Introduction: In spite of the recent improvements in prenatal and postnatal cares, there is an increase of respiratory distress in premature newborns that need to be put on ventilators. Due to intratracheal intubation and ventilation systems, there is an increase of ventilator-associated infection among such neonates; thus, calling for more attention and evaluation. Accurate diagnosis and immediate treatment of these infections may decrease the onset of respiratory complications, the cost due to prolonged hospitalization, drug consumption and neonatal mortality.Materials and Methods: This is a cross-sectional study. The sampling technique used for the study was easy and based on goals. The population of the study were selected among intubated newborns in neonatal intensive care of Bahman 22nd Hospital in Mashhad. The subjects were diagnosed for Respiratory Distresses (RDS) during the years 2006 to 2007. Tracheal culture was done and antibiograms were created for all the cases while changing the tube. Also, the results of blood culture, the number of tubes being changed, the duration of intubation and the number of suctions were studied. Having completed the information forms, the data were evaluated with SPSS software running Fisher test and K2.Results: Among 100 neonates who were studied, 34 cases had positive tracheal culture. The organisms identified included: Coagulase positive staph (30%), C. Negative staph (23%) and E. coli (23%). The results of blood culture were positive in 6% of the cases. 40% of the subjects were suctioned 10-12 times a day and 60% of them were put on intubators 3-5 days and 50% of them had their tracheal tubes changed 3 to 4 times during hospitalization period.Conclusion: Repeated sterile suctioning as well as reducing the time of intubation and the number of tube changing diminished the formation of organism colonization in trachea.

Background & Aim: Although trachea-bronchial suctioning (TBS) is one of the important nursing procedures in intensive care units (ICU), it may be associated with some complications. Using closed system suctioning (CSS) is one of the ways to decrease the rate of complications due to continued ventilation and oxygenation at the time of suctioning. However, CSS' secretion removal is not efficient enough. Higher values of suction pressure have been recommended to enhance the efficacy of CSS. The aim of this study was to compare the efficacy of two levels of negative suction pressure in secretion removal of CSS used for mechanically ventilated (MV) patients. Materials & Methods: Fifty eligible adult MV patients (twenty in each group) with Random allocation participated in this clinical trial study with cross-over design. Each patient was suctioned using CSS, connected to a central suction device, with 100 and 200 mmHg pressures with a two-hour interval. Efficacy of suctioning was measured by the absence of secretion flow at the end of suctioning. Volume of the secretions was measured and compared in each suctioning. Statistical analyses were done using Minitab and SPSS software considering the significance level of 0. 05. Results: CSS using 200 mmHg resulted in an efficacy of 96% for removing secretions, compared to 34% for 100 mmHg (P = <0. 0001). Suctioning volume was increased significantly higher with 200 mmHg suction pressure compared to values with 100 mmHg (1. 72 [95% confidence interval (CI): 1. 4; 2. 0]; P<0. 0001). Conclusion: Application of CSS with Suctioning pressure 200 mmHg is recommended for trachea-bronchial suctioning in mechanically ventilated patients, because nearly complete removal of respiratory suctioning in most subjects.

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: Intratracheal suctioning is a standard method of nursing care for intubated patients with the aim of cleaning airway for good oxygenation. The aim of this study was to evaluate the effects of intratracheal suctioning on blood pressure, heart rate, and arterial oxygen saturation.Materials and Methods: This was a semi-experimental research in which the patients admitted to intensive care unit of Kashani teaching center of Shahr-e-kord University in 2005. The data were collected by a questionnaire form 35 patient by observation and measurement of blood pressure, heart rate and arterial oxygen saturation.Results: The findings showed that during suctioning, systolic pressure, diastolic pressure, and heart rate increased and arterial oxygen saturation decreased significantly, when compared with pre-suctioning period. The same occurred when these parameters were compared between pre-suctioning period and I minute post-suction, except for arterial oxygen saturation that had not statistically significant decline, I minute after suctioning. The parameters under study remained increased (including arterial oxygen saturation that decreased during suctioning) 3 minutes after suctioning, but this increase was not statistically significant when compared with pre-suctioning period. The study showed that parameters in I and 3 minutes after suctioning were also significantly different from those of suctioning period.Conclusion: The finding of this research showed that the maximum changes of blood pressure and heart rate (increase) and arterial oxygen saturation (decrease) occurs during suctioning and maximum changes of blood pressure and heart rate (decrease) and arterial oxygen saturation (increase) occurs 3 minutes after suctioning. Therefore, hyper oxygenation, hemodynamic and SpO2 monitoring before, during and after suctioning are recommended.