The Effect of the Open and Closed System Suctions on Pain Severity and Physiological Indicators in Mechanically Ventilated Patients with Traumatic Brain Injury: A Randomised Controlled Trial
Yıl: 2020 Cilt: 48 Sayı: 3 Sayfa Aralığı: 202 - 207 Metin Dili: İngilizce DOI: 10.5152/TJAR.2019.03342 İndeks Tarihi: 12-05-2021
The Effect of the Open and Closed System Suctions on Pain Severity and Physiological Indicators in Mechanically Ventilated Patients with Traumatic Brain Injury: A Randomised Controlled Trial
Öz: Objective: Tracheal suctioning can cause pain and physiological indicator variations in patients with traumatic brain injury (TBI). The aim ofthe present study was to compare pain severity and physiological indicator variations during the closed tracheal suction system (CTSS) and opentracheal suction system (OTSS) in patients with TBI.Methods: This study was a clinical trial. Samples included all ventilated patients with TBI. The patients were randomly divided into the OTSSand CTSS groups. In both groups, the Critical Care Pain Observation Tool (CPOT) and physiological indicators were recorded by three nursesprior to suctioning, the end of suctioning and 5 min after suction completion. Data were analysed using the independent t-test and repeatedmeasurement tests.Results: A total of 112 patients participated in the present study. Before the interventions, the mean value of the Glasgow Coma Scale was6.45±1.13, blood pressure 128.33±20.54, saturated oxygen in arterial blood (SpO2) 96.74±2.76, respiratory rate (RR) 15.06±3.98, end-tidalCO2 (EtCO2) 36.2±21.98, heart rate 82.18±42.33 and CPOT-based pain 0.43±0.94 in the patients. Independent t-test was used to compareCTSS and OTSS, suggesting significant differences with respect to the mean values of SpO2, RR and EtCO2 immediately after suctioning. Thistest showed significant differences between the two groups with respect to pain intensity at all three points of measurement. The two groups werealso found to be significantly different with respect to RR measured 5 min after suctioning (p<0.05).Conclusion: Compared to OTSS, CTSS can cause higher reductions in pain levels during and after suctioning in patients with head traumasand can also cause higher improvements in physiological indicators, such as RR, O2 saturation and EtCO2.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. Maas AIR, Menon DK, Adelson PD, Andelic N, Bell MJ, Belli A, et al. Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research. Lancet Neurol 2017; 16: 987-1048. [CrossRef]
- 2. John P.A, Dominic B, Justin M. Neurocritical Care A Guide to Practical Management. Springer London Dordrecht Heidelberg New York. 2010:1.
- 3. Mohammadpour A, Amini S, Shakeri MT, Mirzaei S. Comparing the effect of open and closed endotracheal suctioning on pain and oxygenation in post CABG patients under mechanical ventilation. Iran J Nurs Midwifery Res 2015; 20: 195-9.
- 4. Pedersen C.M, Rosendahl-Nielsen M, Hjermind J, Egerod I. Endotracheal suctioning of the adult intubated patient. Intensive Crit Care Nurs 2009; 25: 21-30. [CrossRef]
- 5. Juneja D, Javeri Y, Singh O, Nasa P, Pandey R, Uniyal B. Comparing influence of intermittent subglottic secretions drainage with/without closed suction systems on the incidence of ventilator associated pneumonia. Indian J Crit Care Med 2011; 15: 168-72. [CrossRef]
- 6. Seguin PH, Perrichet H, Le Pabic E, Launey Y, Tiercin M, Corre R, et al. Effect of continuous versus intermittent subglottic suctioning on tracheal mucosa by the mallinckrodt taperguard evac oral tracheal tube in intensive care unit ventilated patients: A prospective randomized study. Indian J Crit Care Med 2018; 22: 1-4. [CrossRef]
- 7. Jeong JH, Nam SJ, Cho YJ, Lee YJ, Kim SJ, Song IA, et al. A Closed-Suction Catheter with a Pressure Valve Can Reduce Tracheal Mucosal Injury in Intubated Patients. Korean J Crit Care Med 2014; 29: 7-12. [CrossRef]
