Introduction: One of the major goals of nursing in trauma patients is clearing the airway. Therefore, this study aimed to compare the side effects of suction and nelaton catheter in patients with brain trauma.Methods: This study is a randomized clinical trial consisting of 80 patients admitted to intensive care unit of Shahid Rahnemun hospital in Yazd. Underlying variables and suction side effects were evaluated in both suction and nelaton groups. Finally, descriptive and inferential statistical analyses were performed using SPSS Ver 16 such as Chi-square and T-test.Results: The nelaton reduced the patients’ need to suction (P-Value for third and fourth days was respectively 0.003 and 0.004). After total suction with nelaton catheter, O2SAT decreased for the patients (P-Value of first day=0.06, second day=0.004, third day=0.002, fourth day=0.001). Comparing O2SAT between these two types of catheter, a significant difference was observed on the fourth day (P-Value=0.002). The mean heart rate increased in both groups after suctioning (P-Value=0.0001), though no difference was found in heart rate between the two groups (P-Value of first day=0.37, the second day=0.13, the third day=0.57, fourth day=0.09). The difference between the two groups in regard with frequency of bleeding chips after suctioning proved to be significant from the third day of the study. In other words, patients in suction catheter were reported to have more bleeding chips. (P-Value of first day =0.9, second day=0.14, third day=0.001, fourth day=0.001). No significant difference was found with respect to infection (P-Value=0.8).Conclusion: The study findings revealed that applying catheter nelaton can reduce the injury and bleeding to the patient’s trachea to a significant percentage and can lead to less O2SAT fall.

Meconium-stained amniotic fluid (MSAF) occurs in approximately 5-20% of live births that meconium aspiration syndrome occurs in approximately 4-5% of these neonates after birth with breathing meconium goes to the small bronchial tree and clinical manifestation such as respiratory distress and tachypena, is present. Thease patients have high mortality and morbidity. For this reason, we studied two groups of infants with meconium stained fluid and compaired mortality and morbidity in two groups. One group was intubated and suction immediately after, and other group was not intubated. In this study, that was prospective and analytical cross-sectional, infants who were delivered with meconium-stained amniotic fluid (MSAF) throught a 3 years period (1996-1999) AkbarAbadi Hospital were studied. In this period 33037 infants were delivered and meconium-stained amniotic fluid (MSAF) occurred in 3254 (9.85%) of this live births. In 217 instance (6.67%) amniotic fluid was thick, in 188 (86.64%) of this infants the trachea was immediately. After birth intubated and suctioned. But unfortunately in 29 infants (13.36%). The trachea was not immediately after birth intubated and suctioned. In the intubated group complications included: Sepsis 17.55% (25 patients), pneumothorax 13.82% (26 patients), respiratory distress syndrome (RDS) 15.42% (29 patients), peresistent fetal circulation (PFC) 3.19% (6 patient). In 29 infants (13.36%) that we couldn’t intubated and suctioned, complications included: sepsis 10.34% (3 infants), pneumothorax 37.93% (11 infants), RDS 17.24% (5 infants), PFC 6.9% (2 infants). In all in intubated group complications were in 45.74% (86 infants) that 6.38% (12 infants) of this were died. In unintubated group, complications were seen in 72.41% (21 infants), that 13.79% (4 infants) were died. In this study intubation and suction immediately after birth in thick meconium-stained amniotic fluid decreased meconium Aspiration syndrome but increased it’s morbidity.

