@2025 Afarand., IRAN
ISSN: 2252-0805 The Horizon of Medical Sciences 2014;20(2):87-92
ISSN: 2252-0805 The Horizon of Medical Sciences 2014;20(2):87-92
Comparing the Effect of Open and Closed Endotracheal Suctioning on Patients’ Hemodynamic Factors after Coronary Artery Bypass Grafting under Mechanical Ventilation
ARTICLE INFO
Article Type
Original ResearchAuthors
Mohammad Pour A. (1 )Amini Sh. (2 )
Shakeri M.T. (3 )
Mirzaei S. (*)
(*) Nursing-Midwifery Department, Nursing & Midwifery Faculty, Gonabad University of Medical Sciences, Gonabad, Iran
(1 ) Medical-Surgical Nursing Department, Nursing & Midwifery Faculty, Gonabad University of Medical Sciences, Gonabad, Iran
(2 ) Anesthesiology Department, Medicine Faculty, Mashhad University of Medical Sciences, Mashhad, Iran
(3 ) Social Medicine Department, Medicine Faculty, Mashhad University of Medical Sciences, Mashhad, Iran
Correspondence
Address: No. 18, 13th Banafshe Street, Sajjad Bolevard, Mashhad, Khorasan Razavi, Iran. Postal Code: 9187743446Phone: +985118525208
Fax: +985118591057
sahereh_mirzaei@yahoo.com
Article History
Received: March 5, 2014Accepted: May 12, 2014
ePublished: July 1, 2014
ABSTRACT
Aims
Endotracheal suctioning in patients after coronary artery bypass grafting and
under mechanical ventilation can be performed to remove endotracheal secretions
with two open and closed methods. The aim of this study was to compare the effect
of open and closed endotracheal suctioning on hemodynamic factors of patients after
coronary artery bypass grafting under mechanical ventilation.
Materials & Methods This study is a single-blind clinical trial which was done in the intensive care unit of open heart surgery of Imam Reza Hospital of Mashhad on 130 patients after coronary artery bypass grafting under mechanical ventilation who met the criteria of the study in 2013. Subjects were randomly divided into two open and closed suctioning groups with two-stage method after convenience sampling method. Mean arterial pressure and heart rate were compared at baseline, immediately after suctioning, and at one minute interval after suctioning for five minutes between the two groups. For data analysis, repeated measures ANOVA, independent T and paired T tests were used through SPSS 16 software.
Findings Heart rate and mean arterial pressure did not change significantly between the two groups during and after open and closed suction system. No significant difference observed with regards to heart rhythm in both suction system groups as well.
Conclusion Changes in mean arterial pressure, heart rate and heart rhythm in patients with coronary artery bypass grafting under open and closed suctioning are the same and one system could not be preferred over the other.
Materials & Methods This study is a single-blind clinical trial which was done in the intensive care unit of open heart surgery of Imam Reza Hospital of Mashhad on 130 patients after coronary artery bypass grafting under mechanical ventilation who met the criteria of the study in 2013. Subjects were randomly divided into two open and closed suctioning groups with two-stage method after convenience sampling method. Mean arterial pressure and heart rate were compared at baseline, immediately after suctioning, and at one minute interval after suctioning for five minutes between the two groups. For data analysis, repeated measures ANOVA, independent T and paired T tests were used through SPSS 16 software.
Findings Heart rate and mean arterial pressure did not change significantly between the two groups during and after open and closed suction system. No significant difference observed with regards to heart rhythm in both suction system groups as well.
Conclusion Changes in mean arterial pressure, heart rate and heart rhythm in patients with coronary artery bypass grafting under open and closed suctioning are the same and one system could not be preferred over the other.
CITATION LINKS
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[4]Mir Mohammad Sadeghi M, Naghiloo A, Najarzadegan MR. Evaluating the relative frequency and predicting factors of acute renal failure following coronary artery bypass grafting. ARYA Atheroscler. 2013;9(5):287-92.
[5]Blackledge HM, Squire IB. Improving long-term outcomes following coronary artery bypass graft or percutaneous coronary revascularisation: Results from a large, population-based cohort with first intervention 1995- 2004. Heart. 2009;95(4):304-11.
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[7]Serruys PW, Morice MC, Kappetein AP, Colombo A, Holmes DR, et al. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. N Engl J Med. 2009;360(10):961-72.
