개방형 흡인술과 폐쇄형 흡인술이 인공호흡기 사용 중환자의 산소포화도와 활력징후에 미치는 효과

A Comparison of the Opened Versus Closed-System of Suctioning -In Oxygen Saturation, Vital Signs and Suction Time-

  • 서민숙 (중앙대학교 의과대학 간호학과 대학원) ;
  • 박경숙 (중앙대학교 의과대학 간호학과 대학원)
  • 투고 : 2007.09.05
  • 심사 : 2008.08.19
  • 발행 : 2009.04.30

초록

Purpose: The purpose of this study was to compare the difference of change in oxygen saturation, vital signs and suction time taken for the suctioning during endotracheal suctioning performed with closed suction system and with opened suction system. Methods: Data were collected from 31 adult patients with ventilator treatment who were admitted to a university hospital in Seoul and the collection period was from July 1 to November 15, 2005. Oxygen saturation, heart rate, respiration rate and mean arterial pressure were collected immediately prior to the suctioning intervention, during and 1 and 5 minutes after the suctioning from opened suction system and closed suction system. Results: 1) The difference in oxygen saturation was statistically significant in recovery time for oxygen saturation to return to baseline values after suctioning was significantly rapid on closed suction system (p<.05). 2) The difference in heart rate, respiration rate and mean arterial pressure was statistically insignificant 3) The suction time was shorter in closed suction system. Conclusion: Closed suction system is more efficient, as compared with the open suction system in the ventilator treatment.

키워드

참고문헌

  1. Clochesy, J. M., Breu, C., Cardin, S., Whittaker, A., & Rudy, E. B. (1996). Critical care nursing(2nd ed.). Philadelpia, W.B.: Saunders Company.
  2. Choi, M. Y., Kim, J. H., Park, M. J., Choi, Smi., & Lee, K. S. (2004). Physiology. Seoul: Hyunmoonsa.
  3. Cohen, J. (1988). Statistical power analysis for behavioral science. New York: Academic Press.
  4. Crimlisk, J. T., Paris, R., Mcgonagle, E. G., Calcutt, J. A., & Farber, H. W. (1994). The closed tracheal suction system: Implication for critical care nursing. Dimens Crit Care Nurs, 13(6), 292-300. https://doi.org/10.1097/00003465-199411000-00003
  5. DePew, C. L., Moseley, M. J., Clark, E. G., & Morales, C. C. (1994). Open vs closed-system endotracheal suctioning: A cost comparison. Crit Care Nurse, 14(1), 94-100.
  6. Hardie, D. K., & Kirchhoff, K. T. (1989). A comparison of the open versus closed-system of suctioning. Heart Lung, 18(3), 305.
  7. Hong, O. S., & Kang, G. S. (1987). Basic nursing. Seoul: Korean Nurses Association.
  8. Hopkins, M., Mahlmeister, M., Koo, P., & Cohen, N. (1990). The effect of closed vs open endotracheal suctioning on $PaO_{2}$ in ventilated patients. Heart Lung, 19(3), 308.
  9. John, R. E. (2004). Airway management. Crit Care Nurse, 24(2), 93-96.
  10. Kang, J. H. (1993). A study on the determination of nursing cost for critical patients in a general hospital. Unpublished master's thesis, Seoul National University, Seoul.
  11. Kim, D. S. (1997). Medical respiratory physiology. Seoul: Korea Medical Book Publishing Company.
  12. Kim, M. S., Ahn, Y. M., Park, I. O., Choi, S. J., & Yoo, M. Y. (1998). The effects of open endotracheal suctioning (ETS) and close ETS on oxygen saturation and heart rate in premature infants with respiratory distress syndrome. J Korean Acad Nurs, 28(3), 529-543.
  13. Oh, H., & Seo, W. (2003). A meta-analysis of the effects of various interventions in preventing endotracheal suction induced hypoxia. J Clin Nurs, 12(6), 912-924. https://doi.org/10.1046/j.1365-2702.2003.00796.x
  14. Lee, C. K., Ng, K. S., Tan, S. G., & Ang, R. (2001). Effect of different endotracheal suctioning systems on cardiorespiratory parameters of ventilated-patients. Ann Acad Med Singapore, 30(3), 239-244.
  15. Lee, E. S., Kim, S. H., & Kim, J. S. (2004). Effects of a closed endotracheal suction system on oxygen saturation, ventilator-associated pneumonia, and nursing efficacy. J Korean Acad Nurs, 34(7), 1315-1315.
  16. Park, M. Y. (2002). Open vs closed endotracheal suction system: A hemodynamics comparison. Unpublished master's thesis, Ewha Womans University, Seoul.
  17. Park, Y. Y. (1997). A Comparative study on closed vs. open endotracheal suctioning on the newborn infants treated with ventilator. J Korean Hosp Nurs, 3(1), 47-62.
  18. Pilbeam, S. P. (1998). Mechanical ventilation: Physiological and clinical applications(3rd ed.). St. Louis: Mosby.
  19. Paul-Allen, J., & Ostrow, C. L. (2000). Survey of nursing practices with closed-system suction. Am J Crit Care, 9(1), 9-19.
  20. Sole, M. L., Byers, J. F., Ludy, J. E., & Ostrow, C. L. (2002). Suctioning techniques and airway management practices: pilot study and instrument evaluation. Am J Crit Care, 11(4), 363-368.
  21. Yum, H. K., Lee, S. S., Lee, H. P., Chin, J. Y. & Choi, S. J. (2005). Essentials of mechanical ventilation. Seoul: Koonja Publishing Company.