title: Effect of lung hyperinflation and endotracheal suctioning on heart rate and rhythm in patients after coronary artery bypass graft surgery.
abstract: We examined the effect of lung hyperinflation and suction on PaO2, heart rate, and rhythm in patients after coronary artery bypass graft surgery (N = 26). Three lung hyperinflation breaths, at one of five randomly ordered volumes (tidal volume, 12 cc/kg, 14 cc/kg, 16 cc/kg, or 18 cc/kg of lean body weight) were delivered, by a ventilator (fraction of inspired oxygen 1.0), followed by 10 seconds of continuous suction. Lung hyperinflation and suctioning were repeated three times. Repeated-measures analysis of variance revealed a statistically significant increase (p = 0.000) in PaO2 immediately after the third suction pass, which was volume dependent (p = 0.009). A statistically significant (p less than 0.001) increase in heart rate from baseline occurred over the three lung hyperinflation-suctioning sequences that was not volume dependent. The mean increase in heart rate was 6.8 beats/min. The majority of rhythm changes for lung hyperinflation and suctioning were from normal sinus rhythm to sinus tachycardia. Suction was associated with a greater incidence of rhythm (53.9%) and arrhythmia (80.8%) changes. The most frequent arrhythmia was premature atrial contraction.
authors.affiliation: College of Nursing, Ohio State University, Columbus 43210-1289.
authors.forename: K S
authors.initials: KS
authors.lastname: Stone
authors.forename: S A
authors.initials: SA
authors.lastname: Talaganis
authors.forename: B
authors.initials: B
authors.lastname: Preusser
authors.forename: D S
authors.initials: DS
authors.lastname: Gonyon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000209:etiology* / Q000503:physiopathology; D001026:Coronary Artery Bypass; D005260:Female; D006339:Heart Rate; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial / Q000009:adverse effects*; D013396:Suction / Q000009:adverse effects