trial. The sample of the study included 98 patients with mechanical ventilation support who met the selection criteria. The patients were randomly assigned to control and music therapy groups. Patients in the control group were routinely suctioned as usual. Patients in the music group received music therapy 20 min before, during, and 20 min after endotracheal suctioning. The primary outcome was the pain relief during suctioning. Results: Forty patients in each arm completed the study. Pain scores in the Critical Care Pain Observation Tool and Behavioral Pain Scale were lower in the music group than in the control group during endotracheal suctioning (group: F = 14.85, p = 0.000; F = 9.04, p = 0.000, respectively). It was also found to be a significant interaction effect between the groups and time (group × time: F = 17.35, p = 0.000; F = 18.00, p = 0.000, respectively). Conclusion: The Critical Care Pain Observation Tool and Behavioral Pain Scale in the current study generally demonstrated similar pain scores during the painful procedure. Our findings support that music therapy may act as a nonpharmacological therapy to relieve procedural pain in patients on mechanical ventilation.

scholarly journals Efficacy of intravenous Tramadol in prevention of catheter-related bladder discomfort in upper urinary tract surgery

2019 ◽  
Vol 6 (2) ◽  
pp. 45-50
Author(s):  
Sujita Manandhar ◽  
Kishor Manandhar
Keyword(s):  
Urinary Tract ◽  
General Anesthesia ◽  
Normal Saline ◽  
Upper Urinary Tract ◽  
Sedation Score ◽  
Adult Patients ◽  
Urinary Catheterization ◽  
Medical Sciences ◽  
Analgesic Requirement ◽  
Ramsay Sedation Score

Introductions: Catheter-related bladder discomfort (CRBD) is common in patients with urinary catheterization. Centrally acting intravenous opioid like Tramadol inhibits detrusor activity and incidence of CRBD. Present study aims to analyze efficacy of intravenous (IV) Tramadol in prevention of CRBD in patients undergoing upper urinary tract surgery. Methods: Adult patients undergoing elective open upper urinary tract surgeries at Bir Hospital, National Academy of Medical Sciences (NAMS), Nepal, over a period of six months, requiring urinary catheterization were randomly divided into Control (C) and Tramadol (T) groups. After general anesthesia, patients in T-group received IV Tramadol 1.0 mg/kg and C-group received normal saline 30 minutes before extubation. In post-operative ward, CRBD was graded as mild, moderate or severe at 0, 1, 2 and 6 hours. Post-operative Ramsay sedation score and nausea vomiting were compared in two groups. Results: There were total 70 patients, 35 in each of groups-T and C. Incidence of CRBD in T-group was significantly low compared to the C-group at all points of evaluation (p<0.05). Postoperative sedation score, analgesic requirement and nausea vomiting were not significantly different in two groups. Conclusions: Intravenous Tramadol administered before extubation in upper urinary tract surgery reduces the incidence of CRBD.

scholarly journals Comparison of Antimicrobial Efficacy of Calcium Hydroxide and 2% Chlorhexidine as Medicaments

2018 ◽  
Vol 5 (2) ◽  
pp. 8-11
Author(s):  
Rupan Tripathi ◽  
Vanita Gautam ◽  
V. K. Pahwa ◽  
Vikas Agrhari ◽  
Manu Batra ◽  
...  
Keyword(s):  
Calcium Hydroxide ◽  
Normal Saline ◽  
Antimicrobial Efficacy ◽  
Control Group ◽  
Medical Sciences ◽  
Human Teeth ◽  
Honestly Significant Difference ◽  
Significant Difference ◽  
Post Hoc ◽  
Chlorhexidine Gel

