بررسي شيوع ديمي ريتمي هاي قلبي ، تغييرات فشارخون و ميزان اشباع هموگلوبين حين ساكشن تراشه و برونش در بيماران بستري در بخش هاي مراقبت ويژه

Frequency of Cardiac Dysrythmia, Blood Pressure Changes and Level of Arterial Oxygen Saturation During Endotracheal Suctioning in Intensive Care Unit Patients

Introduction: Tracheobronchial suctioning has some complications for the patient. One of these complications is cardiac dysrythmia. Some articles mention ventricular extra systole to be common after suctioning but some other articles indicate bradycardia or premature arterial contraction (PAC) as the most common dysrythmia during endotracheol suctioning. Objective: In attention to the danger of cardiac dysrythmia during suctioning and also different existing opinions among researchers, the present study is conducted to determine the frequency of cardiac dysrythmia during tracheobranchial suctioning. Materials and Methods: Four hundred patients aging 18-65 under mechanical ventilation from intensive care units of Ayetoloh Kashani Center were selected. EKG, systolic and diastolic arterial pressure (SAP, DAP), heart rate (HR) and arterial hemoglobin saturation were recorded before the endotracheal suctioning. Then standard endotracheal suctioning was done and these parameters were determined during the suctioning. At the end of suctioning another EKG was taken and shown to the cardiologist. Data were analyzed using descriptive statistics, ratios and also analysis variance. Results: Mean age of the patients and M/F ratio were 33+14 yrs. and 17.2 respectively. The most common abnormal rhythm during the suctioning was sinus tachycardia (33%). No other arrhythmias were seen in this study. The greater increase in HR occurred 2 minutes after endotracheal suctioning (114+20 vs. 102116 pre suctioning)(P<0.05). Patientsʹ systolic blood pressure significantly rose after suctioning (P<0.05). There was insignificant difference in diastolic BP and saturated arterial hemoglobin. Conclusion: These findings suggested that endotracheal suctioning can induce sinus tachycardia but other dysrythmias, which may be dangerous in the patients under mechanical ventilation, did not occur in this study. Perhaps suctioning tracheal and bronchial secretions under correct medical conditions causes no dangerous arrythmias.