ISSN:
1432-1238
Keywords:
Endotracheal suctioning
;
Arterial blood gases
;
Respiratory failure
;
Hypoxia
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract The occurrence of hypoxia during endotracheal tube suctioning and its prevention was examined in 25 hemodynamically stable and non-cyanosed pediatric patients. In each patient 4 suction and treatment protocols were studied: 1. pre- and post-suction arterial blood gases (ABG) with no treatment (control). 2. ABG with pre-suction oxygenation. 3. ABG with presuction hyperinflation. 4. ABG with postsuction hyperinflation. With no presuction treatment the PO2 and saturation fell significantly after suctioning from control level of 116.6±9.4 mmHg to 93±9.3 mmHg post-suction and 97.2±0.4% to 92.8±1.4% (p〈0.001) respectively. In 6 patients with low but adequate pre-suction PO2, hypoxic levels (PO2〈60 mmHg) were found post-suction. The significant fall in PO2 was completely prevented by pre-suction oxygenation. Post-suction hyperinflation induced a rapid return of the PO2 to control levels. These results suggest that severe hypoxia might occur during endotracheal suctioning and can be prevented by pre-oxygenation. We recommend 1 min oxygenation with FiO2 1.0 prior to suctioning procedures and intermittent hyperinflation with 100% oxygen during repeated endotracheal suction passes to prevent hypoxia, especially in children in respiratory failure who already have low or borderline pre-suction PO2.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF01699853
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