Long-Term Effects of Saline Instilled During Endotracheal Suction in Pediatric Intensive Care: A Randomized Trial.

Autor:	McKinley DF; Dianne F. McKinley is a clinical nurse, Intensive Care Unit, Royal Children's Hospital, Parkville, Victoria, Australia. Sharon B. Kinney is a nurse consultant, Department of Nursing Research, Royal Children's Hospital; and a senior lecturer, Departments of Nursing and Pediatrics, The University of Melbourne, Victoria. Beverley Copnell is an associate professor, School of Nursing and Midwifery, La Trobe University, Victoria. Frank Shann is a medical doctor, Intensive Care Unit, Royal Children's Hospital. di.mckinley@rch.org.au., Kinney SB; Dianne F. McKinley is a clinical nurse, Intensive Care Unit, Royal Children's Hospital, Parkville, Victoria, Australia. Sharon B. Kinney is a nurse consultant, Department of Nursing Research, Royal Children's Hospital; and a senior lecturer, Departments of Nursing and Pediatrics, The University of Melbourne, Victoria. Beverley Copnell is an associate professor, School of Nursing and Midwifery, La Trobe University, Victoria. Frank Shann is a medical doctor, Intensive Care Unit, Royal Children's Hospital., Copnell B; Dianne F. McKinley is a clinical nurse, Intensive Care Unit, Royal Children's Hospital, Parkville, Victoria, Australia. Sharon B. Kinney is a nurse consultant, Department of Nursing Research, Royal Children's Hospital; and a senior lecturer, Departments of Nursing and Pediatrics, The University of Melbourne, Victoria. Beverley Copnell is an associate professor, School of Nursing and Midwifery, La Trobe University, Victoria. Frank Shann is a medical doctor, Intensive Care Unit, Royal Children's Hospital., Shann F; Dianne F. McKinley is a clinical nurse, Intensive Care Unit, Royal Children's Hospital, Parkville, Victoria, Australia. Sharon B. Kinney is a nurse consultant, Department of Nursing Research, Royal Children's Hospital; and a senior lecturer, Departments of Nursing and Pediatrics, The University of Melbourne, Victoria. Beverley Copnell is an associate professor, School of Nursing and Midwifery, La Trobe University, Victoria. Frank Shann is a medical doctor, Intensive Care Unit, Royal Children's Hospital.
Jazyk:	angličtina
Zdroj:	American journal of critical care : an official publication, American Association of Critical-Care Nurses [Am J Crit Care] 2018 Nov; Vol. 27 (6), pp. 486-494.
DOI:	10.4037/ajcc2018615
Abstrakt:	Background: Saline instillation is still used to assist in removal of secretions from endotracheal tubes in some pediatric intensive care units. Objective: To compare the effect of using either no saline, quarter-normal (0.225%) saline, or normal (0.9%) saline during endotracheal suctioning of children receiving ventilatory support in a pediatric intensive care unit. Method: An unblinded, randomized trial with 3 treatment groups was conducted with 427 children who received ventilatory support for at least 12 hours. Children were randomly assigned to receive no saline, 0.225% saline, or 0.9% saline during routine endotracheal suctioning. Results: The primary outcome was the number of hours of invasive mechanical ventilation; oxygen therapy and length of stay in the unit were secondary outcomes. There were 138 children randomly assigned to the no-saline group, 141 to the 0.225% saline group, and 148 to the 0.9% saline group. In Kaplan-Meier intention-to-treat analysis, the median (interquartile range) number of hours of invasive mechanical ventilation was 32 (20-68), 43 (21-86), and 40 (20-87) in the no-saline, 0.225% saline, and 0.9% saline groups, respectively. Although the no-saline group received fewer hours of invasive ventilation, oxygen therapy, and intensive care than the other groups combined, the differences were not statistically significant. Conclusion: Using no saline was at least as effective as using either 0.225% or 0.9% saline in endotracheal suctioning. The optimal policy may be to routinely use no saline with endotracheal suctioning in children but allow the occasional use of 0.9% saline when secretions are thick. (©2018 American Association of Critical-Care Nurses.)
Databáze:	MEDLINE
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