The effect of saline lavage prior to suctioning.
OBJECTIVE
To determine the effect on oxygen saturation of instilling a saline bolus into artificial airways prior to suctioning, as measured by pulse oximeter.


METHODS
Quasi-experimental, single-case, counterbalanced design.


METHODS
The surgical, medical and coronary intensive care units of a federal, teaching medical center.


METHODS
Subjects were 40 men, more than 40 years old, in need of intensive care nursing and mechanical ventilation.


METHODS
Subjects were suctioned as needed for 24 hours. A 5-mL saline bolus was instilled every other time the subject was suctioned. Outcome measurements were done immediately before and after suctioning and at 1-minute intervals for 5 minutes after suctioning.


METHODS
Noninvasive oxygen saturation values.


RESULTS
The instillation of a saline bolus was found to have an adverse effect on oxygen saturation that worsened over time. Significant changes in oxygen saturation as a result of saline bolus instillation were found at 2,3,4 and 5 minutes after instillation.


CONCLUSIONS
These results indicate that instilling saline prior to suctioning has an adverse effect on oxygen saturation. These results support the recommendation that the practice of instilling saline prior to suctioning should be abandoned as a routine procedure. More study is needed to investigate whether a specific group of patients may actually benefit from this procedure.
Ackerman
M H
MH
Veterans Affairs Medical Center, Buffalo, NY.
D000368:Aged; D015400:Clinical Nursing Research; D002985:Clinical Protocols; D006801:Humans; D000860:Hypoxia / Q000097:blood* / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D007442:Intubation, Intratracheal / Q000451:nursing*; D008297:Male; D008875:Middle Aged; D010092:Oximetry; D010100:Oxygen / Q000097:blood*; D011897:Random Allocation; D012680:Sensitivity and Specificity; D012965:Sodium Chloride; D013396:Suction / Q000009:adverse effects* / Q000451:nursing*; D007507:Therapeutic Irrigation / Q000009:adverse effects / Q000451:nursing; D013997:Time Factors; D014139:Tracheostomy / Q000451:nursing*; D016896:Treatment Outcome
D012965:Sodium Chloride; D010100:Oxygen