Effects of endotracheal suctioning on respiratory parameters in Pediatric Intensive Care Unit: a prospective observational study

Abstract

Introduction The endotracheal suctioning is an invasive practice performed in critical care units that allows removal of the pulmonary secretions in intubated patients. During this procedure, patients are exposed to potential risks that health professionals, should prevent or minimize. At date is a shortage of published studies on the frequency of endotracheal suction in pediatric critically ill patients. It is supposed that the endotracheal suction does not affect significantly the assessment of short-term respiratory parameters and therefore may be deferred by the clinical condition of the patient. Methods The study carried out from 1 January to 30 September 2016 in mechanically ventilated pediatric patients at pediatric intensive care unit of Salesi children’s Hospital of Ancona. The study involved the collection of two venous blood samples taken from a central venous catheter: the first blood gas analysis was performed on each patient 1 minute before endotracheal aspiration and after a time interval of about 30 minutes from the endotracheal suctioning a second sample from the same vascular access device. Mean and percentages were calculated for qualitative variables, mean and standard deviation were calculated for quantitative parameters. For inferential purposes, to evaluate the effects of endotracheal aspiration on respiratory parameters detected by blood gas analysis, the student T test was performed for paired data with a 95% confidence interval. Results A total of 40 patients were recruited, of which 14 were females (35%) and 26 were males (65%). The results were as follows: For pH, the mean of the difference in values is .0065 [95% CI -0.0067 - 0.0197]. According to T test for paired data, a p=.3256 was obtained. From the inferential point of view, this difference is not considered statistically significant. For the pO2 the mean of the difference in values is .03 [95% CI-1.62 -1.67]. According to T tests for paired data, a p =.9756 was obtained. For the pCO2, the mean of the difference in values is -1.88 [95% CI -3.81 - 0.06] with a p value = .0577.
 Discussion Our findings highlighted no statistically significant differences between pre and post endotracheal aspiration values of pH, pO2 and pCO2. This suggests that the aspiration has beneficial effects on the pulmonary mechanics. Therefore, it is declared that the reduction of the frequency of endotracheal aspiration pediatric cause a reduction of the related infectious risks, reducing costs and respiratory nosocomial infections leading to reduced length of hospital stay.