Postoperative head and neck cancer patients with artificial airways: the effect of saline lavage on tracheal mucus evacuation and oxygen saturation.
The practice of normal saline bolus instillation prior to suctioning is being questioned as to its harmful effects on patients' oxygenation levels. However, there are no clinical data to support halting its use on patients undergoing major head and neck procedures with unique airway concerns.


METHODS
Twenty postoperative nonventilated head and neck cancer patients with a tracheostomy were studied at the Pittsburgh Cancer Institute/University of Pittsburgh Medical Center. The authors were interested in evaluating arterial oxygen saturation elicited by suctioning with and without a 5-cc saline bolus and the amount of secretions obtained by the different methods of suctioning. Measures of SaO2 values were monitored at baseline and immediately after suctioning, as well as 15, 30, and 45 seconds, and 1, 2, 3, and 5 minutes following the end of suctioning. Methodology was a quasi-experimental, single-case, repeated-measures design which allowed patients to serve as their own controls.


RESULTS
The mean sputum weight with normal saline was 7.75 g, and 4.53 g without saline. Findings concerning SaO2 showed that no saturation levels dropped below 95%.


CONCLUSIONS
We concluded that using normal saline instillation as part of the suctioning procedure does significantly enhance mobilizing bloody mucus tracheal secretions common in postoperative head and neck cancer patients and does not cause oxygen desaturation.
Hudak
M
M
Bond-Domb
A
A
D015400:Clinical Nursing Research; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009093:Mucus; D010100:Oxygen / Q000097:blood; D011182:Postoperative Care; D012965:Sodium Chloride; D013396:Suction / Q000451:nursing*; D007507:Therapeutic Irrigation / Q000451:nursing*; D014139:Tracheostomy / Q000451:nursing*
D012965:Sodium Chloride; D010100:Oxygen