[8]Seyyed Mazhari M, Pishgou’ei AH, Zareian A, Habibi H. Effect of open and closed endotracheal suction systems on heart rhythm and artery blood oxygen level in intensive care patients. J Crit Care Nurs. 2010;2(4):1-2.
[9]Pedersen CM, Rosendahl-Nielsen M, Hiermind J, EgeroldI. Endoteracheal suctioning of the adult intubated patient-what is the evidence?. Intensive Crit Care Nurs. 2009;25(1):21-30.
[10]Jongerden IP, Kesecioglu J, Speelberg B, Buiting AG, Leverstein-van Hall MA, Bonten MJ. Changes in heart rate, mean arterial pressure, and oxygen saturation after open and closed endotracheal suctioning: A prospective observational study. J Crit Care. 2012;27(6):647-54.
[11]Nazmiyeh H, Mirjalili MR, Emami Maibodi R. Comparison of the effects of open and closed endotracheal suction on cardiovascular and ventilation parameters for patients undergoing mechanical ventilation. J Rafsanjan Univ Med Sci. 2010;9(2):97-106. [Persian]
[12]Subirana M, Solà I, Benito S. Closed tracheal suction systems versus open tracheal suction systems for mechanically ventilated adult patients. Cochrane Database Syst Rev. 2007;(4):CD004581.
[13]Rodrigues RR, Sawada AY, Rouby JJ, Fukuda MJ, Neves FH, Carmona MJ, et al. Computed tomography assessment of lung structure in patients undergoing cardiac surgery with cardiopulmonary bypass. Braz J Med Biol Res. 2011;44(6):598-605.
[14]Briassoulis G, Briassoulis P, Michaeloudi E, Fitrolaki DM, Spanaki AM, Briassouli E. The effects of endotracheal suctioning on the accuracy of oxygen consumption and carbon dioxide production measurements and pulmonary mechanics calculated by a compact metabolic monitor. Anesth Analg. 2009;109(3):873-9.
[15]Weitl J, Bettstetter H. Indication for the use of closed endotracheal suction. Artifitial respiration with high positive end expiratory pressure. Anaesthetist. 1994;43(6):359-63.
[16]Jongerden IP, Rovers MM, Grypdonck MH, Bonten MJ. Open and closed endotracheal suction systems in mechanically ventilated intensive care patients: a metaanalysis. Crit Care Med. 2007;35(1):260-70.
[17]Cereda M, Villa F, Colombo E, Greco G, Nacoti M, Pesenti A. Closed system endotracheal suctioning maintains lung volume during volume-controlled mechanical ventilation. Intensive Care Med. 2001;27(4):648-54.
[18]Valderas CD, Bravo PC, Torres GJ, Corniero PA, Ambit LR, López AE. Repercussion on respiratory and hemodynamic parameters with a closed system of aspiration of secretion. Enferm Intensiva. 2004;15(1):3-10.
[19]Lee CK, Ng KS, Tan SG, Ang R. Effect of different endotracheal suctioning systems on cardiorespiratory parameters of ventilated patients. Ann Acad Med Singapore.2001;30(3):239-44.
[20]Zolfaghari M, Nikbakht Nasrabadi A, Karimi A, Haghani H. Effects of open and closed endotracheal suction on vital signs in intensive care patients. Hayat. 2008;14(1):13-20. [Persian]
[21]Lee ES, Kim SH, Kim JS. Effects of a closed endotracheal suction system on oxygen saturation ventilator associated pneumonia and nursing efficacy. Taehan Kanhan Hakhoe Chi. 2004;34(7):1315-25.
[22]Hashemi SJ, Jabal Ameli M, Soltani HA, Heydari SM. Frequency of cardiac dysrythmia, blood pressure changes and level of arterial oxygen saturation during endotracheal suctioning in intensive care unit patients. J Guilan Uni Med Sci. 2006;14(56):48-53.
[2]Rahmani R. Heart critical cares in CCU. 1st ed. Tehran: Teymourzade; 2001. [Persian]
[3]Ascione R, Lloyd CT, Underwood MJ, Lotto AA, Pitsis AA, Angelini GD. Inflammatory response after coronary revascularization with or without cardiopulmonary bypass. Ann Thorac Surg. 2000;69(4):1198-204.
[4]Mir Mohammad Sadeghi M, Naghiloo A, Najarzadegan MR. Evaluating the relative frequency and predicting factors of acute renal failure following coronary artery bypass grafting. ARYA Atheroscler. 2013;9(5):287-92.
