A Meta analysis on effects of different sputum suction time_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

HUO Shaojuan ^1,2 , TIAN Jinhui ³ , ZENG Xiaoli ² , LI Fei ² , ZHOU Linlin ¹ , SU Yan ¹ ,  LIU Xiaoju ²

1. College of Nursing, Lanzhou University, Lanzhou, Gansu 730000, P. R. China;
2. Department of Geratological Respiratory Medicine, The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P. R. China;
3. Evidence-based Medicine Center, Lanzhou University, Lanzhou, Gansu 730000, P. R. China;

Corresponding author：

LIU Xiaoju, Email: liuxiaoju835@126.com

Keywords：

Time-worn ritual endotracheal suction; On-demand invasive airway suction; Meta-analysis

DOI：

10.7507/1671-6205.201809044

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To analyze the effects of time-worn ritual endotracheal suction (TRES) and on-demand invasive airway suction (OIAS) for patients.Methods PubMed, EMBASE, Cochrane Library, Web of Science, EBSCO, CBM, CNKI, WanFang and VIP databases were searched for all randomized controlled trials (RCTs) comparing TRES with OIAS for patients. The studies were selected according to inclusion and exclusion criteria. The articles were assessed and data were extracted from them. The RevMan 5.3 software was used to analyze the data.Results Seventeen randomized controlled trials were included finally, and 2 029 patients were included, involving 1 028 patients in the control group and 1 001 patients in the experimental group. The results of meta-analysis showed that compared with TRES, OIAS could reduce the damage to the airway mucosa injury (RR=0.18, 95%CI 0.13 - 0.26, P<0.000 01), reduce secondary respiratory infections (RR=0.44, 95%CI 0.30 - 0.65, P<0.000 1), decrease the occurrence of phlegm blockade (RR=0.20, 95%CI 0.13 - 0.33, P<0.000 01), shorten the hospital stay (MD=5.03, 5%CI 3.17 - 6.89, P<0.000 01), but not influence the drop in oxygen saturation and the drop in blood oxygen pressure (RR=0.50, 95%CI 0.21 - 1.17, P=0.11). However there was no significant difference in mortality between two groups (P=0.46).Conclusion OIAS is preferred for patients who need suction than TRES.

Citation： HUO Shaojuan, TIAN Jinhui, ZENG Xiaoli, LI Fei, ZHOU Linlin, SU Yan, LIU Xiaoju. A Meta analysis on effects of different sputum suction time. Chinese Journal of Respiratory and Critical Care Medicine, 2019, 18(5): 461-468. doi: 10.7507/1671-6205.201809044 Copy

