Journal of Korean Academy of Nursing

The Effects of Chest Vibration Prior to Endotracheal Suctioning on Oxygenation and the Amount of Lung Secretions in Premature Infants with Respiratory Distress Syndrome: Ahn Young Mee; Journal of Korean Academy of Nursing 1998;28(3):591-601. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.1998.28.3.591

The Effects of Open Endotracheal Suctioning(ETS) and Close ETS on Oxygen Saturation and Heart Rate in Premature Infants with Respiratory Distress Syndrome: Mi Soon Kim, Young Mee Ahn, In Ok Park, Sook Ja Choi, Mi Young Yoo; Journal of Korean Academy of Nursing 1998;28(3):529-539. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.1998.28.3.529

Abstract PDF: Prematurity is the main cause for respiratory distress syndrome(RDS) in neonates. The goal in the treatment of RDS is to maintain respiration with adequate oxygenation. ETS needs to be performed to remove lung secretions in the ventilated premature infants with RDS. Oxygen saturation(SpO2) and heart rate(HR) were compared in 22 premature infants with RDS using two types of ETS: open ETS versus close ETS. The results showed there was no significant difference in the SpO2 and HR returned to the baseline within 1 minute after suctioning. But in some case, there was a significantly greater incidence in the decrease of SpO2 below 90% occurred in the open ETS than in the close ETS. It implies that closed ETS may be beneficial to premature infants who tend to develop desaturation easily.

Concept Analysis of Endotracheal Suctioning(ETS): Young Mee Ahn; Journal of Korean Academy of Nursing 2005;35(2):292-302. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2005.35.2.292

Abstract PDF: Purpose
Concept analysis was performed on the behavioral concept of endotracheal suctioning (ETS), to identify the goal, to develop astandardized clinical protocol, to identify the antecedents and consequences, and to differentiate the improper use of ETS.
Method
Walker & Avant's concept analysis was employed using clinical guidelines, books and review articles in which the procedures of ETS were written in detail and published in Pubmed within the last 20 years.
Result
The macro-goal of ETS was to remove accumulated respiratory secretions. Three defining attributes of ETS were identified; catheter, suctioning and asepsis. Each attribute involved empirical referents, such as the size and depth of thecatheter, the suction pressure, duration and method for suctioning. The antecedents of ETS were identical to the clinical evidences for the need of ETS such as the nursing assessment data. The consequences of ETS serve as an evaluation criteria on the effectsof ETS based on the goal of ETS.
Conclusion
The concept analysis of ETS demonstrates an example of considering a specific nursing protocol of ETS as a behavioral concept, applying concept analysis to it to identify it's key behavioral components as defining attributes and empirical referents and then developing and applying the standard ETS protocol.

Meta-Analysis on the Effectiveness of Interventions Applied to Preventing Endotracheal Suction-Induced Hypoxemia: Hyun Soo Oh; Journal of Korean Academy of Nursing 2003;33(1):42-50. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2003.33.1.42

Abstract: Purpose
This study was conducted to investigate the effects of the suction-induced hypoxemia interventions.
Method
30 suction-induced hypoxemia interventions were reviewed for the purpose of meta-analysis.
Result
The study showed that both preoxygenation and insufflation were the most frequently examined oxygenation time periods, and hyperoxygenation combined with hyperinflation was the most commonly applied oxygenation method in order to prevent suction-induced hypoxemia. The greatest effect was obtained by providing oxygenation before and after suctioning, whereas negative effect(the contrary results from the study hypotheses) was frequently obtained by applying insufflation only. Applying hyperoxygenation combined with hyperinflation had the greatest effect over that of applying hyperoxygenation only, even though the difference between effect sizes of both methods were statistically significant.
Conclusion
The results of meta-analysis showed that the occurrence rate of hypoxemia after suctioning was significantly reduced with the overall interventions for hypoxemia (decreasing 40% of occurrence rate), independent with time periods or methods for providing oxygenation.

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