Background & Aim: Nowadays, mechanical ventilators are being used for some patients in ICUs due to various physiological and clinical causes. Keeping endotracheal tube clean and open is necessary in order to improve the patient’s oxygenation. This study aimed to investigate the effects of open and closed system endotracheal suctioning on vital signs of patients in ICU.Methods & Materials: In this quasi-experimental study, 40 patients from Shariaty Hospital’s ICU were selected using convenience sampling method. Data was collected using a record sheet. The sheet consisted of demographic characteristics and vital signs including blood pressure, mean arterial blood pressure, heart rate, respiratory rate, and arterial blood oxygen saturation percentage. Endotracheal suctioning was done randomly in 90 minute intervals once using closed method and once using open method. All patients were hyper oxygenated by Ambo bag for 2 minutes before and after the procedures. The patients’ vital signs were checked and recorded using SIEMENS 680 2xi monitor before, and 2 minutes and 5 minutes after the procedures. Data were analyzed using SPSS software.Results: Systolic and diastolic blood pressures, and heart rate showed higher increase 2 and 5 minutes after the open method compared to close method (P<0.001). Arterial blood oxygen saturation percentage reduced in the open method more than in the closed one 2 and 5 minutes after the procedure (P<0.001). No significant difference was seen in the patients’ respiratory rate in two methods (P>0.05).Conclusion: Closed endotracheal suction system results in lower disturbances in the vital signs than the open system. Therefore, for better results, the closed endotracheal suctioning is suggested.

Background: If not done properly, suction causes complications such as hypoxia, cardiac arrhythmias or even death. Suction is being used in most hospital wards. Closed Suction appears to have fewer side effects, although studies have reported dissimilar results.Aim: The aim of this study was to compare the effect of open (control) with closed (test) endotracheal suctioning on patients’ Hemodynamic state.Methods: This study was a randomized clinical trial in 86 patients admitted in the ICU of Besat hospital of hamedan in 2013, being divided into two groups: open (control) and closed (test) endotracheal suctioning.Systolic and diastolic blood pressure, mean arterial pressure (MAP), heart rate, arterial O2 saturation (SPO2), respiratory rate and the incidence of disrrythmia were recorded in patients' questionnaires immediately, and afterwards 2 and 5 minutes after endotracheal suctioning by open and closed methods. Data analysis was performed by Repeated Measure ANOVA, t test, chi-square and Fisher's exact test.Results: A total of 102 patients were included in the study. Sixteen patients were excluded from the study and data from 86 patients were analyzed. No statistically significant differences in age (15/0P=) and sex (33/0P=) were found between the two groups.Hemodynamics index in two groups was similar before the suctioning (P>0.05). In the open group, there was an increase in diastolic blood pressure (P=0.017), mean arterial pressure (P=0.019), heart rate (P=0.003) and respiratory rate (P<0.0001) immediately, 2 and 5 minutes after suctioning in comparison to the closed group (P>0.05). Systolic blood pressure, SPO2 and incidence of disrrythmia were similar in the two groups.Conclusion: Endotracheal suctioning by closed method had lower effects on patients' Hemodynamic status rather than the open system. Hence, closed endotracheal suctioning is recommended in the ICU.

Background and Objectives: Artificial airway suctioning is an important intervention to take care of mechanically ventilated patients. The aim of this research was to determine the effect of artificial airway suction based on the comprehensive criteria for suctioning on the patients' hemodynamic status in ICU.Materials and Methods: This study was a randomized clinical trial by before-after design with one control 60 group. mechanically ventilated patients admitted to the ICU were selected by convenience sampling and were assigned into two 30-member groups using a block random allocation method. To collect the data, we used demographic and hemodynamic status sheet. In experimental and control groups the need for suctioning was determined on the basis of comprehensive and common suction standards respectively. Hemodynamic status was determined before suctioning and 2 and 5 minutes after suctioning. The data were analyzed by SPSS 17 software.Results: Compare the mean of arterial pressure (MAP) and O2 saturation between two groups respectively showed a significant difference in 2minutes (P=0.001 and P=0.015) and minutes (P=0.006 and P=0.001) after intervention. The mean difference of MAP (p=0.041), oxygen saturation (p=0.001) and diastolic blood pressure (p=0.021) were significantly different from the Baseline after 2 and 5 minutes of the intervention.Conclusion: It seems suctioning based on comprehensive criteria is effective in preventing side effects and maintaining hemodynamic stability in mechanically ventilated patients.

