Document Type : Research articles
Authors
1
, Clinical instructor Pediatric Nursing department, Faculty of Nursing, Alexandria University, Egypt.
2
Professor Emeritus Pediatric Nursing department, Faculty of Nursing, Alexandria University, Egypt.
3
, Assistant Professor Pediatrics Department, Faculty of Medicine, Alexandria University, Egypt.
4
Lecturer in Pediatric Nursing Pediatric Nursing department, Faculty of Nursing, Alexandria University, Egypt.
Abstract
Background: A mechanical ventilator is a significant life-saving intervention for preterm
neonates. Thus, those neonates need recurrent endotracheal suctioning to remove pulmonary
secretions. However, it is necessary, as it is a noxious stimulus, and physiological changes can be
observed during this procedure. Therefore, critical neonatal nurses have a crucial role during
endotracheal suctioning with minimal negative side effects. Aim of the study: to evaluate the
impact of minimally invasive endotracheal suctioning on physiological parameters among
mechanically ventilated preterm. Design: A quasi-experimental research design was used.
Settings: This study was conducted at the Neonatal Intensive Care Unit at Alexandria University
Children's Hospital at El-Shatby. Subjects and Method: A convenient sample of 60
mechanically ventilated preterm neonates who were admitted to the previously mentioned
settings (25 neonates from were fulfilled the following criteria; mechanically ventilated preterm
neonates on invasive endotracheal tube, gestational age less than 37 weeks at birth and not
receiving any sedatives. Those neonates were distributed equally into control and study groups
(30 neonates in each one). Preterm neonates in the control group experienced routine
endotracheal suctioning in the unit (deep suctioning) by the assigned neonatal nurse. In contrast,
those in the study group experienced minimally invasive endotracheal suctioning by the
researcher. Physiological parameters of neonates were assessed before, during, immediately, after
three and ten minutes of the procedure. Results: it was found that more than three-quarters of
preterm neonates (76.7%) in the study group had normal heart rate immediately after suctioning,
compared to most of the neonates in the control group (96.7%) who still recorded tachycardia
(p<0.001). A statistically significant difference between both groups of the study was found
immediately after and after three minutes of suctioning concerning respiratory rate (p<0.001),
whereas around two-thirds of neonates in the study had normal respiratory rate, but almost all of
the neonates in the control group recorded tachypnea (p<0.001). Regarding oxygen saturation
during suctioning, the means of oxygen saturation were 88.4±7.0% and 90.0±3.6% in the control
and study groups, respectively. A statistically significant difference was found between both
groups of study (p=0.001). Conclusion: This study demonstrates that minimally invasive
endotracheal suctioning in intubated preterm neonates had less effect on physiological parameter
alterations than routine deep endotracheal suctioning. Recommendations: The following
recommendations are suggested: The critical neonatal nurse must assess the need of neonates for
suctioning and monitor the preterm infant during and after the procedure. Additionally, those
nurses need to practice minimal invasive endotracheal suctioning for preterm neonates to aviod
potential outcomes.
Keywords
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