Effects of Closed Endotracheal Suctioning on Systemic and Cerebral Oxygenation and Hemodynamics in Children
| Autor: | Balagangadhar R. Totapally, Teshaun Francis, Madhuradhar Chegondi, Andre Raszynski, Wei-Chiang Lin, Sayed Naqvi |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
Suction (medicine) Adolescent Critical Illness medicine.medical_treatment Hemodynamics Suction Intensive Care Units Pediatric Critical Care and Intensive Care Medicine Tertiary care 03 medical and health sciences 0302 clinical medicine Cerebral oxygenation 030225 pediatrics Intubation Intratracheal medicine Humans Intubation Prospective Studies Child Oxygen saturation (medicine) Endotracheal tube Spectroscopy Near-Infrared business.industry Endotracheal suctioning Infant Newborn Infant Electroencephalography Oxygen 030228 respiratory system Cerebrovascular Circulation Child Preschool Anesthesia Pediatrics Perinatology and Child Health Female business |
| Zdroj: | Pediatric Critical Care Medicine. 19:e23-e30 |
| ISSN: | 1529-7535 |
| DOI: | 10.1097/pcc.0000000000001377 |
| Popis: | To evaluate the effects of closed endotracheal tube suctioning on systemic oxygen saturation, cerebral regional oxygen saturation, and somatic regional (renal) oxygen saturation and hemodynamic variables in children.Prospective observational.A tertiary care PICU.Children aged 0-18 years, requiring invasive mechanical ventilation and with an arterial line.Closed endotracheal suction.The study included 19 sedated and intubated children, 0-18 years old. They were enrolled in an ongoing prospective observational study. We used near-infrared spectroscopy for cerebral regional oxygen saturation and somatic regional (renal) oxygen saturation. The timing of each closed endotracheal tube suctioning event was accurately identified from video recordings. We extracted systemic oxygen saturation, cerebral regional oxygen saturation, somatic regional (renal) oxygen saturation, heart rate, and systolic blood pressure and diastolic blood pressure for 5 minutes before and 5 minutes after each event and used these data for analysis. One-minute average values of these variables were used for repeated-measures analysis. We analyzed 287 endotracheal tube suctioning episodes in 19 children. Saline was instilled into the endotracheal tube during 61 episodes. The mean heart rate (107.0 ± 18.7 vs 110.2 ± 10.4; p0.05), mean arterial blood pressure (81.5 ± 16.1 vs 83.0 ± 15.6 mm Hg; p0.05), and the mean cerebral regional oxygen saturation (64.8 ± 8.3 vs 65.8 ± 8.3; p0.05) were increased after suctioning. The mean systemic oxygen saturation (96.9 ± 2.7 vs 96.7 ± 2.7; p = 0.013) was decreased, whereas the mean somatic regional (renal) oxygen saturation was not significantly different after endotracheal tube suctioning. Repeated-measures analysis revealed transient increases in heart rate, respiratory rate, systolic blood pressure, and diastolic blood pressure; a sustained increase in cerebral regional oxygen saturation; and transient decreases in systemic oxygen saturation and somatic regional (renal) oxygen saturation. Saline instillation did not affect oxygenation or hemodynamic variables.Closed endotracheal tube suctioning in sedated children is associated with transient but clinically insignificant changes in heart rate, blood pressure, cerebral regional oxygen saturation, systemic oxygen saturation, and somatic regional (renal) oxygen saturation. Saline instillation during endotracheal tube suctioning had no adverse effects on systemic or cerebral oxygenation. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|