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.

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

Evaluation of Nursing Intervention on Post-operative Pain Among Surgical Patients in Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife Osun State

2018 ◽  
Vol 8 (11) ◽  
Author(s):  
Olajide Tayo Emmanuel ◽  
Adetunji Oluseye Adetayo ◽  
Ope-Babadele Oluwatosin Oyindamola ◽  
Ojo Eunice Abimbola ◽  
Salawu Rasidi Akinade
Keyword(s):  
Teaching Hospital ◽  
Nursing Intervention ◽  
University Teaching ◽  
Surgical Patients ◽  
Post Operative Pain

scholarly journals Are Probiotics and Prebiotics Safe for Use during Pregnancy and Lactation? A Systematic Review and Meta-Analysis

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2382
Author(s):  
Hauna Sheyholislami ◽  
Kristin L. Connor
Keyword(s):  
Systematic Review ◽  
Adverse Effects ◽  
English Language ◽  
Clinical Decision Making ◽  
Lactobacillus Rhamnosus ◽  
Potential Health ◽  
Increased Risk ◽  
Pregnancy And Lactation ◽  
Adverse Pregnancy ◽  
Synbiotic Supplementation

Probiotic and prebiotic products have shown potential health benefits, including for the prevention of adverse pregnancy outcomes. The incidence of adverse effects in pregnant people and their infants associated with probiotic/prebiotic/synbiotic intake, however, remains unclear. The objectives of this study were to evaluate the evidence on adverse effects of maternal probiotic, prebiotic, and/or synbiotic supplementation during pregnancy and lactation and interpret the findings to help inform clinical decision-making and care of this population. A systematic review was conducted following PRISMA guidelines. Scientific databases were searched using pre-determined terms, and risk of bias assessments were conducted to determine study quality. Inclusion criteria were English language studies, human studies, access to full-text, and probiotic/prebiotic/synbiotic supplementation to the mother and not the infant. In total, 11/100 eligible studies reported adverse effects and were eligible for inclusion in quantitative analysis, and data were visualised in a GOfER diagram. Probiotic and prebiotic products are safe for use during pregnancy and lactation. One study reported increased risk of vaginal discharge and changes in stool consistency (relative risk [95% CI]: 3.67 [1.04, 13.0]) when administering Lactobacillus rhamnosus and L. reuteri. Adverse effects associated with probiotic and prebiotic use do not pose any serious health concerns to mother or infant. Our findings and knowledge translation visualisations provide healthcare professionals and consumers with information to make evidence-informed decisions about the use of pre- and probiotics.

Purulent Otitis Media: Differences Between Populations in Different Environments

PEDIATRICS ◽  
1974 ◽  
Vol 53 (2) ◽  
pp. 135-136
Author(s):  
Patrick Manning ◽  
Mary Ellen Avery ◽  
Alan Ross
Keyword(s):  
Hearing Loss ◽  
Adverse Effects ◽  
Language Development ◽  
Otitis Media ◽  
Early Life ◽  
Educational Programs ◽  
Previous Issue ◽  
High Incidence ◽  
History Of ◽  
Tympanic Membranes

The paper by Kaplan and colleagues in a previous issue starts by emphasizing the unusually high incidence of otitis media among Eskimo children. Forty-one percent of their cohort of 489 Alaskan Eskimo children, followed for ten years, had perforations or scars of the tympanic membranes; significant hearing losses were present in 16% of the group. Among the 374 children with a history of otorrhea, 291 (78%) had their first attack before their second birthday. The adverse effects of hearing loss in early life on language development were underscored by the authors, who quite properly point out the need for special educational programs.

Cardiovascular events in patients with type 2 diabetes

2002 ◽  
Vol 2 (1_suppl) ◽  
pp. S4-S8
Author(s):  
Erland Erdmann
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Risk Factor ◽  
Adverse Effects ◽  
Cardiovascular Events ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Increased Risk

Diabetes is a common risk factor for cardiovascular disease. Coronary heart disease and left ventricular dysfunction are more common in diabetic patients than in non-diabetic patients, and diabetic patients benefit less from revascularisation procedures. This increased risk can only partly be explained by the adverse effects of diabetes on established risk factors; hence, a substantial part of the excess risk must be attributable to direct effects of hyperglycaemia and diabetes. In type 2 diabetes, hyperinsulinaemia, insulin resistance and hyperglycaemia have a number of potential adverse effects, including effects on endothelial function and coagulation. Risk factor modification has been shown to reduce the occurrence of cardiovascular events in patients with diabetes; indeed, diabetic patients appear to benefit more in absolute terms than non-diabetic patients. There is thus a strong case for intensive treatment of risk factors, including insulin resistance and hyperglycaemia, in patients with type 2 diabetes.

scholarly journals Opioid Use and the Risk of Respiratory Depression and Death in the Pediatric Population

2013 ◽  
Vol 18 (4) ◽  
pp. 269-276 ◽  
Author(s):  
Marianne R. Whittaker
Keyword(s):  
Clinical Trials ◽  
Adverse Effects ◽  
Respiratory Depression ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Opioid Use ◽  
Randomized Controlled ◽  
Randomized Controlled Studies ◽  
Increased Risk ◽  
Significant Difference

BACKGROUND Pediatric patients may be at an increased risk of adverse effects from various medications. Recently, there have been a number of serious adverse events, including several pediatric patients experiencing severe respiratory depression and death as a result of the use of codeine for pain control following tonsillectomy and adenoidectomy. OBJECTIVE To assess the safety of opioid agonists in pediatric patients undergoing operative procedures or have experienced trauma and to evaluate the risk of respiratory depression and death among this population. METHODS PubMed and Medline were searched to identify randomized controlled studies from 1994 to 2012 addressing postsurgery/trauma opioid use in pediatric patients. Relative risks and confidence intervals (CIs) were calculated using data available in clinical trials. RESULTS A total of 16 clinical trials were evaluated for this review. Randomized controlled trials included studies comparing opioids versus non-opioids for a variety of painful conditions. The relative risk of respiratory depression associated with opioid use in 1 trial was 1.63 (95% CI: 0.64–6.13). The remaining 15 trials reviewed described no significant difference in respiratory depression or adverse effects associated with treatment. No deaths were attributed to opioid use in any of these studies. CONCLUSION Opioid-associated respiratory depression was very rare and no deaths were reported in the reviewed studies. These findings under the well-defined conditions of controlled studies may not be the best means of determining overall opioid-associated side effects in pediatric patients.

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