title: Comparing the effect of open and closed endotracheal suctioning on pain and oxygenation in post CABG patients under mechanical ventilation.
abstract: BACKGROUND
  The aim of this study was to compare changes in pain, oxygenation, and ventilation following endotracheal suctioning with open and closed suctioning systems in post coronary artery bypass grafting (CABG) patients.
  
  
  METHODS
  130 post CABG mechanically ventilated patients were randomly allocated to undergo either open (n = 75) or closed (n = 55) endotracheal suctioning for 15 s. The patients received 100% oxygen for 1 min before and after suctioning. Pain score using critical-care pain objective tool (CPOT) was compared during suctioning between the two groups. Arterial oxygen pressure (PaO2), PaO2 to fraction of inspired oxygen (FiO2) (PF) ratio, and arterial carbon dioxide pressure (PaCO2) were compared at baseline and 5 min after suctioning. Peripheral oxygen saturation (SpO2) was compared at baseline, during suctioning, and at 1 min interval after suctioning for 5 min between the two groups.
  
  
  RESULTS
  The patients were the same with regard to CPOT scores, i.e. 3.21 (1.89) and 2.94 (1.56) in the open and closed suctioning systems, respectively. SpO2 did not change significantly between the two groups. Changes in PaO2 and PF ratio was more significant in the open than in the closed system (P = 0.007). Patients in the open group had a higher PaCO2 than those in the closed group, i.e. 40.54 (6.56) versus 38.02 (6.10), and the P value was 0.027.
  
  
  CONCLUSIONS
  Our study revealed that patients' pain and SpO2 changes are similar following endotracheal suctioning in both suctioning systems. However, oxygenation and ventilation are better preserved with closed suctioning system.
authors: Department of Nursing, School of Nursing and Midwifery, Gonabad University of Medical Sciences, Gonabad, Iran.
authors: Ali
authors: A
authors: Mohammadpour
authors: Department of Anesthesiology and Critical Care, Mashhad University of Medical Sciences, Mashhad, Iran.
authors: Shahram
authors: S
authors: Amini
authors: Department of Social Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors: Mohammad Taghi
authors: MT
authors: Shakeri
authors: School of Nursing and Midwifery, Gonabad University of Medical Sciences, Gonabad, Iran.
authors: Sahereh
authors: S
authors: Mirzaei
keywords: Closed suctioning; coronary artery bypass grafting; endotracheal suctioning; open suctioning; oxygenation; pain; ventilation