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Normal Saline Instillation with Suctioning and its Effect on Oxygen Saturation, Heart Rate, and Cardiac Rhythm
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Background
Although the researches indicated disadvantages of using normal saline (NS) before suctioning, it still used by nurses in many Iranian critical care units.
Aim
The purpose of this study was to determine the effect of NS instillation on multiple trauma patients' oxygen saturation, heart rate and cardiac rhythm.
Setting and design
A cross-over design was used to allow sample to be as their own control. This study was approved by Kerman Medical University.
Methodology
50 multiple trauma patients who were admitted in intensive care unit and mechanically ventilated for at least 24 hours were randomly assigned to suctioning with or without NS. Surveyed parameters were measured and recorded at intervals of 1, 2, and 5 minute before and after suctioning by standard monitoring apparatus. EKG tapes recorded initiate 5 second before suctioning and continue during suctioning approximately 20 second.
Statistical Anlysis
A Kolmogorov-Smirnov test indicated that the data were sampled from a population with normal distribution. The comparison between the two groups in three measured factors was done using a descriptive analysis, and independent ttest, and cross table with chi-square test.
Results
Oxygen saturation in both groups was changed. In group 2(with NS), there was a decrease in oxygen saturation, whereas in another group, except at interval of 1 minute, there was an increase in oxygen saturation. This difference was statistically significant. In both groups, heart rate was increased after suctioning at three intervals. In both group there was not found dangerous arrhythmia .
Conclusion
This study suggests that instillation of NS before suctioning can cause adverse effect on oxygen saturation but has no effect on heart rate and cardiac rhythm. It seems that Iranian nurses believed that using NS have positive effects on suctioning. Such an attitude could be changed by some educational programs by which nurses can improve their knowledge about disadvantages of using NS with suctioning; and become aware of the strategies they can use to qualify suctioning.
Keywords
- Rogers K . The respiratory system. 1st ed . New York : Britannica educational publishing; 2010.
- Kaur SH , Heard S. Airway management and endotrachel intubation . In : Irwin R S , Rippe M J, editors. Intensive care medicine . 6th ed. Philadelphia : Lippincott Williams Wilkins; 2008.p. 4–18.
- Fisher A C, Charlebois L D, Tribble S S, Merrel K P . Patient management : Respiratory system. In : Morton P G , Fontaine D k . Critical care nursing a holistic approach . 9th ed. Philadelphia : Lippincott Williams Wilkins; 2009. P.567– 625.
- . Akgul S , Akyolcum N . Effect of normal saline on endotracheal suctioning . Journal of Clinical Nursing 2002; 11:826–30.
- Leur G P , Zwaveling J H , Loef B G , Schans C P . Endotrachel suctioning versus minimally invasive airway suctioning in intubated patient : prospective randomised controlled trial . Intensive Care Med 2003; 29: 425–32.
- Halm m , Krisko –hagel K .Instillation normal saline with suctioning : beneficial technique or potentially harmful sacred cow ?.Am J Crit Care 2008;17:469–72.
- Ji Y R , Kim H S , Instillation of normal saline before suctioning in patient with pneumonia .Yonsei Medical Journal 2002;3:607–12.
- . Akerman M H . The effect of saline lavage prior to suctioning. Am J Crit care 1993;2:226–30.
- Akerman M H , Mick D J . Instillation of normal saline before suctioning in patient with pulmonary infection: a prospective randomaized controlled trial . Am J Crit Care1998; 7: 261–6.
- Ridling D A , Martin L D , Barton L S . Endothracheal suctioning with or without instillation of isotonic sodium chloride solution in critically ill children. Am J Crit Care 2003;12:212–19.
- Hagler D A , Traver G A . Endotheracheal saline and suction : Sources of lower airway contamination . Am J Crit Care 1993:3:444–47.
- Lerga C et al . Endotracheal suctioning of secretion : effect of instillation of normal serum . Enferm Intensive 1997;8:129–37.
- Shorten D R , Byme P G , Jones R L . Infant responses to saline instillation and suctioning . J Obstet Gynecol Neonatal Nurse 1991;20:464–69.
- Oneal P V , Grap M G , Thompson C , Dudley W . Level of dyspnoea experienced in mechanically ventilated adults with and without saline instillation prior to endotracheal suctioning . Intensive Crit Care Nurse 2001;17:356–63.
- Gray JE, MacIntyre NR, Kronenberger WG . The effect of bolus normal saline instillation in conjunction with endotracheal suctioning . Respiratory care 1990;35:791– 99.
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