대한간호학회지 (Journal of Korean Academy of Nursing)

한국간호과학회 (Korean Society of Nursing Science)
권호 표지

기관내 흡인으로 인한 저산소증 예방을 위한 중재 효과에 대한 메타분석

Meta-Analysis on the Effectiveness of Interventions Applied to Preventing Endotracheal Suction-Induced Hypoxemia

  • 발행 : 2003.02.01
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초록

Purpose: This study was conducted to investigate the effects of the suction-induced hypoxemia interventions. Method: 30 suction-induced hypoxemia interventions were reviewed for the purpose of meta-analysis. Result: The study showed that both preoxygenation and insufflation were the most frequently examined oxygenation time periods, and hyperoxygenation combined with hyperinflation was the most commonly applied oxygenation method in order to prevent suction-induced hypoxemia. The greatest effect was obtained by providing oxygenation before and after suctioning, whereas negative effect(the contrary results from the study hypotheses) was frequently obtained by applying insufflation only. Applying hyperoxygenation combined with hyperinflation had the greatest effect over that of applying hyperoxygenation only, even though the difference between effect sizes of both methods were statistically significant. Conclusion: The results of meta-analysis showed that the occurrence rate of hypoxemia after suctioning was significantly reduced with the overall interventions for hypoxemia (decreasing 40% of occurrence rate), independent with time periods or methods for providing oxygenation.