[5]Blackledge HM, Squire IB. Improving long-term outcomes following coronary artery bypass graft or percutaneous coronary revascularisation: Results from a large, population-based cohort with first intervention 1995- 2004. Heart. 2009;95(4):304-11.
[6]Van Domburg RT, Kappetein AP, Bogers AJ. The clinical outcome after coronary bypass surgery: A 30-year follow-up study. Eur Heart J. 2009;30(4):453-8.
[7]Serruys PW, Morice MC, Kappetein AP, Colombo A, Holmes DR, et al. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. N Engl J Med. 2009;360(10):961-72.
[8]Seyyed Mazhari M, Pishgou’ei AH, Zareian A, Habibi H. Effect of open and closed endotracheal suction systems on heart rhythm and artery blood oxygen level in intensive care patients. J Crit Care Nurs. 2010;2(4):1-2.
[9]Pedersen CM, Rosendahl-Nielsen M, Hiermind J, EgeroldI. Endoteracheal suctioning of the adult intubated patient-what is the evidence?. Intensive Crit Care Nurs. 2009;25(1):21-30.
[10]Jongerden IP, Kesecioglu J, Speelberg B, Buiting AG, Leverstein-van Hall MA, Bonten MJ. Changes in heart rate, mean arterial pressure, and oxygen saturation after open and closed endotracheal suctioning: A prospective observational study. J Crit Care. 2012;27(6):647-54.
[11]Nazmiyeh H, Mirjalili MR, Emami Maibodi R. Comparison of the effects of open and closed endotracheal suction on cardiovascular and ventilation parameters for patients undergoing mechanical ventilation. J Rafsanjan Univ Med Sci. 2010;9(2):97-106. [Persian]
[12]Subirana M, Solà I, Benito S. Closed tracheal suction systems versus open tracheal suction systems for mechanically ventilated adult patients. Cochrane Database Syst Rev. 2007;(4):CD004581.
[13]Rodrigues RR, Sawada AY, Rouby JJ, Fukuda MJ, Neves FH, Carmona MJ, et al. Computed tomography assessment of lung structure in patients undergoing cardiac surgery with cardiopulmonary bypass. Braz J Med Biol Res. 2011;44(6):598-605.
[14]Briassoulis G, Briassoulis P, Michaeloudi E, Fitrolaki DM, Spanaki AM, Briassouli E. The effects of endotracheal suctioning on the accuracy of oxygen consumption and carbon dioxide production measurements and pulmonary mechanics calculated by a compact metabolic monitor. Anesth Analg. 2009;109(3):873-9.
[15]Weitl J, Bettstetter H. Indication for the use of closed endotracheal suction. Artifitial respiration with high positive end expiratory pressure. Anaesthetist. 1994;43(6):359-63.
[16]Jongerden IP, Rovers MM, Grypdonck MH, Bonten MJ. Open and closed endotracheal suction systems in mechanically ventilated intensive care patients: a metaanalysis. Crit Care Med. 2007;35(1):260-70.
[17]Cereda M, Villa F, Colombo E, Greco G, Nacoti M, Pesenti A. Closed system endotracheal suctioning maintains lung volume during volume-controlled mechanical ventilation. Intensive Care Med. 2001;27(4):648-54.
[18]Valderas CD, Bravo PC, Torres GJ, Corniero PA, Ambit LR, López AE. Repercussion on respiratory and hemodynamic parameters with a closed system of aspiration of secretion. Enferm Intensiva. 2004;15(1):3-10.
[19]Lee CK, Ng KS, Tan SG, Ang R. Effect of different endotracheal suctioning systems on cardiorespiratory parameters of ventilated patients. Ann Acad Med Singapore.2001;30(3):239-44.
[20]Zolfaghari M, Nikbakht Nasrabadi A, Karimi A, Haghani H. Effects of open and closed endotracheal suction on vital signs in intensive care patients. Hayat. 2008;14(1):13-20. [Persian]
[21]Lee ES, Kim SH, Kim JS. Effects of a closed endotracheal suction system on oxygen saturation ventilator associated pneumonia and nursing efficacy. Taehan Kanhan Hakhoe Chi. 2004;34(7):1315-25.
[22]Hashemi SJ, Jabal Ameli M, Soltani HA, Heydari SM. Frequency of cardiac dysrythmia, blood pressure changes and level of arterial oxygen saturation during endotracheal suctioning in intensive care unit patients. J Guilan Uni Med Sci. 2006;14(56):48-53.