Journal of Korean Academy of Nursing (대한간호학회지)

Korean Society of Nursing Science (한국간호과학회)
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Effects of a Closed Endotracheal Suction System on Oxygen Saturation, Ventilator-Associated Pneumonia, and Nursing Efficacy

폐쇄형 흡인술이 인공호흡기 환자의 산소포화도, 인공호흡기 관련 폐렴 및 흡인간호 효율성에 미치는 영향

  • Lee Eun-Sook (Department of Nursing, Chonnam National University Medical School, Chonnam Research Institute of Nursing Science) ;
  • Kim Sung-Hyo (Department of Nursing, Chonnam National University Graduate School) ;
  • Kim Jung-Sook (Department of Intensive Care Unit, Chonnam National University Hospital)
  • 이은숙 (전남대학교 의과대학 간호학과, 간호과학연구소) ;
  • 김성효 (전남대학교 대학원 간호학과) ;
  • 김정숙 (전남대학교 병원)
  • Published : 2004.12.01
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Abstract

Purpose: The purpose of this study was to examine the effects of a closed endotracheal suction system(CES) on oxygen saturation, ventilator associated pneumonia(VAP), and nursing efficacy in mechanically ventilated patients. Method: This study was conducted in the intensive care unit of a University Hospital in Gwangju City. Data was collected from July to October, 2003. Seventy mechanically ventilated patients were randomly divided into two groups; 32 for CES and 38 for open endotracheal suction system(OES) protocol. Twenty one nurses were also involved to examine the nurses' attitude of usefulness about CES. Result: $SaO_2$ was significantly different between CES and OES. The incidence of VAP in CES was lower than that of OES. Nursing efficacy was related to time, cost, and usefulness of the suction system. Time of suctioning in CES was shorter than that of OES. CES also contributed significantly to lower the cost of treatment than OES. The usefulness score of CES increased after 6 months of use. Conclusion: CES prevented VAP, was cost effective, and a safe suctioning system. CES can be used with patients with sensitivity to hypoxygenation and with a high risk of VAP.