1.	American Association for Respiratory Care. AARC Clinical Practice Guidelines. Endotracheal Suctioning of Mechanically Ventilated Patients with Artificial Airways 2010. Respir Care, 2010, 55(6): 758-764.
2.	李秀萍, 郑湘毅. 背心式高频振动排痰与机械振动排痰对老年肺部感染患者的效果观察. 中国呼吸与危重监护杂志, 2017, 16(3): 241-244.
3.	Riiser C, Stenkjær RL, Nystrand S. Development and implementation of evidence based clinical guideline regarding endotracheal suctioning of the intubated neonate. Arch Dis Child, 2014, 99(Suppl 2): A535.
4.	Bruschettini M, Zappettini S, Moja L, et al. Frequency of endotracheal suctioning for the prevention of respiratory morbidity in ventilated newborns. Cochrane Database Syst Rev, 2016, 3: CD011493.
5.	魏丽丽, 韩斌如, 王军. 机械通气患者按需吸痰的研究进展. 西南国防医药, 2018, 28(1): 92-94.
6.	Wood CJ. Can nurses safely assess the need for endotracheal suction in short-term ventilated patients, instead of using routine techniques?. Intensive Crit Care Nurs, 1998, 14(4): 170-178.
7.	王冬, 蒋嘉丽. 按时吸痰 or 按需吸痰. 齐齐哈尔医学院学报, 2012, 33(16): 2284-2285.
8.	李思媛. 120 例 ICU 气管插管患者按需吸痰护理干预的效果观察. 医药卫生 (全文版), 2016, 42(4): 42.
9.	Van de Leur JP, Zwaveling JH, Loef BG, et al. Patient recollection of airway suctioning in the ICU: routine versus a minimally invasive procedure. Intensive Care Med, 2003, 29(3): 433-436.
10.	Van de Leur JP, Zwaveling JH, Loef BG, et al. Endotracheal suctioning versus minimally invasive airway suctioning in intubated patients: a prospective randomised controlled trial. Intensive Care Med, 2003, 29(3): 426-432.
11.	康慧. 解析非定时吸痰技术及护理对气管切开患者的影响. 大家健康 (学术版), 2012, 6(7): 8-9.
12.	徐林凤. 非定时吸痰技术及护理对气管切开患者的效果评价. 吉林医学, 2014, 35(12): 2712-2713.
13.	庞林薇. 非定时吸痰技术及护理对气管切开患者的干预作用分析. 世界临床医学, 2015, 9(4): 215.
14.	邓业芹, 许业梅, 沈佩君. 新生儿人工气道吸痰时机的研究. 临床护理杂志, 2012, 11(6): 28-29.
15.	莫兰. 不同吸痰时机对新生儿机械通气治疗的护理观察. 中国现代药物应用, 2015, 9(13): 190-192.
16.	张蔚. 不同吸痰方式对早产儿机械通气效果及并发症的影响. 临床儿科杂志, 2008, 26(3): 195-196.
17.	胡秀芬, 闫硕, 周文平. 分时护理在肺癌手术患者术后机械吸痰护理中的应用研究. 实用临床医药杂志, 2015, 19(16): 64-66.
18.	周凤芝, 王慧慧, 王胜文. 气管插管患者吸痰护理最佳时机探讨. 中国医药指南, 2013, 11(3): 636.
19.	李智慧, 郭建华, 袁艺源, 等. 神经外科气管切开患者按需吸痰护理效果评价. 实用医院临床杂志, 2015, 12(5): 198-200.
20.	许金娇, 何友云. 颅脑损伤气管切开病人吸痰时机的探讨. 全科护理, 2012, 10(3B): 698-699.
21.	卓雅淑, 林义清. 按需吸痰对气管切开患者并发肺炎的影响. 现代医院, 2007, 7(5): 81.
22.	刘均. 胸外科病人气管插管按需吸痰护理干预的效果观察. 全科护理, 2014, 12(1): 58-59.
23.	Lavigne MC. Comparing suctioning techniques used to assist mechanical ventilation: Protecting you and your patients. Int J Infect Control, 2016, 12(2): 1-12.
24.	Elsaman SE. Effect of application of Endotracheal Suction Guidelines on cardiorespiratory parameters of mechanically ventilated patients. IOSR J Nurs Health Sci, 2017, 6(1): 41-48.
25.	Lema G, Fernández M, Zuleta J, et al. Differences in morbidity for as-needed endotracheal suctioning protocol vs a routine endotracheal suctioning in pediatric intensive care: a randomized controlled trial. Pediatr Crit Care Med, 2014, 15(4 Suppl): Abstract 420.
26.	Pourmand A, Lee D, Davis S, et al. Point-of-care ultrasound utilizations in the emergency airway management: an evidence-based review. Am J Emerg Med, 2017, 35(8): 1202-1206.
27.	Jongerden IP, Buiting AG, Leverstein-van Hall MA, et al. Effect of open and closed endotracheal suctioning on cross-transmission with Gram-negative bacteria: a prospective crossover study. Crit Care Med, 2011, 39(6): 1313-1321.
28.	余威英, 徐小娟, 魏凌云, 等. 呼吸机相关性肺炎感染的危险因素分析. 中华医院感染学杂志, 2014, 24(1): 112-113, 127.
29.	Khan U, Atkinson SS, Gable B, et al. Initial validation of a modified suction task training system. Can J Respir Ther, 2015, 51(1): 13-17.
30.	Kuriyama A, Umakoshi N, Fujinaga J, et al. Impact of closed versus open tracheal suctioning systems for mechanically ventilated adults: a systematic review and meta-analysis. Intensive Care Med, 2015, 41(3): 402-411.
31.	Kohan M, Rezaei-Adaryani M, Najaf-Yarandi A, et al. Effects of expiratory ribcage compression before endotracheal suctioning on arterial blood gases in patients receiving mechanical ventilation. Nurs Crit Care, 2014, 19(5): 255-261.
32.	Davies K, Monterosso L, Bulsara M, et al. Clinical indicators for the initiation of endotracheal suction in children: an integrative review. Aust Crit Care, 2015, 28(1): 11-18.
33.	袁璐, 陈庆红, 向利红, 等. 吸痰时机对麻醉恢复室患者拔管时心血管反应的影响. 护理学杂志, 2018, 33(10): 56-57.