INTRODUCTION: The use of intracanal medicaments help in elimination of bacteria that remain even after cleaning and shaping. This study isdone to compare the antimicrobial efficacy of2% chlorhexidine gel and calcium hydroxide as an intracanal medicament against E.faecalis.MATERIAL  & METHODS: Sixty extracted single-rooted human teeth were prepared with standard method. After contaminating the canals with E. Faecalis and incubated for seven days, the samples were divided into four groups (n=15). Normal saline was used as control group. The teeth in each group were treated with normal saline, calcium hydroxide and 2% chlorhexidine gel. Microbial samples were obtained from the dentinal shavings of root and colony forming units (CFU) of E.faecalis were recorded after 24hrs, 72hrs and 7 days.RESULTS: To determine the significance of the differences between the different groups, ANOVA(Analysis of variance) and Tukeys Honestly significant Difference (HSD) Post hoc test were performed. Mean CFU of calcium hydroxide group and 2% chlorhexidine group was statistically significantly different from CFU of all other groups (p<0.01).CONCLUSION: Mean CFU of calcium hydroxide was found to increase at 24 hrs and decreases at 72 hrs and 7 days.The antimicrobial efficacy 2% chlorhexidine gel was better than calcium hydroxide paste.Journal of Universal College of Medical Sciences (2017)Vol.05 No.02 Issue 16, Page: 8-11

scholarly journals Gelatine sponge application in myoma bed to achieve hemostasis during myomectomy – A pilot study

2016 ◽  
Vol 7 (4) ◽  
pp. 19-23
Author(s):  
Manidip Pal ◽  
Suvanjan Chatterjee ◽  
Soma Bandyopadhyay
Keyword(s):  
Pilot Study ◽  
Blood Loss ◽  
Normal Saline ◽  
Medical Sciences ◽  
Operative Blood Loss ◽  
Local Infiltration ◽  
Case Duration ◽  
Good Technique ◽  
Duration Of Operation

Aims and Objectives: To study the efficacy of gelatine absorbable sponge to achieve hemostasis of myoma bed during myomectomy.Materials and Methods: Patient < 40 years with diagnosis of fibroid planned for myomectomy were included. Local infiltration around myoma was done with vasopressin diluted with normal saline (10 units of vasopressin mixed with 100 ml of normal saline). Myomas are easily removed. Gelatin absorbable sponge was applied over the myoma bed and the bed was closed. Proper hemostasis was maintained. Hb deficit was measured postoperatively.Results: Fifteen cases were studied. Vasopressin (diluted) administration ranged from 30-200 ml. Intra-operative blood loss of about 50 ml was noticed in 6 cases, 80 ml – 3 cases, 100 ml – 3 cases, 200 ml – 2 cases, 400 – 1 case. Duration of operation ranged from 60 – 150 minutes. Pre and post-operative Hb% estimation revealed that there was no change in Hb% in 3 cases.Conclusion: Gelatin absorbable sponge application over the myoma bed while closing the area is a good technique to achieve hemostasis during myomectomy. Asian Journal of Medical Sciences Vol.7(4) 2016 19-23   

scholarly journals Physiotherapy approach after lung transplantation in a critically ill COVID-19 patient: a case report

2021 ◽  
Author(s):  
Veronica Rossi ◽  
Serena Tammaro ◽  
Martina Santambrogio ◽  
Mariangela Retucci ◽  
Francesca Gallo ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Lung Transplantation ◽  
Early Mobilization ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Bilateral Lung Transplantation ◽  
Non Invasive Ventilation ◽  
Respiratory Parameters ◽  
Bilateral Lung

This study describes the case of an 18-years-old male affected by severe COVID-19, who was receiving bilateral lung transplantation (LT), after 71 days of mechanical ventilation and 55 days of veno-venous extracorporeal membrane oxygenation. From post-operative day 2, early mobilization and physiotherapy treatments were performed. Weaning from mechanical ventilation, the use of non-invasive ventilation and tracheostomy management were included in the treatment. Forty-five days after LT the patient was discharged at home, showing improvements in terms of functional and respiratory parameters, quality of life and mood. While evidences about physiotherapy treatments in lung transplantation post severe COVID-19 remain limited, early approach and a multidisciplinary team may be considered key elements for functional recovery of these subjects.

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