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Paper Information

Journal:   IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH (IJNMR)   MAY-JUNE 2014 , Volume 19 , Number 3; Page(s) 285 To 289.
 
Paper: 

THE EFFECT OF EXPIRATORY RIB CAGE COMPRESSION BEFORE ENDOTRACHEAL SUCTIONING ON THE VITAL SIGNS IN PATIENTS UNDER MECHANICAL VENTILATION

 
 
Author(s):  PAYAMI BOUSARI MITRA, SHIRVANI YADOLAH*, AGHA HASSAN KASHANI SAEED, MOUSAVINASAB NOUR ALDIN
 
* MOUSAVI HOSPITAL, ZANJAN UNIVERSITY OF MEDICAL SCIENCES, ZANJAN, IRAN
 
Abstract: 

Background: In patients undergoing mechanical ventilation, mucus production and secretion is high as a result of the endotracheal tube. Because endotracheal suction in these patients is essential, chest physiotherapy techniques such as expiratory rib cage compression before endotracheal suctioning can be used as a means to facilitate mobilizing and removing airway secretion and improving alveolar ventilation. As one of the complications of mechanical ventilation and endotracheal suctioning is decrease of cardiac output, this study was carried out to determine the effect of expiratory rib cage compression before endotracheal suctioning on the vital signs in patients under mechanical ventilation.
Materials and Methods: This study was a randomized clinical trial with a crossover design. The study subjects included 50 mechanically ventilated patients, hospitalized in intensive care wards of Valiasr and Mousavi hospitals in Zanjan, Iran. Subjects were selected by consecutive sampling and randomly allocated to groups 1 and 2. The patients received endotracheal suctioning with or without rib cage compression, with a minimum of 3 h interval between the two interventions. Expiratory rib cage compression was performed for 5 min before endotracheal suctioning. Vital signs were measured 5 min before and 15 and 25 min after endotracheal suctioning. Data were recorded on a data recording sheet. Data were analyzed using pairedt -tests.
Results: There were statistically signifi cant differences in the means of vital signs measured 5 min before with 15 and 25 min after endotracheal suctioning with rib cage compression (P<0.01). There was no signifi cant difference in the means of diastolic pressure measured 25 min after with baseline in this stage). But on the reverse mode, there was a signifi cant difference between the means of pulse and respiratory rate 15 min after endotracheal suctioning and the baseline values (P<0.002). This effect continued up to 25 min after endotracheal suctioning just for respiratory rate (P=0.016). Moreover, there were statistically signifi cant differences in the means of vital signs measured 5 min before and 15 min after endotracheal suctioning between the two methods (P
£0001).
Conclusions: Findings showed that expiratory rib cage compression before endotracheal suctioning improves the vital signs to normal range in patients under mechanical ventilation. More studies are suggested on performing expiratory rib cage compression before endotracheal suctioning in patients undergoing mechanical ventilation.

 
Keyword(s): ENDOTRACHEAL SUCTIONING, EXPIRATORY RIB CAGE COMPRESSION, MECHANICAL VENTILATION, VITAL SIGNS
 
References: 
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