1. American Association for Respiratory Care. AARC Clinical Practice Guidelines. Endotracheal Suctioning of Mechanically Ventilated Patients with Artificial Airways 2010. Respir Care, 2010, 55(6): 758-764.
2. 李秀萍, 郑湘毅. 背心式高频振动排痰与机械振动排痰对老年肺部感染患者的效果观察. 中国呼吸与危重监护杂志, 2017, 16(3): 241-244.
3. Riiser C, Stenkjær RL, Nystrand S. Development and implementation of evidence based clinical guideline regarding endotracheal suctioning of the intubated neonate. Arch Dis Child, 2014, 99(Suppl 2): A535.
4. Bruschettini M, Zappettini S, Moja L, et al. Frequency of endotracheal suctioning for the prevention of respiratory morbidity in ventilated newborns. Cochrane Database Syst Rev, 2016, 3: CD011493.
5. 魏丽丽, 韩斌如, 王军. 机械通气患者按需吸痰的研究进展. 西南国防医药, 2018, 28(1): 92-94.
6. Wood CJ. Can nurses safely assess the need for endotracheal suction in short-term ventilated patients, instead of using routine techniques?. Intensive Crit Care Nurs, 1998, 14(4): 170-178.
7. 王冬, 蒋嘉丽. 按时吸痰 or 按需吸痰. 齐齐哈尔医学院学报, 2012, 33(16): 2284-2285.
8. 李思媛. 120 例 ICU 气管插管患者按需吸痰护理干预的效果观察. 医药卫生 (全文版), 2016, 42(4): 42.
9. Van de Leur JP, Zwaveling JH, Loef BG, et al. Patient recollection of airway suctioning in the ICU: routine versus a minimally invasive procedure. Intensive Care Med, 2003, 29(3): 433-436.
10. Van de Leur JP, Zwaveling JH, Loef BG, et al. Endotracheal suctioning versus minimally invasive airway suctioning in intubated patients: a prospective randomised controlled trial. Intensive Care Med, 2003, 29(3): 426-432.
11. 康慧. 解析非定时吸痰技术及护理对气管切开患者的影响. 大家健康 (学术版), 2012, 6(7): 8-9.
12. 徐林凤. 非定时吸痰技术及护理对气管切开患者的效果评价. 吉林医学, 2014, 35(12): 2712-2713.
13. 庞林薇. 非定时吸痰技术及护理对气管切开患者的干预作用分析. 世界临床医学, 2015, 9(4): 215.
14. 邓业芹, 许业梅, 沈佩君. 新生儿人工气道吸痰时机的研究. 临床护理杂志, 2012, 11(6): 28-29.
15. 莫兰. 不同吸痰时机对新生儿机械通气治疗的护理观察. 中国现代药物应用, 2015, 9(13): 190-192.
16. 张蔚. 不同吸痰方式对早产儿机械通气效果及并发症的影响. 临床儿科杂志, 2008, 26(3): 195-196.
17. 胡秀芬, 闫硕, 周文平. 分时护理在肺癌手术患者术后机械吸痰护理中的应用研究. 实用临床医药杂志, 2015, 19(16): 64-66.
18. 周凤芝, 王慧慧, 王胜文. 气管插管患者吸痰护理最佳时机探讨. 中国医药指南, 2013, 11(3): 636.
19. 李智慧, 郭建华, 袁艺源, 等. 神经外科气管切开患者按需吸痰护理效果评价. 实用医院临床杂志, 2015, 12(5): 198-200.
20. 许金娇, 何友云. 颅脑损伤气管切开病人吸痰时机的探讨. 全科护理, 2012, 10(3B): 698-699.
21. 卓雅淑, 林义清. 按需吸痰对气管切开患者并发肺炎的影响. 现代医院, 2007, 7(5): 81.
22. 刘均. 胸外科病人气管插管按需吸痰护理干预的效果观察. 全科护理, 2014, 12(1): 58-59.
