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document
End-expiratory lung volume recovers more slowly after closed endotracheal suctioning than after open suctioning : a randomized crossover study . PURPOSE Endotracheal suctioning causes significant lung derecruitment . Closed suction ( CS ) minimizes lung volume loss during suction , and therefore , volumes are presumed to recover more quickly postsuctioning . Conflicting evidence exists regarding this . We examined the effects of open suction ( OS ) and CS on lung volume loss during suctioning , and recovery of end-expiratory lung volume ( EELV ) up to 30 minutes postsuction . MATERIAL AND METHODS Randomized crossover study examining 20 patients postcardiac surgery . CS and OS were performed in random order , 30 minutes apart . Lung impedance was measured during suction , and end-expiratory lung impedance was measured at baseline and postsuctioning using electrical impedance tomography . Oximetry , partial pressure of oxygen in the alveoli/fraction of inspired oxygen ratio and compliance were collected . RESULTS Reductions in lung impedance during suctioning were less for CS than for OS ( mean difference , -905 impedance units ; 95 % confidence interval [ CI ] , -1234 to -587 ; P < .001 ) . However , at all points postsuctioning , EELV recovered more slowly after CS than after OS . There were no statistically significant differences in the other respiratory parameters . CONCLUSIONS Closed suctioning minimized lung volume loss during suctioning but , counterintuitively , resulted in slower recovery of EELV postsuction compared with OS . Therefore , the use of CS can not be assumed to be protective of lung volumes postsuctioning . Consideration should be given to restoring EELV after either suction method via a recruitment maneuver .
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Intervention_Physical
closed endotracheal suctioning
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Intervention_Physical
open suctioning :
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Intervention_Physical
Closed suction ( CS )
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Intervention_Physical
open suction ( OS )
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Intervention_Physical
CS
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Intervention_Physical
suctioning
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Intervention_Physical
CS
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Intervention_Physical
OS
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Intervention_Physical
CS
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Intervention_Physical
OS
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Intervention_Physical
CS
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Intervention_Physical
OS
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Intervention_Physical
Closed suctioning
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Intervention_Physical
OS
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Intervention_Physical
CS
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Outcome_Physical
endotracheal
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Outcome_Physical
lung volume
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Outcome_Physical
end-expiratory lung volume ( EELV )
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Outcome_Physical
postcardiac
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Outcome_Physical
Lung impedance
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Outcome_Physical
Oximetry
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Outcome_Physical
partial pressure of oxygen in the alveoli/fraction of inspired oxygen ratio
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Outcome_Mental
compliance
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Outcome_Physical
impedance
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Outcome_Physical
EELV
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Participant_Condition
End-expiratory lung volume
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Participant_Sample-size
20 patients postcardiac surgery