Keywords

References

  1. Blackwood, B. (1998). The practice and perception of intensive care staff using the closed suctioning system. J Adv. Nursing, 28(5), 1020-1032
  2. Brown, S. E., Stansbury, D. W., & Merrill, E. J. (1983). Prevention of suctioning-related arterial oxygen desaturation. Chest, 83(4), 621-627
  3. Carlon, G. C., Fox, S. J., & Ackerman, N. J. (1987). Evaluation of a closed-tracheal suction system. Critical Care Med., 15, 522-25
  4. CDC (Centers for Disease Control and Prevention. (1995). National Nosocomial Infections Surveillance Semiannual Report, Am. J Infect. Control, 23, 377-385 https://doi.org/10.1016/0196-6553(95)90270-8
  5. Cereda, M., Villa, F., Colombl, E., Greco, G., Nacoti, M., & Pesenti, A. (2001). Closed system endotracheal suctioning maintains lung volume during volume-controlled mechanical ventilation. Intensive Care Med, 27(4), 648-654
  6. DeHaven, B., Morgan, J., Ball, S., Kirton, O., & Shatz, D. (1998). Closed system suction catheter change q 3 day does not impact nosocomial pneumonia in mechanically ventilated patients in a trauma ICU. Critical Care Med., 26(1), 109
  7. Demers, R. R. (1982). Complications of endotracheal suctioning procedures. Respiratory Care, 1, 453-457
  8. Depew, C. L., Moseley, M. J., Clark, E. G., & Morales, C. C. (1994). Open vs closed-system endotracheal suctioning : A cost comparison. Critical Care Nurse, 14(1), 94-100
  9. Deppe, S. A., Kelly, J. W., Thoi, L. L., Chudy, J. H., Longfield, R. N., Ducey, J. P., Truwit, C. L., & Antopol, M. R. (1990). Incidence of cololnization, nosocomial pneumonia, and mortality in critically ill patients using a Trach Care closed-suction system versus an open-suction system: Prospective, randomized study. Critical Care Med, 8, 1389-1393
  10. Grap, M. J., & Munro, C. L. (1997). Ventilator associated pneumonia: clinical significance and implications for nursing, Heart & Lung, 26(6), 419-429 https://doi.org/10.1016/S0147-9563(97)90035-2
  11. Haley, R. W. (1998). Cost-benefit analysis of infection control programs. In J. V. Bennett, & P. S. Brachman (Eds.), Hospital infection (pp. 249-265). Philadelphia; Lippincott- Raven publishers
  12. Harris, J. R., & Miller, T. H. (2000). Preventing nosocomial pneumonia, Critical Care Nurse, 20(1), 51-66
  13. Hijazi, M. H., & Machantyre, N. R. (2000). Advances in infection control, Ventilator-associated pneumonia, Seminar in respiratory and Critical Care Medicine, 21, 245-246
  14. Johnson, K. L., Kearney, P. A., Johnson, S. B., Niblett, J. B., MacMillan, N. L., & McClain, R. E. (1994). Closed versus open endotracheal suctioning: Cost and physiologic consequences. Critical Care Med, 22(4), 658-666
  15. Kim, M. S., Ahn, Y. M., Park, I. O., Choi, S. J., & Yoo, M. Y. (1998). The effect of open endotracheal suctioning (ETS) and close ETS on oxygen saturation and heart rate in premature infants with respiratory distress syndrome. J Korean Academy of Nursing, 28(3), 529-539
  16. Kim, N. C, & Kim, S. Y. (2001). Risk factor for nosocomial pneumonia in patients at NS ICU. J Korea Community Health Nursing Academic Society, 15(2), 239-248
  17. Lee, E. S., Kim, S. H., Kim, J. S., Shin, E. S. (2004). Incidence of colonization, ventilator-assiciated pneumonia as related to the type of endotracheal suction system in mechanically ventilated patients. Chonnam Medical Journal, 40(1), 47-54
  18. McCauley, C. S., & Boller, responses to endotracheal Medicine, 16, 1165-1166
  19. Munford, F. (1991). Use of a closed-suction catheter system on ventilated patients. Am J Inject Control, 19, 120
  20. Noll, M. L., Hix, C. D., & Scott, G. (1990). Closed tracheal suction systems: effectiveness and nursing implications. American Association of Critical-Care Nursing, 1(2), 318-326
  21. Oh, M. D., Oh H. S., Choe, K. W., Jeong, J. S., Pai, C H., Park, E. S., Kim, J. M., & Lee, S. J. (1999). Nosocomial pneumonia in intensive care patients: a prospective study evaluating attributable hospital stay and cost. J Korean Society for Nosocomial Infection Control, 4, 179-191
  22. Schifman R. B., Howanitz, P. J. (1994). Nosocomial infection: a college of american pathologists Q-probe study in 512 north american institutions. Arch Pathol Lab Med, 118, 115-119
  23. Segal-Maurer, S., Urban, C, & Rahal, J. (1996). Current perspectives on multi drug-resistant bacteria, Epidemiology and control. Infect Dis Clin North Am, 10, 939-957 https://doi.org/10.1016/S0891-5520(05)70334-2
  24. Weber, D. J. (1994). Prevention of endotracheal suction induced arterial desaturation with a closed airway system catheter. Respiratory Care, 39(6), 620-627
  25. Weitl, J., & Bettstetter, H. (1994). Indication for the use of closed endotracheal suction : Artificial respiration with high positive end-expiratory pressure. Anaeshtesist, 43(6), 359-363
  26. Zeitoun, S. S., De Barros, A. L., & Diccini, S. (2003). A prospective, randomized study of ventilator-associated pneumonia in patients using a closed vs. open suction system. J Clinical Nursing, 12(4), 484-489