Application and promotion of continuous aspiration of subglottic secretionby stabilized pressure suction technique

Abstract

Objective Through the popularization of the technique of stabilized pressure of the subglottic secretion, to improve the drainage effect of subglottic secretion of intensive care unit (ICU) patients in this region, and to improve the quality of subglottic secretion management. Methods The stabilized pressure device on continuous aspiration of subglottic secretion was designed and the pressure-stabilized technique for subglotted secretion was promoted in 7 hospitals in Zhejiang province from January to December of 2018. The quality of drainage of subglottic secretion before and after the promotion of the stabilized technique were compared. In every hospital the included research objects were divided into two groups, and the subglottic secretion stabilized pressure devices adopted two suctioning methods of intermittent and continuous accordingly in the two groups: intermittent group (n=161) and continuous group (n=160) , the incidence of blockage of decompression holes and instability of negative pressure control were compared between the two groups, and the incidences of drainage, cough, blockage of tube and mucosal injury during were compared. Results After promotion, the quality of subglotted secretion suctioning in 7 hospitals all improved, among which the dimensions of suction operation and outcome indicator showed statistically significant difference before and after promotion (P<0.05) . In terms of the performance of stabilized pressure device, the blockage rate of decompression holes in continuous group (3.13%) was higher than that in intermittent group, and the incidence of negative pressure control instability (3.75%) was lower than that in intermittent group; in terms of the effect of subglottic drainage, the drainage flow rate of subglottic secretion in continuous group was (53.55±5.92) ml/d, and the daily coughing times were (3.01±1.13) , both better than the intermittent group, the difference was statistically significant (t=12.374, -2.625; P< 0.05) . Conclusions Subglottic secretion pressure-stabilized device has good performance, and the technology of pressure-stabilized can effectively improve drainage effect. The method of continuous is recommended in this study, which has a significant effect on improving the drainage quality of subglottic secretion and has a good promotion effect. Key words: Intensive care unit; Subglottic secretion; Suction technique; Technique promotion