- 8. Javadi M, Hejr H, Zolad M, Khalili A, Paymard A. Comparing the effect of endotracheal tube suction using open method with two different size catheters 12 and 14 on discharge secretion, pain, heart rate, blood pressure, and arterial oxygen saturation of patients in the intensive care unit: A randomized clinical trial. Annals of Tropical Medicine and Public Health 2017; 10: 1312-7. [CrossRef]
- 9. Stamenkovic DM, Laycock H, Karanikolas M, Ladjevic NG, Neskovic V, Bantel C. Chronic Pain and Chronic Opioid Use After Intensive Care Discharge - Is It Time to Change Practice? Front Pharmacol 2019; 10: 23. [CrossRef]
- 10. Haddad SH, Arabi YM. Critical care management of severe traumatic brain injury in adults. Scand J Trauma Resusc Emerg Med 2012; 20: 12. [CrossRef]
- 11. Dobscha SK, Clark ME, Morasco BJ, Freeman M, Campbell R, Helfand M. Systematic review of the literature on pain in patients with polytrauma including traumatic brain injury. Pain Med 2009; 10: 1200-17. [CrossRef]
- 12. Ugras GA, Aksoy G. The effects of open and closed endotracheal suctioning on intracranial pressure and cerebral perfusion pressure: a crossover, single-blind clinical trial. J Neurosci Nurs 2012; 44: E1-8. [CrossRef]
- 13. Chen HJ, Chen YM. Pain Assessment: Validation of the Physiologic Indicators in the Ventilated Adult Patient. Pain Manag Nurs 2015; 16: 105-11. [CrossRef]
- 14. Kuriyama A, Umakoshi N, Fujinaga J, Takada T. Impact of closed versus open tracheal suctioning systems for mechanically ventilated adults: a systematic review and meta-analysis. Intensive Care Med 2015; 41: 402-11. [CrossRef]
- 15. Jongerden Irene P, Kesecioglu J, Speelberg B, Buiting Anton G, Leverstein-van Hall Maurine A, Bonten Marc J. Changes in heart rate, mean arterial pressure, and oxygen saturation after open and closed endotracheal suctioning: A prospective observational study. J Crit Care 2012; 27: 647-54. [CrossRef]
- 16. Jongerden Irene P, Rovers Maroeska M, Grypdonck Mieke H, Bonten Marc J. Open and closed endotracheal suction systems in mechanically ventilated intensive care patients: A meta-analysis. Crit Care Med 2007; 35: 260-70. [CrossRef]
- 17. Lasocki S, Lu Q, Sartorius A, Fouillat D, Remerand F, Rouby JJ. Open and Closed-Circuit Endotracheal Suctioning in Acute Lung Injury: Efficiency and Effects on Gas Exchange. Anesthesiology 2006; 104: 9. [CrossRef]
- 18. Ayfer A, Suzan Y. Effects of Open and Closed Suctioning Systems on Pain in Newborns Treated with Mechanical Ventilation. American Society for Pain Management Nursing 2016; 15: 11.
- 19. Gelinas C, Johnston C. Pain assessment in the critically ill ventilated adult: validation of the critical-care pain observation tool and physiologic indicators. Clin J Pain 2007; 23: 497-505. [CrossRef]
- 20. Dastdadeh R, Ebadi A, Vahedian-Azimi A. Comparison of the Effect of Open and Closed Endotracheal Suctioning Methods on Pain and Agitation in Medical ICU Patients: A Clinical Trial. Anesth Pain Med 2016; 6: 1-8. [CrossRef]
- 21. Subhash Mengar R. A comparative Study to Assess the Effectiveness of Open tracheal Suction System and closed tracheal Suction System on Physiological Parameters. Int J Nurs Education 2018; 10: 109-12. [CrossRef]
- 22. Afshari A, Safari M, Oshvandi K, Soltanian AR. The Effect of the Open and Closed System Suctions on Cardiopulmonary Parameters: Time and Costs in Patients Under Mechanical Ventilation. Nurs Midwifery Stud 2014; 3: 1-6. [CrossRef
| APA | Ebrahimian A, Tourdeh M, Paknazar F, Davari H (2020). The Effect of the Open and Closed System Suctions on Pain Severity and Physiological Indicators in Mechanically Ventilated Patients with Traumatic Brain Injury: A Randomised Controlled Trial. , 202 - 207. 10.5152/TJAR.2019.03342 |
| Chicago | Ebrahimian Abbasali,Tourdeh Maedeh,Paknazar Fatemeh,Davari Hossein The Effect of the Open and Closed System Suctions on Pain Severity and Physiological Indicators in Mechanically Ventilated Patients with Traumatic Brain Injury: A Randomised Controlled Trial. (2020): 202 - 207. 10.5152/TJAR.2019.03342 |
