Introduction: Endotracheal suction
plays a crucial role in the management of mechanically ventilated patients.
This study aims to evaluate the clinical effectiveness and safety of suction
tubes with markings in mechanically ventilated pediatric patients. Materials
and Methods: A randomized assignment was carried out on a cohort of 52
pediatric patients who underwent mechanical ventilation in the Pediatric
Intensive Care Unit at the Third Affiliated Hospital of Sun Yat-sen University,
covering the period from January 2022 to December 2022. These patients were
divided into two groups: an improved group (n = 26) utilizing marked suction
tubes, and a regular group (n = 26) employing conventional suction tubes. The
objective of our study was to evaluate the clinical effectiveness of marked
suction tubes. Results: The effects of the improved group on the vital signs of
children undergoing mechanical ventilation were small and statistically
significant compared with the regular group (p < 0.05). Additionally, the
improved group exhibited a reduced frequency of sputum suction, shorter mechanical
ventilation duration, and fewer days of hospitalization in the PICU compared to
the regular group during the ventilation period. Notably, the difference in the
duration of PICU hospitalization was statistically significant (p < 0.05).
Moreover, the incidence of adverse reactions in the improved group was notably
lower, with statistically significant differences observed in airway mucous
membrane damage and irritating cough when compared to the regular group (p <
0.05). Conclusion: The utilization of marked suction tubes provides clinical
nurses with clear guidance for performing suctioning with ease, efficiency and
safety. Consequently, advocating for the widespread implementation of marked
suction tubes in clinical practice is a commendable pursuit.
References
[1]
Esteban, A., Frutos-Vivar, F., Muriel, A., Ferguson, N.D., Peñuelas, O., Abraira, V., et al. (2013) Evolution of Mortality over Time in Patients Receiving Mechanical Ventilation. American Journal of Respiratory and Critical Care Medicine, 188, 220-230. https://doi.org/10.1164/rccm.201212-2169OC
[2]
Branson, R.D. (2007) Secretion Management in the Mechanically Ventilated Patient. Respiratory Care, 52, 1328-1342.
[3]
Clini, E. and Ambrosino, N. (2005) Early Physiotherapy in the Respiratory Intensive Care Unit. Respiratory Medicine, 99, 1096-1104.
https://doi.org/10.1016/j.rmed.2005.02.024
[4]
Khemani, R.G., Smith, L., Lopez-Fernandez, Y.M., Kwok, J., Morzov, R., Klein, M., et al. (2019) Pediatric Acute Respiratory Distress Syndrome Incidence and Epidemiology (PARDIE): An International Observational Study. The Lancet Respiratory Medicine, 7, 115-128. https://doi.org/10.1016/S2213-2600(18)30344-8
[5]
Tusman, G., Böhm, S.H., Warner, D.O. and Sprung, J. (2012) Atelectasis and Perioperative Pulmonary Complications in High-Risk Patients. Current Opinion in Anaesthesiology, 25, 1-10. https://doi.org/10.1097/ACO.0b013e32834dd1eb
[6]
Schults, J.A., Long, D.A., Mitchell, M.L., Cooke, M., Gibbons, K., Pearson, K. and Schibler, A. (2020) Adverse Events and Practice Variability Associated with Paediatric Endotracheal Suction: An Observational Study. Australian Critical Care, 33, 350-357. https://doi.org/10.1016/j.aucc.2019.08.002
[7]
Schults, J.A., Cooke, M., Long, D., Schibler, A., Ware, R.S., Charles, K., Irwin, A., and Mitchell, M.L. (2021) Normal Saline and Lung Recruitment with Paediatric Endotracheal Suction (NARES): A Pilot, Factorial, Randomised Controlled Trial. Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses, 34, 530-538. https://doi.org/10.1016/j.aucc.2021.01.006
[8]
Chegondi, M., Francis, T., Lin, W.C., Naqvi, S., Raszynski, A. and Totapally, B.R. (2018) Effects of Closed Endotracheal Suctioning on Systemic and Cerebral Oxygenation and Hemodynamics in Children. Pediatric Critical Care Medicine, 19, e23-e30. https://doi.org/10.1097/PCC.0000000000001377
[9]
Morrow, B.M. and Argent, A.C. (2008) A Comprehensive Review of Pediatric Endotracheal Suctioning: Effects, Indications, and Clinical Practice. Pediatric Critical Care Medicine, 9, 465-477. https://doi.org/10.1097/PCC.0b013e31818499cc
[10]
Abdallah, H., Weingart, M.F., Fuller, R., Pegues, D., Fitzpatrick, R. and Kelly, B.J. (2021) Subglottic Suction Frequency and Adverse Ventilator-Associated Events during Critical Illness. Infection Control and Hospital Epidemiology, 42, 826-832.
https://doi.org/10.1017/ice.2020.1298
[11]
American Association for Respiratory Care (2010) AARC Clinical Practice Guidelines. Endotracheal Suctioning of Mechanically Ventilated Patients with artificial Airways 2010. Respiratory Care, 55, 758-764.
[12]
Mwakanyanga, E.T., Masika, G.M. and Tarimo, E.A.M. (2018) Intensive Care Nurses’ Knowledge and Practice on Endotracheal Suctioning of the Intubated Patient: A Quantitative Cross-Sectional Observational Study. PLOS ONE, 13, e0201743.
https://doi.org/10.1371/journal.pone.0201743
[13]
Guglielminotti, J., Desmonts, J.M. and Dureuil, B. (1998) Effects of Tracheal Suctioning on Respiratory Resistances in Mechanically Ventilated Patients. Chest, 113, 1335-1338. https://doi.org/10.1378/chest.113.5.1335
[14]
Ye, Q.L. (2012) Advances in the Study of Endotracheal Suctioning in Mechanically Ventilated Patients. Chinese Journal of Modern Nursing, 18, 1982-1982.
[15]
Tume, L.N. and Copnell, B. (2015) Endotracheal Suctioning of the Critically Ill Child. Journal of Pediatric Intensive Care, 4, 56-63.
https://doi.org/10.1055/s-0035-1556747
[16]
Gillies, D. and Spence, K. (2011) Deep versus Shallow Suction of Endotracheal Tubes in Ventilated Neonates and Young Infants. The Cochrane Database of Systematic Reviews, 2011, CD003309.
https://doi.org/10.1002/14651858.CD003309.pub2
[17]
Fisk, A.C. (2018) The Effects of Endotracheal Suctioning in the Pediatric Population: An Integrative Review. Dimensions of Critical Care Nursing, 37, 44-56.
https://doi.org/10.1097/DCC.0000000000000275
[18]
Limperopoulos, C., Gauvreau, K.K., O’Leary, H., Moore, M., Bassan, H., Eichenwald, E.C., Soul, J.S., Ringer, S.A., Di Salvo, D.N. and du Plessis, A.J. (2008) Cerebral Hemodynamic Changes during Intensive Care of Preterm Infants. Pediatrics, 122, e1006-e1013. https://doi.org/10.1542/peds.2008-0768
[19]
Morrow, B.M., Futter, M.J. and Argent, A.C. (2004) Endotracheal Suctioning: From Principles to Practice. Intensive Care Medicine, 30, 1167-1174.
https://doi.org/10.1007/s00134-004-2238-0
[20]
de la Escalera, A., Moreno, L.E., Salichs, M.A. and Armingol, J.M. (1997) Road Traffic Sign Detection and Classification. IEEE Transactions on Industrial Electronics, 44, 848-859. https://doi.org/10.1109/41.649946