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참고문헌

  1. 송혜향 (1998). 의학, 간호학, 사회과학 연구의 메타분석법, 서울, 청문각
  2. Barnes, C. A., & Kirchhoff, K. T. (1986). Minimizing hypoxemia due to endotracheal suctioning: A review of the literature, Heart & Lung, 15(2), 164-178
  3. Bulechek, G. M., & McCloskey, J. C. (1999). Nursing Interventions: Effective nursing treatment, Philadelphia, Pennsylvania, Saunders
  4. Riegel, B., & Forshee, T. (1985). A review and critique of the literature on preoxygenation for endotracheal suctioning, Heart & Lung, 14, 507-518
  5. Wainwright, S. P., & Gould, D. (1996). Endotracheal suctioning: An Example of the problems of relevance and rigour in clinical research, J of Clinical Nursing, 5, 389-398
  6. Anderson, K. M. (1989). The effects of manual baggings versus mechanical ventilatory sighing on oxygenation during the suctioning precedure, Heart & Lung, 18, 301-302
  7. Arai, T., Hatano, Y., Komatsu, K., Takada, T., Miyake, C., Harioka, T., & Reshad, K. (1985). Real-time analysis of the change in arterial oxygen tension during endotracheal suction with a fiberoptic bronchoscope, Critical Care Medicine, 13(1), 855-858
  8. Baker, P., Baker, J. P., & Koen, P. A. (1983). Endotracheal suctioning techniques in hypoxemic patients, Respir Care, 28(12), 1563-1568
  9. Belling, D., Kelley, R. R., Simon, R. (1978). Use of the swivel adaptor aperture during suctioning to prevent hypoxeia in the mechanically ventilated patient, Heart & Lung, 7(2), 320-322
  10. Johnson, K. J., Kearney, P. A., Johnson, S. B., Niblett, S. B., & McClain, R. E. (1994). Closed versus open endotracheal suctioning: Costs and physiologic consequences, Critical Care Medicine, 22(4), 658-666
  11. Bodai B. (1982). A means of suctiomng without cardiopulmonary depression. Heart and Lung, 11, 172
  12. Bodai, B. I., Walton, C. B., Briggs, S., & Goldstein, M. (1987). A clinical evaluation of an oxygen insufflation/suction catheter, Heart & Lung, 16(1), 39-46
  13. Brocard, L., Mion, G., Isabey, D., Bertrand, C., Messadi, A., Mancebo, J., Boussignac, G., Vasile, N., Lemaire, F., & Harf, A. (1991). Constant-flow insufflation prevents arterial oxygen desaturation during endotracheal suctioning, Am Rev Respir Dis, 144, 395-400
  14. Brown, S., Stansbury, D. W., Stansbury, D. W., Merrill, E. J., Linden, G. S., & Light, R. W. (1983). Prevention of suctioning-related arterial oxygen desaturation, Chest, 4, 621-627
  15. Carlon, G. C., Fox, S. J., & Ackman, N. J. (1987). Evaluation of a closed-tracheal suction system, Critical Care Medicine, 15(5), 522-525
  16. Chulay, M. (1988). Arterial blood gas change with a hyperinflation and hyperoxygenation suctioning intervention in critically ill patient, Heart & Lung, 17(6), 654-661
  17. Clark, A., Winslow, E. H., Tyler, D.O., & White, K. M. (1990). Effects of endotracheal suctioning on mixed venous oxygen saturation and heart in critically ill adults, Heart & Lung, 19(5), 552-557
  18. Crabtree Goodnough, S. K. (1985). The effects of oxygen and hyperinflation on arterial oxygen tension after endotracheal suctioning, Heart & Lung, 14(1), 11-17
  19. Craig, K. C., Benson, M. S., & Pierson, D. J. (1984). Prevention of arterial oxygen desaturation during closed-airway endotracheal suction: Effect of ventilator mode, Respir Care, 29(10), 1013-1018
  20. Dougla, S., & Larson, E. L. (1985). The effect of a positive end-expiratory pressure adapter on oxygenation during endotracheal suctioning, Heart & Lung, 14(4), 306-400
  21. Fell, T., & Cheney, F. W. (1971). Prevention of hypoxia during endotracheal suction, Ann Surg, 174(1), 24-28
  22. Hodgson, C., Denehy, L., Ntoumenopoulos, G., Santamaria, J., & Carroll, S. (2000). An investigation of the early effects of manual lung hyperinflation in critically III patients, Anaesth Intensive Care, 28, 255-261
  23. Jung, R. C., & Newman, J. (1982). Minimizing hypoxia during endotracheal airway care, Heart & Lung, 11(3), 208-212
  24. Kathleen, S. S., Talaganis, A. T., Preusser, B., & Gonyon, D. S. (1991). Effect of lung hyperinflation and endotracheal suctioning on heart rate and rhythm in patients after coronary artery bypass graft surgery, Heart & Lung, 20(5), 443-450
  25. Lagnrehr, E., Washburn, S., Guthrie, M. (1981). Oxygen insufflation during endotracheal suctioning. Heart and Lung, 10, 1028
  26. Lookinland, S., & Appel, P. L. (1991). Hemodynamic and oxygen transport changes following endotracheal suctioning in trauma patients, Nursing Research, 40(3), 133-138
  27. Ntoumenopoulos, G., Gild, A., & Cooper, D. J. (1998). The effect of manual lung hyperinflation and postural drainage on pulmonary complications in mechanically ventilated trauma patients, Anaesth Intensive Care, 26, 492-496
  28. Pierce, J. B., & Piazza, D. E. (1987). Differences in postsuctioning arterial blood oxygen concentration values using two postoxygenation methods, Heart & Lung, 16(1), 34-38
  29. Preusser, B. A., Stone, K. S., Gonyon, D. S., Winningham, M. L., Groch, K. F, & Karl, J. E. (1988). Effects of two methods of preoxygenation on mean arterial pressure, cardiac output, peak airway pressure, and postsuction hypoxemia, Heart & Lung, 17(3), 290-299
  30. Rogge, J. A., Bunde, L., & Baun, M. M. (1989). Effectiveness of oxygen concentrations of less than 100% before and after endotracheal suction in patients with chronic obstructive pulmonary disease, Heart & Lung, 18(1), 64-71
  31. Skelley, B., Deeren, S., & Powaser, M. (1980). The effectiveness of two preoxygenation methods to prevent endotracheal suction-induced hypoxemia. Heart and Lung, 9 : 316
  32. Smith, R. M., Benson, M. S., & Schone, R. B. (1987). The efficacy of oxygen insufflation in preventing arterial oxygen desaturation during endotracheal suctioning of mechanically ventilated patients, Respir Care, 32(10), 865-869
  33. Stone, K. S., Vorst, E. C., Lanham, B., & Zahn, S. (1989). Effects of lung hyperinflation on mean arterial pressure and postsuctioning hypoxemia, Heart & Lung, 18(4), 377-385
  34. Weitl, J., & Bettstetter, H. (1994). Indication for use of the closed suction system in respiratory therapy with high levels of positive end-expiratory pressure, Anaesthesist, 43, 359-363