title: Effects of expiratory ribcage compression before endotracheal suctioning on arterial blood gases in patients receiving mechanical ventilation.
abstract: OBJECTIVE
  To investigate the effects of expiratory ribcage compression (ERCC) before endotracheal suctioning on the arterial blood gases (ABG) in patients receiving mechanical ventilation.
  
  
  BACKGROUND
  Endotracheal suctioning is one of the most frequently used methods for airway clearance in patients receiving mechanical ventilation. Chest physiotherapy techniques such as ERCC before endotracheal suctioning can be used as a means to facilitate mobilizing and removing airway secretions and improving alveolar ventilation.
  
  
  METHODS
  A prospective, randomized, controlled cross-over design.
  
  
  METHODS
  A randomized controlled cross-over trial with a convenience sample of 70 mechanically ventilated patients was conducted from 2006 to 2007. The patients received endotracheal suctioning with (experiment-period) or without (control-period) an antecedent 5-min expiratory ribcage. All the patients experienced both periods with at least a 3-h washed-out interval between the two periods. ABG were measured 5 min before and 25 min after endotracheal suctioning.
  
  
  RESULTS
  The statistical tests showed that the levels of partial pressure of oxygen (PaO2 )/fraction of inspired oxygen (FiO2 ), partial pressure of carbon dioxide (PaCO2 ) and arterial oxygen saturation (SaO2 ) in the experimental period at 25 min after the intervention were significantly different from the control period. The tests also revealed that the levels of these variables at 25 min after suctioning were also significantly different from baseline values. However, these differences were clinically significant only for PaO2 /FiO2 .
  
  
  CONCLUSIONS
  By improving the levels of PaO2 /FiO2 , ERCC can reduce the patients' need for oxygen and hence it can at least reduce the side effects of oxygen therapy.
  
  
  CONCLUSIONS
  Improving PaO2 /FiO2 levels means less need for oxygen therapy. Hence, by applying ERCC we can at least minimize the side effects of oxygen therapy.
authors.affiliation: M Kohan, BSN, MSN, Lecturer, Department of Operating Room, Alborz University of Medical Sciences, Karaj, Iran.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Kohan
authors.forename: Morteza
authors.initials: M
authors.lastname: Rezaei-Adaryani
authors.forename: Akram
authors.initials: A
authors.lastname: Najaf-Yarandi
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Hoseini
authors.forename: Nahid
authors.initials: N
authors.lastname: Mohammad-Taheri
mesh_terms: D000328:Adult; D000368:Aged; D058109:Airway Management / Q000379:methods*; D000402:Airway Obstruction / Q000628:therapy*; D001158:Arteries / Q000737:chemistry*; D001784:Blood Gas Analysis; D002245:Carbon Dioxide / Q000097:blood; D019245:Compressive Strength; D018592:Cross-Over Studies; D005260:Female; D005740:Gases / Q000097:blood*; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D010100:Oxygen / Q000097:blood; D011446:Prospective Studies; D011659:Pulmonary Gas Exchange / Q000502:physiology*; D012121:Respiration, Artificial / Q000379:methods*
chemical_list: D005740:Gases; D002245:Carbon Dioxide; D010100:Oxygen
keywords: Arterial blood gases; Critical care nursing; Endotracheal suctioning; Expiratory ribcage compression