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ORIGINAL ARTICLE
Year : 2015  |  Volume : 20  |  Issue : 2  |  Page : 195-199

Comparing the effect of open and closed endotracheal suctioning on pain and oxygenation in post CABG patients under mechanical ventilation


1 Department of Nursing, School of Nursing and Midwifery, Gonabad University of Medical Sciences, Gonabad, Iran
2 Department of Anesthesiology and Critical Care, Mashhad University of Medical Sciences, Mashhad, Iran
3 Department of Social Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
4 School of Nursing and Midwifery, Gonabad University of Medical Sciences, Gonabad, Iran

Correspondence Address:
Sahereh Mirzaei
Cardiac Surgery ICU, Imam Reza Hospital, Mashhad
Iran
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Source of Support: Gonabad University of Medical Sciences, Conflict of Interest: None


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Clinical trial registration IRCT2013042713134N1

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Background: The aim of this study was to compare changes in pain, oxygenation, and ventilation following endotracheal suctioning with open and closed suctioning systems in post coronary artery bypass grafting (CABG) patients. Materials and Methods:130 post CABG mechanically ventilated patients were randomly allocated to undergo either open (n0 = 75) or closed (n = 55) endotracheal suctioning for 15 s. The patients received 100% oxygen for 1 min before and after suctioning. Pain score using critical-care pain objective tool (CPOT) was compared during suctioning between the two groups. Arterial oxygen pressure (PaO 2 ), PaO 2 to fraction of inspired oxygen (FiO 2 ) (PF) ratio, and arterial carbon dioxide pressure (PaCO 2 ) were compared at baseline and 5 min after suctioning. Peripheral oxygen saturation (SpO 2 ) was compared at baseline, during suctioning, and at 1 min interval after suctioning for 5 min between the two groups. Results:The patients were the same with regard to CPOT scores, i.e. 3.21 (1.89) and 2.94 (1.56) in the open and closed suctioning systems, respectively. SpO 2 did not change significantly between the two groups. Changes in PaO 2 and PF ratio was more significant in the open than in the closed system (P = 0.007). Patients in the open group had a higher PaCO 2 than those in the closed group, i.e. 40.54 (6.56) versus 38.02 (6.10), and the P value was 0.027. Conclusions: Our study revealed that patients' pain and SpO 2 changes are similar following endotracheal suctioning in both suctioning systems. However, oxygenation and ventilation are better preserved with closed suctioning system.


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