Comparison of the Feasibility and Safety of Nasotracheal Suctioning With Curved Edge Catheter Versus Conventional Suction Catheter in Critically 111 Subjects: A Prospective Randomized Crossover Trial.
BACKGROUND: Nasotracheal suctioning (NTS) is accomplished by inserting a suction catheter into the trachea through the nasopharynx. It is a useful procedure in critically ill patients whose ability to cough and mobilize secretions is impaired. It was assumed that using a suction catheter with an ang...
| Publicado en: | Respiratory Care Vol. 60; no. 12; pp. 1826 - 1834 |
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| Autores principales: | , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Dec2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=111385992&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 111385992 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Dec2015 vid: 60 iid: 12 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 111385992 111385992 111385992 10.4187/respcare.03875 111385992 ppf: 1826 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Comparison of the Feasibility and Safety of Nasotracheal Suctioning With Curved Edge Catheter Versus Conventional Suction Catheter in Critically 111 Subjects: A Prospective Randomized Crossover Trial. aug: au: Grigoriadis, Konstantinos E. Angouras, Dimitrios C. Flevari, Aikaterini Xathos, Theodoras affil: Department of Physical Therapy, Attikon University Hospital, Athens, Greece sug: subj: Suctioning, Nasopharyngeal Endotracheal Tubes Utilization Equipment Design Pilot Studies Critically Ill Patients Inpatients Intensive Care Units Academic Medical Centers Greece Greece Crossover Design Aged P-Value Confidence Intervals Odds Ratio Descriptive Statistics Data Analysis Software Kaplan-Meier Estimator Regression Wilcoxon Rank Sum Test Chi Square Test Patient Safety Clinical Assessment Tools Aged: 65+ years ab: BACKGROUND: Nasotracheal suctioning (NTS) is accomplished by inserting a suction catheter into the trachea through the nasopharynx. It is a useful procedure in critically ill patients whose ability to cough and mobilize secretions is impaired. It was assumed that using a suction catheter with an angular tip would facilitate entry into the trachea. The primary outcome was the success rate and the ease of insertion by using a curved edge catheter (Tiemann type) compared with a conventional suction catheter. The secondary outcome was the monitoring of subject's vital signs during the intervention. METHODS: Non-intubated subjects hospitalized in 2 adult ICUs underwent 2 consecutive NTSs each, using either a 14 French curved edge catheter or a 14 French conventional suction catheter, randomly. RESULTS: Twenty subjects with a mean age of 75.5 y were enrolled for a time period of 5 months. The tracheal access success rate was 19/52 (successful/unsuccessful attempts) using a curved edge catheter (36.5%, 95% CI 23.6-51.0%) compared with 12/130 (9.2%, 95% CI 4.8-15.5%) using a conventional suction catheter. The insertion was 5.6 times more likely to be achieved by using a curved edge catheter (odds ratio 5.66, 95 % CI 2.49-12.84, P < .001). The number of attempts required to succeed in the insertion was significantly lower when using a curved edge catheter than when using a conventional suction catheter (for nasopharynx, median [range] of 1 [1] versus 2.5 [8], P = .001; for trachea, median [range] of 2 [9] versus 9 [9], P = .002). The time required for successful insertion into the nasopharynx and trachea was significantly shorter when using a curved edge catheter than when using a conventional suction catheter (for nasopharynx, median [range] of 3 [11] s versus 5.3 [18] s, P = .038; for trachea, median [range] of 6 [27] s versus 20 [25] s, P = .002). The traumatic rate (percentage of catheters with blood present on the tip) was exactly the same for both catheters (30%). CONCLUSIONS: It is more likely that tracheal access will be achieved using a curved edge catheter. A shorter process time and fewer attempts are required for successful NTS using a curved edge catheter, and it seems to be an equally safe procedure. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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