بررسي تاثير دو روش ساكشن تراشه با سيستم باز و فايبراپتيك در بيماران تحت تنفس مكانيكي بستري در بخش مراقبت هاي ويژه مركز آموزشي درماني آيت الله طالقاني در سال1385

Study the two ways, open endotracheal suction and fiberoptic suction in mechanical ventilated patients in intensive care unit of Taleghani Medical Educational Center 2005 -2006

Background: The hospitalized patients in intensive care unit who are undergone by long-term supportive ventilation, will involve in lung anatomic and physiologic changes. These changes will appear as decreasing the effective pulmonary volumes because of assembling lung secretion and atelectasis that will decrease the alveolar and arterial blood gases interchanging, consequently. Itʹs results are excessive pulmonary shunt and decreasing the ratio of ventilation to blood flow. There are some effective ways for preventing these problems such as some attempts like chest physiotherapy, tracheal tube replacement and exchange it, suctioning the endotracheal tube simply by tube and by using fiberoptic, so we did this survey to study the effects of two ways of suctioning in patients of intensive care unit who were ventilated mechanically. Materials and Methodes: In this study we selected 45 patients as sampels who were hospitalized in intensive care unit of Taleghani hospital. These patients didnʹt have any underline disease and at least were undergone the mechanical ventilation for 48 hours .Then we divided them into two groups of 22 and 23 people and in a cross over way each group was suctioned by open method first, then in 24 hours, by using of fiberoptic method. We measured blood gases before and after suctioning from both 2 methods and recorded in a check list. Data were analyzed by using of descriptive statistical and T paired . Results: This studyʹs data showed that artery oxygen pressure was 216 after open suction and 189/7 after close suction which their differences between these two was significant and also artery CO2 pressure after close suction (38/8) was prominently higher than its amount after open suction (35/9) (P=0/00l). The average of airway resistance after open and close suctioning orderly were 25/4 and 24/7 that had significant difference (p=0/036). Data about average of lung compliance showed,this average after open suction was 45/9 and after close suction was 45/9 too, which were the same. Conclusion: In spite of several studies data which showed close suction is more effective from aspects of consuming the time, expenses and more influence on ventilation for mechanical ventilated patients and they represented that decreasing airway resistance and increasing lung compliance in this method is more effective but in our study, close suction just in decreasing the airway resistance significantly was more effective than open method so it is recommended to other colleagues to study more about these two methods.