Background and aim: Ventilator-associated pneumonia (VAP) is one of the common nosocominal infections in intensive care units (ICU) which leads to high mortality rates. Endotracheal suctioning is routinely performed in mechanically ventilated patients to clear secretions. The aim of this study was to compare the effect of closed versus open endotracheal suction methods on development of ventilator-associated pneumonia.Materials and Methods: This randomized control trial included 156 hospitalized patients in intensive care units of the hospitals of Arak University of Medical Sciences. Patients who had required mechanical ventilation and been transferred to ICU in less than 24 hours after their admission and had endotracheal tubes for less than six hours were assigned randomly into two groups. Routine open suction and closed suction methods were used for control (n=74) and intervention (n=82) groups respectively. After 72 hours the patients were examined for signs and symptoms of pneumonia based on clinical pulmonary infection score (CPIS).Results: The results of this study showed the incidence of pneumonia in the intervention and control groups were 28% and 48.6% respectively. Considering the incidence of pneumonia, there was a significant difference between the two groups (P=0.01). Patients with history of cigarette smoking had increased incidence of pneumonia but no difference was detected in the incidence of pneumonia between males and females.Conclusion: Considering the decreased risk of transfer of contamination via medical devices and personnel's hands, use of closed suction method can lead to a decrease in the incidence of ventilator associated pneumonia.

Background and Objective: Although suction is an important nursing intervention in neonates under ventilation, it can lead to complications such as pain, respiratory distress, hypoxemia, bronchospasm and hospital infection. The purpose of this study was to determine the relationship between pain score and its effective indices in neonatal endotracheal open suction under ventilator in the neonatal intensive care unit of Hamadan hospitals. Materials and Methods: This descriptive correlational study was performed on 120 preterm infants under ventilation in Neonatal intensive care unit of Hamadan hospitals. First, 5 minutes before the patient suction, the respiratory rate and oxygen saturation of the neonatal arterial blood were recorded by the researcher in three shifts based on the findings of the direct monitoring of the infant. During and 5 minutes after suction, the respiratory rate and oxygen saturation index was re-recorded. Data were analyzed using descriptive and regression tests. Results: According on the results of the applied linear regression model, there was a statistically significant relationship between the pressure of the suction device, the duration of suction and the number of suctions with the pain score(P =0. 000) but there was no statistically significant relationship between the size of the suction catheter and the pain score (P =0. 235). Conclusion: Endotracheal open suction in premature infants can greatly affect the number of respiration and oxygen saturation in the arterial blood and increase the pain score in these infants.

Background: Connecting the chest bottle system to suction apparatus is a common practice after thoracotomies. The loud and unpleasant sound of air bubbling in the chest bottle while connecting to suction, might be troublesome to the patient and others. This problem has not been considered appropriately until now.In our study we tried to solve it by making a simple device and connecting it to the chest bottle.Materials and methods: By connecting two little sized funnels using tapes, we made a device which can be connected to chest bottle and acts like a muffler and decrease the sound of bubbling caused by suctionin. Results: The device was used in 10 patients, and their satisfaction following its use was increased due to the considerable suctioning sound decrease.Conclusion: This reduction of sound was sendible to both the patients and examiners.This simple easily accessible and cheap device can effectively reduce the sound of chest bottle suctioning.

2Abstract Aim. In this review article, the cost-effectiveness of disposable suction bottles in Iran was discussed. Background. Healthcare-associated infections (HAIs) cause mortality and morbidity in patients, especially in the intensive care unit. There are different methods and instructions to control HAI, which is an important and fundamental problem related to suction. Method. Searching out for articles through databases including Science Direct, PubMed, Cochrane, Medline, SID, Scopus, CINAHL, OVID, Iran Doc and Magiran using the keywords "disposable suction", "hospital infection", "waste management" and their English equivalent were conducted. Articles that were published between 2000 and 2022 and were more related to the main focus of the research topic were selected. The inclusion criteria included their publication in reputable scientific journals, publication in Farsi or English, and access to the full text of the article. Exclusion criteria included publishing articles in weak and invalid journals. Findings. Disposable suction bottles was evaluated in five domain including hospital infection control and prevention, water consumption management, ease of use, waste management, and cost effectiveness. Conclusion. Considering the lack of manpower for disinfecting disposable suction bottles, the costs of disinfectant solutions and their improper use in diluting them, and the management of waste water from used solutions and emptying suction cups; disposable suction bottles have priority over reusable suction bottles in Iran.