| MLA | Ebrahimian Abbasali,Tourdeh Maedeh,Paknazar Fatemeh,Davari Hossein The Effect of the Open and Closed System Suctions on Pain Severity and Physiological Indicators in Mechanically Ventilated Patients with Traumatic Brain Injury: A Randomised Controlled Trial. , 2020, ss.202 - 207. 10.5152/TJAR.2019.03342 |
| AMA | Ebrahimian A,Tourdeh M,Paknazar F,Davari H The Effect of the Open and Closed System Suctions on Pain Severity and Physiological Indicators in Mechanically Ventilated Patients with Traumatic Brain Injury: A Randomised Controlled Trial. . 2020; 202 - 207. 10.5152/TJAR.2019.03342 |
| Vancouver | Ebrahimian A,Tourdeh M,Paknazar F,Davari H The Effect of the Open and Closed System Suctions on Pain Severity and Physiological Indicators in Mechanically Ventilated Patients with Traumatic Brain Injury: A Randomised Controlled Trial. . 2020; 202 - 207. 10.5152/TJAR.2019.03342 |
| IEEE | Ebrahimian A,Tourdeh M,Paknazar F,Davari H "The Effect of the Open and Closed System Suctions on Pain Severity and Physiological Indicators in Mechanically Ventilated Patients with Traumatic Brain Injury: A Randomised Controlled Trial." , ss.202 - 207, 2020. 10.5152/TJAR.2019.03342 |
| ISNAD | Ebrahimian, Abbasali vd. "The Effect of the Open and Closed System Suctions on Pain Severity and Physiological Indicators in Mechanically Ventilated Patients with Traumatic Brain Injury: A Randomised Controlled Trial". (2020), 202-207. https://doi.org/10.5152/TJAR.2019.03342 |
| APA | Ebrahimian A, Tourdeh M, Paknazar F, Davari H (2020). The Effect of the Open and Closed System Suctions on Pain Severity and Physiological Indicators in Mechanically Ventilated Patients with Traumatic Brain Injury: A Randomised Controlled Trial. Turkish Journal of Anaesthesiology and Reanimation, 48(3), 202 - 207. 10.5152/TJAR.2019.03342 |
| Chicago | Ebrahimian Abbasali,Tourdeh Maedeh,Paknazar Fatemeh,Davari Hossein The Effect of the Open and Closed System Suctions on Pain Severity and Physiological Indicators in Mechanically Ventilated Patients with Traumatic Brain Injury: A Randomised Controlled Trial. Turkish Journal of Anaesthesiology and Reanimation 48, no.3 (2020): 202 - 207. 10.5152/TJAR.2019.03342 |
| MLA | Ebrahimian Abbasali,Tourdeh Maedeh,Paknazar Fatemeh,Davari Hossein The Effect of the Open and Closed System Suctions on Pain Severity and Physiological Indicators in Mechanically Ventilated Patients with Traumatic Brain Injury: A Randomised Controlled Trial. Turkish Journal of Anaesthesiology and Reanimation, vol.48, no.3, 2020, ss.202 - 207. 10.5152/TJAR.2019.03342 |
| AMA | Ebrahimian A,Tourdeh M,Paknazar F,Davari H The Effect of the Open and Closed System Suctions on Pain Severity and Physiological Indicators in Mechanically Ventilated Patients with Traumatic Brain Injury: A Randomised Controlled Trial. Turkish Journal of Anaesthesiology and Reanimation. 2020; 48(3): 202 - 207. 10.5152/TJAR.2019.03342 |
| Vancouver | Ebrahimian A,Tourdeh M,Paknazar F,Davari H The Effect of the Open and Closed System Suctions on Pain Severity and Physiological Indicators in Mechanically Ventilated Patients with Traumatic Brain Injury: A Randomised Controlled Trial. Turkish Journal of Anaesthesiology and Reanimation. 2020; 48(3): 202 - 207. 10.5152/TJAR.2019.03342 |
| IEEE | Ebrahimian A,Tourdeh M,Paknazar F,Davari H "The Effect of the Open and Closed System Suctions on Pain Severity and Physiological Indicators in Mechanically Ventilated Patients with Traumatic Brain Injury: A Randomised Controlled Trial." Turkish Journal of Anaesthesiology and Reanimation, 48, ss.202 - 207, 2020. 10.5152/TJAR.2019.03342 |
| ISNAD | Ebrahimian, Abbasali vd. "The Effect of the Open and Closed System Suctions on Pain Severity and Physiological Indicators in Mechanically Ventilated Patients with Traumatic Brain Injury: A Randomised Controlled Trial". Turkish Journal of Anaesthesiology and Reanimation 48/3 (2020), 202-207. https://doi.org/10.5152/TJAR.2019.03342 |