23. Lavigne MC. Comparing suctioning techniques used to assist mechanical ventilation: Protecting you and your patients. Int J Infect Control, 2016, 12(2): 1-12.
24. Elsaman SE. Effect of application of Endotracheal Suction Guidelines on cardiorespiratory parameters of mechanically ventilated patients. IOSR J Nurs Health Sci, 2017, 6(1): 41-48.
25. Lema G, Fernández M, Zuleta J, et al. Differences in morbidity for as-needed endotracheal suctioning protocol vs a routine endotracheal suctioning in pediatric intensive care: a randomized controlled trial. Pediatr Crit Care Med, 2014, 15(4 Suppl): Abstract 420.
26. Pourmand A, Lee D, Davis S, et al. Point-of-care ultrasound utilizations in the emergency airway management: an evidence-based review. Am J Emerg Med, 2017, 35(8): 1202-1206.
27. Jongerden IP, Buiting AG, Leverstein-van Hall MA, et al. Effect of open and closed endotracheal suctioning on cross-transmission with Gram-negative bacteria: a prospective crossover study. Crit Care Med, 2011, 39(6): 1313-1321.
28. 余威英, 徐小娟, 魏凌云, 等. 呼吸机相关性肺炎感染的危险因素分析. 中华医院感染学杂志, 2014, 24(1): 112-113, 127.
29. Khan U, Atkinson SS, Gable B, et al. Initial validation of a modified suction task training system. Can J Respir Ther, 2015, 51(1): 13-17.
30. Kuriyama A, Umakoshi N, Fujinaga J, et al. Impact of closed versus open tracheal suctioning systems for mechanically ventilated adults: a systematic review and meta-analysis. Intensive Care Med, 2015, 41(3): 402-411.
31. Kohan M, Rezaei-Adaryani M, Najaf-Yarandi A, et al. Effects of expiratory ribcage compression before endotracheal suctioning on arterial blood gases in patients receiving mechanical ventilation. Nurs Crit Care, 2014, 19(5): 255-261.
32. Davies K, Monterosso L, Bulsara M, et al. Clinical indicators for the initiation of endotracheal suction in children: an integrative review. Aust Crit Care, 2015, 28(1): 11-18.
33. 袁璐, 陈庆红, 向利红, 等. 吸痰时机对麻醉恢复室患者拔管时心血管反应的影响. 护理学杂志, 2018, 33(10): 56-57.

Previous Article
Application of goal directed analgesia in noninvasive positive pressure ventilation
Next Article
Predictive value of mini-fluid challenge for volume responsiveness

Chinese Journal of Respiratory and Critical Care Medicine

A Meta analysis on effects of different sputum suction time

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content