Abstract
This study was conducted to evaluate the effects of open endotracheal suctioning on gas exchange and respiratory mechanics in ARF patients under the modes of PCV or VCV. Ninety-six ARF patients were treated with open endotracheal suctioning and their variations in respiratory mechanics and gas exchange after the suctions were compared. Under PCV mode, compared with the initial level of tidal volume (V T), ARF patients showed 30.0% and 27.8% decrease at 1 min and 10 min, respectively. Furthermore, the initial respiratory system compliance (C rs) decreased by 29.6% and 28.5% at 1 min and 10 min, respectively. Under VCV mode, compared with the initial level, 38.6% and 37.5% increase in peak airway pressure (PAP) were found at 1 min and 10 min, respectively. Under PCV mode, the initial PaO2 increased by 6.4% and 10.2 % at 3 min and 10 min, respectively, while 18.9% and 30.6% increase of the initial PaO2 were observed under VCV mode. Summarily, endotracheal suctioning may impair gas exchange and decrease lung compliance in ARF patients receiving mechanical ventilation under both PCV and VCV modes, but endotracheal suctioning effects on gas exchange were more severe and longer-lasting under PCV mode than VCV.
Highlights
Respiratory failure is an acute or chronic condition with impaired gas exchange and pulmonary functions and is characterized by elevated carbon dioxide or decreased oxygen in the arterial blood [1]
No significant differences were found in changes in heart rate (HR) and mean arterial pressure (MAP) at 10 min after suctioning compared with the baseline level under both pressure-controlled ventilation (PCV) and volumecontrolled ventilation (VCV) modes
Endotracheal suctioning may lead to different effects on gas exchange and respiratory mechanics in acute respiratory failure patients under the mode of volumecontrolled ventilation (VCV) and pressure-controlled ventilation (PCV)
Summary
Respiratory failure is an acute or chronic condition with impaired gas exchange and pulmonary functions and is characterized by elevated carbon dioxide or decreased oxygen in the arterial blood [1]. Mechanical ventilation is effective in improving gas exchange, while reducing dyspnea and inspiratory effort in patients with respiratory failure, and averts risks secondary to endotracheal intubation [7, 8]. ARF patients are separated from the ventilator during open endotracheal suctioning, which may decrease positive airway pressure (PAP) and lung volume [4]. Alveolar collapse may induce a further decline in lung volume during negative-pressure suction [12], thereby affecting gas exchange and respiratory mechanics in ARF patients [2]. P 0.538 0.836 0.848 0.247 0.289 investigated the effects of open endotracheal suctioning on respiratory mechanics and gas exchange in ARF patients under PCV and VCV
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