TWO LEVELS OF NEGATIVE PRESSURE IN OPEN TRACHEAL SUCTIONING AND THEIR EFFECT ON CARDIO-RESPIRATORY INDICES AMONG ADULT PATIENTS IN CRITICAL CARE UNIT AT MACHAKOS LEVEL FIVE HOSPITAL- A RANDOMIZED CONTROLLED TRIAL STUDY DONE IN KENYA

Abstract

Background: Tracheal Tube Suctioning is an important procedure performed on intubated patients receiving mechanical ventilation to ensure optimal oxygenation and ventilation. Unfortunately, the most effective and safe negative suction pressure is not yet defined.
Objective: To establish safe and effective level of negative pressure in open
tracheal tube suctioning based on positive cardio-respiratory indices among adult patients in Intensive Care Unit at Machakos Level Five Hospital.
Methods: This was randomized controlled trial study in which 76 participants were randomly allocated to 180mmHg and to 100mmHg negative suction groups to determine the effect of open tracheal tube suctioning on the cardiorespiratory indices of heart rate, respiration rate, peripheral oxygen saturation and blood pressure at four suction time points. Repeated measure analysis of variance and independent t-test were used to assess the differences in the means of the indices within and between groups respectively.
Results: The two levels of suctioning caused significant increase in heart rate (p<0.001), respiration rate (p<0.001), systolic (p<0.001), diastolic (p<0.05) and mean arterial pressure (p<0.001) and significant decrease in peripheral oxygen saturation during suctioning (p<0.001), and there were significant differences between the groups in diastolic (p=0.013) and in mean arterial pressure (p=0.015), where the lower suction level caused a bigger increase in blood pressure.

Conclusion: Suctioning at a higher level of 180mmHg does not cause significant additional physiological disturbances compared to a lower level of 100mmHg. The lower suction pressure of 100mmHg elevates blood pressure more and may therefore be of clinical benefit to hypotensive patients.