Grad Dip Phys
Patterns of instability associated with endotracheal suctioning in infants with singleventricle physiology
Phys, Grad Dip; Guerrero, Rafael; Baines, Paul; Tume, Lyvonne N; Johnson, Robert; Ritson, Paul; Scott, Elaine; Arnold, Philip; Walsh, Laura
Authors
Rafael Guerrero
Paul Baines
Lyvonne N Tume
Robert Johnson
Paul Ritson
Elaine Scott
Philip Arnold
Laura Walsh
Abstract
© 2017 American Association of Critical-Care Nurses. Background In infants with single-ventricle physiology, endotracheal suctioning poses risks because of the instability between pulmonary and systemic blood flow. Objective To examine processes and adverse events associated with endotracheal suctioning in the first 48 hours after 3 surgical procedures: the Norwood or Norwood- Sano procedure, pulmonary artery banding, and the modified Blalock-Taussig shunt. Methods Prospective observational study in a pediatric intensive care unit. Results Bedside nurses collected data from 211 episodes of endotracheal suctioning in 24 infants. Most (62%,130/211) suction episodes were unplanned; 38% (81/211) were planned. The most common reason for unplanned suctioning was arterial desaturation (48%, 62/130 episodes). The infants' oxygen saturation levels before suctioning ranged from 27% to 86%. Serious adverse events occurred in 9% (19/211) of suction episodes. In 8 (42%) of the episodes involving a serious adverse event, the patient received no additional intravenous bolus of analgesic or muscle relaxant before suctioning; in 8 episodes (42%), the patient received both an analgesic and a relaxant; in 3 episodes (16%), the patient received either an analgesic or a relaxant but not both. More adverse events occurred with open suctioning (68%, 13/19) than with closed suctioning (32%, 6/19). Most adverse events (68%, 13/19) occurred during the night shift. Conclusions Significant hemodynamic instability and adverse events occur during routine suctioning in infants with single-ventricle physiology after surgical palliation.
Journal Article Type | Article |
---|---|
Acceptance Date | Nov 1, 2016 |
Online Publication Date | Sep 1, 2017 |
Publication Date | Sep 1, 2017 |
Deposit Date | Jul 24, 2017 |
Publicly Available Date | Sep 1, 2018 |
Journal | American Journal of Critical Care |
Print ISSN | 1062-3264 |
Publisher | American Association of Critical Care Nurses |
Peer Reviewed | Peer Reviewed |
Volume | 26 |
Issue | 5 |
Pages | 388-394 |
DOI | https://doi.org/10.4037/ajcc2017844 |
Keywords | tracheal suction, post-operative, infant, neonate, single ventricle physiology, nursing, heart surgery |
Public URL | https://uwe-repository.worktribe.com/output/881861 |
Publisher URL | http://dx.doi.org/10.4037/ajcc2017844 |
Contract Date | Jul 24, 2017 |
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