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.

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 endotracheal suctioning: “What does the evidence say? What do the nurses think?”: Multimethod study

2015 ◽  
Vol 30 (4) ◽  
pp. 762-767 ◽  
Author(s):  
Hatice Ayhan ◽  
Sevinc Tastan ◽  
Emine Iyigun ◽  
Yagmur Akamca ◽  
Elif Arikan ◽  
...  
Keyword(s):  
Normal Saline ◽  
Endotracheal Suctioning ◽  
Saline Instillation

Insanity Plea: A Review of the Research Literature

1981 ◽  
Vol 9 (4) ◽  
pp. 357-401 ◽  
Author(s):  
Richard A. Pasewark
Keyword(s):  
Data Base ◽  
Research Literature ◽  
Limited Data ◽  
Insanity Plea ◽  
Research Studies

This article summarizes the limited number of data-based research studies relating to the insanity plea that are to be found in the literature. Although some tentative conclusions might be made concerning some aspects of the plea's operation, the limited data base available makes these conclusions highly tentative and demonstrates the need of much further research in this area.

scholarly journals Methodological Peculiarities of the Usage of Stretching Techniques in the Process of Flexibility Development

2017 ◽  
pp. 127-130
Author(s):  
Oksana Romaniuk ◽  
Bohdan Zadvornyi
Keyword(s):  
Human Body ◽  
Physiological Mechanism ◽  
Semantic Content ◽  
Scientific Data ◽  
Physical Activities ◽  
The Body ◽  
Human Being ◽  
Practical Application ◽  
Stretching Exercises

The article is devoted to theoretical and methodological substantiations of the body flexibility development practically applying the stretching techniques. It was generalized scientific data on the organization and methodological features of stretching exercises. Semantic content and structural componential model of stretching usage in the process of flexibility development and the estimation of the changes of this characteristic according to the age were carried out. In particular, some parameters were highlighted especially which allow to recommend that methodology both for individual and group usage were analyzed. Besides, it was analyzed the diversity of physiological mechanism of the influence of stretching on human body, especially it was singled out the effect on mental and physical spheres of human being. The generalized scientific data on the theoretical and practical aspects of flexibility development with the help of stretching techniques indicate the priority of usage of this method in many types of physical activities irrespective of the scope of its practical application.

scholarly journals Biochemical and Haemodynamic Effects of Crystalloid Solutions Administered During Perioperative Period

2009 ◽  
pp. 33-37
Author(s):  
Debasish Banik ◽  
Qumrul Huda ◽  
Abdul Hye ◽  
KM Iqbal
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Pulse Rate ◽  
Normal Saline ◽  
Urine Output ◽  
Perioperative Period ◽  
The Body ◽  
Post Operative Period ◽  
Significant Difference ◽  
Group A

Forty five (45) ASA grade I & II patients aged between 21 to 55 years, scheduled for electiv abdominal surgery (incision not exceeding 15 cm with minimal blood loss, under general anaesthesia were randomly allocated into three groups (A, and C). Patients of Group A, B and C received infusion of 5% dextrose aqua, normal saline and 5% dextrose in normal saline respectively throughout perioperative course (upto 24 hours after operation). Each group received post operative period. Parameters recorded were mean arterial pressure (MAP), Pulse, Serum elecirolyte (Na+, K+), amount of fluid in fused and urine output during operation and postoperatively Blood samples for serum electrolyte estimation were taken just before induction, immediately before reversal and twenty four hours after surgery. A standard anaesthetic technique was followed for all groups.Percentage increase from pre-operative values were calculated for mean arterial pressure, pulse rate and serum electrolytes. The ratio between urine output and fluid infused during per- and post-operative period were calculated. There were statistically significant (p<0.05) difference between group A and C in perand post-operative change in pulse rate and statistically significant difference (p<0.05) in postoperative output/input ratio between group A and B and highly significant (p<0.01) between A and C. Electrolyte containing fluids of higher osmolality caused increased diuresis in per-operative period and increased pulse rate in post-operative period. So, although there are few difference between three fluids, these didnot produce any effects( beneficial or detrimental) on the body system under normal conditions. Journal of BSA, Vol. 19, No. 1 & 2, 2006 p.33-37

Designing Effective Online Educational Literature Searches

2011 ◽  
pp. 190-201
Author(s):  
Robert Sandieson ◽  
Jack Hourcade ◽  
Val Sharpe
Keyword(s):  
Research Policy ◽  
Research Literature ◽  
Source Material ◽  
Online Resources ◽  
Policy And Practice ◽  
Original Source ◽  
General Methodology ◽  
Educational Literature ◽  
Literature Searches ◽  
Research Studies

Knowing the existing research literature has become important for anyone involved with education, informed research, policy, and practice rests on an understanding of unfiltered original source material. Although there has been a proliferation of research studies which are now easily accessible through online resources, being able to find information on specific topics is proving to be a challenge even for experienced researchers. This chapter describes a procedure which first identified field-specific terminology associated with original source material. The parallel terms used in the ERIC database to code the same material was then found. The resulting parallel list of ERIC keywords was tested and validated for preciseness. The finding was that each term’s precision could be established. The general methodology developed here is presented as a way of enhancing peoples’ use of online resources.

The Substrate and Properties of Meridians: A Review of Modern Research

1999 ◽  
Vol 17 (2) ◽  
pp. 134-139 ◽  
Author(s):  
Haifeng Wei ◽  
Lawrence Chung-Long Huang ◽  
Jian Kong
Keyword(s):  
Scientific Theory ◽  
Research Literature ◽  
The Body ◽  
Structural Basis ◽  
Sufficient Evidence ◽  
Partial Explanation ◽  
Normal Tissues ◽  
Vascular Channels ◽  
Ionic Movement ◽  
Orderly Arrangement

Meridians are regarded as the base upon which traditional acupuncture theory is built but, although much research time has been spent on their investigation, no coherent scientific theory has emerged to explain their structure or mode of action. There have been several hypotheses that offer sufficient evidence for a partial explanation for certain meridians. This paper suggests that there is indeed no single answer, but that the various hypotheses should be combined, accepting that different explanations are likely for different meridians or parts of the body. The most useful tool for investigation seems to be the phenomenon of propagated sensation along meridians. Experiments indicate that physical transmission occurs most generally through the interstitial space, specifically along the neurovascular bundles, rather than through vascular channels. The mechanism of meridian activity is likely to be via neuro-transmitters, found particularly along meridian lines, and by ionic movement. This review of research literature, much of which has emanated from China, concludes that there is a real structural basis for the meridians, but that this structure is the orderly arrangement of normal tissues along the line of meridians rather than any special histological feature.

Sign in / Sign up

Export Citation Format

Share Document