Endotracheal suctioning of secretions: effects of instillation of normal serum
Lerga C, Zapata MA, Herce A, Martínez A, Margall MA, Asiain MC.
Unidad de Cuidados Intensivos, Clínica Universitaria de Navarra, Escuela Universitaria de Enfermería, Universidad de Navarra, Pamplona.
Normal saline (NS) instillations in the trachea during the technique of endotracheal suctioning is an habitual practice although there is still some controversy about the benefits and harmful effects caused by this practice.
This study was carried out with the objective to compare the effects of instillation or no instillation of NS during the aspiration technique on the oxygenation, amount of secretion obtained, and hemodynamical and ventilatory parameters.
We studied 176 en dotracheal aspirations recorded in the post-operatory of 25 patients without previous pulmonary disease who underwent heart surgery. The aspiration was performed every two hours, according to the protocol of the study. Each patient was its own case and control, so the same patient was aspired altern actively; with and without NS instillation alternatively. Hemodynamical parameters (arterial blood pressure, heart rate), ventilatory parameters (fidal volume, peak inspiratory pressure, respiratory rate) and oxygenation parameters (PaO2, SaO2, SpO2) were analysed in all the samples. The amount of secretion obtained with both techniques was evaluated using weight calculus and total proteins. When analysing the results, we observed that the technique of en dotracheal aspiration causes increases of the Average Arterial Pressure; when NS is used in the aspiration there is a statistically significant decrease of PaO2.
In the evaluation of the amount of secretions we obtained similar amounts with both techniques. Taking all this into account we recommend the elimination of systematical instillation of physiological serum from the protocols of endotracheal aspiration during this technique.
CITA DEL ARTÍCULO Enferm Intensiva. 1997 Jul-Sep;8(3):129-37