기관내관 흡인 방법에 따른 반정량적 객담배양검사 결과의 양상 비교
Comparison of the Pattern in Semi-Quantitative Sputum Cultures Based on Different Endotracheal Suction Techniques
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Background: The endotracheal suction was one of the critical requirements for severe neurosurgical patients in the prevention of the airway-obstruction, pneumonia, atelectasis, and so on. There were two types of suction methods, closed and open. In the literature, many reported the comparison of the two methods with variable factors, yet, it was still controversial. In this study, we compared the two types of endotracheal suction methods based on the pattern of the sputum cultivation, which was not discussed in the previous studies. Methods: In 2010, 85 patients who had intubation tube for more than 10 days were evaluated in this study. A total of 55 patients were managed with an open suction method, while the other 30 patients were managed with a closed suction method. All patients’ sputum culture was reported semi-quantitatively, and had been classified into 3 different groups, according to the culture pattern. The control group was defined in which the bacterial count was not increased, whereas the non-control group was those with bacterial count increased. We investigated patients’ age, gender, disease-type, suction techniques and the pattern of sputum cultivation. Results: The non-control group was 45.45% in the open suction group, while it was 16.67% in the closed suction group. On the other hand, more control group was observed in the closed suction group (36.67%), than in the open suction group (25.45%) (p < 0.05). There was no statistically significant difference in the analysis based on the pattern of sputum cultivation, age, gender, and disease-type. Conclusions: We suggest that the closed suction methods were more effective in the management of endotracheal tube, according to the pattern of sputum culture.
Abstract
Background: The endotracheal suction was one of the critical requirements for severe neurosurgical patients in the prevention of the airway-obstruction, pneumonia, atelectasis, and so on. There were two types of suction methods, closed and open. In the literature, many reported the comparison of the two methods with variable factors, yet, it was still controversial. In this study, we compared the two types of endotracheal suction methods based on the pattern of the sputum cultivation, which was not discussed in the previous studies. Methods: In 2010, 85 patients who had intubation tube for more than 10 days were evaluated in this study. A total of 55 patients were managed with an open suction method, while the other 30 patients were managed with a closed suction method. All patients’ sputum culture was reported semi-quantitatively, and had been classified into 3 different groups, according to the culture pattern. The control group was defined in which the bacterial count was not increased, whereas the non-control group was those with bacterial count increased. We investigated patients’ age, gender, disease-type, suction techniques and the pattern of sputum cultivation. Results: The non-control group was 45.45% in the open suction group, while it was 16.67% in the closed suction group. On the other hand, more control group was observed in the closed suction group (36.67%), than in the open suction group (25.45%) (p < 0.05). There was no statistically significant difference in the analysis based on the pattern of sputum cultivation, age, gender, and disease-type. Conclusions: We suggest that the closed suction methods were more effective in the management of endotracheal tube, according to the pattern of sputum culture.
참고문헌 (16)
- Brandstater B, "Atelectasis following tracheal suction in infants", Anesthesiology, 31, pp.468~473 (1969)
- Cabal L, "New endotracheal tube adaptor reducing cardiopulmonary effects of suctioning", Crit Care Med, 7, pp.552~555 (1979)
- Kerem E, "Effect of endotracheal suctioning on arterial blood gases in children", Intensive Care Med, 16, pp.95~99 (1990)
- Simbruner G, "Effect of tracheal suction on oxygenation, circulation, and lung mechanics in newborn infants", Arch Dis Child, 56, pp.326~330 (1981)
- 차경숙, "기관 흡인술 유형에 따른 인공호흡기 적용 환자의 기관 내 균집락화와 폐렴 발생률", Journal of Korean Academy of Nursing, 41(2), pp.175~181 (2011), 한국간호과학회
- 이은숙, "폐쇄형 흡인술이 인공호흡기 환자의 산소포화도, 인공호흡기 관련 폐렴 및 흡인간호 효율성에 미치는 영향", Journal of Korean Academy of Nursing, 34(7), pp.1315~1325 (2004), 한국간호과학회
- Lorente L, "Ventilator-associated pneumonia using a closed versus an open tracheal suction system", Crit Care Med, 33, pp.115~119 (2005)
- Combes P, "Nosocomial pneumonia in mechanically ventilated patients, a prospective randomised evaluation of the Stericath closed suctioning system", Intensive Care Med, 26, pp.878~882 (2000)
- Topeli A, "Comparison of the effect of closed versus open endotracheal suction systems on the development of ventilator-associated pneumonia", J Hosp Infect, 58, pp.14~19 (2004)
- Siempos II, "Closed tracheal suction systems for prevention of ventilator-associated pneumonia", Br J Anaesth, 100, pp.299~306 (2008)
- Hoellering AB, "Lung volume and cardiorespiratory changes during open and closed endotracheal suction in ventilated newborn infants", Arch Dis Child Fetal Neonatal Ed, 93, pp.F436~F441 (2008)
- Lindgren S, "Effectiveness and side effects of closed and open suctioning: an experimental evaluation", Intensive Care Med, 30, pp.1630~1637 (2004)
- Myrianthefs PM, "Nosocomial pneumonia", Crit Care Nurs Q, 27, pp.241~257 (2004)
- Rosenthal VD, "INICC Members. International Nosocomial Infection Control Consortium (INICC) report, data summary for 2003-2008, issued June 2009", Am J Infect Control, 38, pp.95~104 (2010)
- Morrow B, "Effect of endotracheal suction on lung dynamics in mechanically-ventilated paediatric patients", Aust J Physiother, 52, pp.121~126 (2006)
- 박혜성, "기계호흡 중인 중증폐렴에서 기관지내시경 검체와 경기관지흡인 검체간의 일치성 및 임상적 의의", 대한중환자의학회지, 26(2), pp.83~88 (2011), 대한중환자의학회
