Inter-Professional-Compassionate pain management during endotracheal suctioning: a valuable lesson from a Chinese surgical intensive care unit

Objective:To compare the effects of a pain management program and routine suctioning methods on the level of pain presence and agitation in Chinese adults admitted to the intensive care unit.To disseminate the results from the implementation of the evidence-informed pain management interventions for reducing pain presence and agitation during endotracheal tube suctioning(ETS)and translate the key finding to clinical nursing practice.Methods:A quasi-experimental study of a two-group post-test design was conducted in adults admitted after surgery to a surgical intensive care unit(SICU)of the Second Affiliated Hospital of Kunming Medical University,Yunnan,China in 2018.Fifty-two adults who met the study eligibility were included after consent,26 in each group.Patients in the control group received usual care while patients in the intervention group received interventions to reduce agitation and pain-related ETS.The impacts of the intervention on the level of pain presence and agitation were measured at 5 measuring time points using the Chinese versions of Critical-Care Pain Observation Tool(CPOT)and Richmond Agitation Sedation Scale(RASS).Results:The level of pain presence in the intervention group statistically significantly decreased during,immediately after,and 5 min after suctioning.The level of agitation in the intervention group significantly decreased during and immediately after suctioning.Conclusions:The findings provide support for the positive pain-relieving effects of the evidence-informed pain-related ETS management interventions when compared with the usual ETS practice.The study interventions were sufficiently effective and safe to maintain patent airway clean and patent as standardized suctioning and helps pain relief.So,evidence-based pain-related ETS management intervention is worthy of recommending to utilize in SICU patients as well as other patients who required suctioning.It is worth noting that integrating pre-emptive analgesia prescription and administration with non-pharmacological intervention plays a critical role in achieving pain relief.

Comparison of the Effectiveness of Marked Suction Tubes vs. Plain Suction Tubes in Pediatric Mechanically Ventilated Patients

Introduction: Endotracheal suction plays a crucial role in the management of mechanically ventilated patients. This study aims to evaluate the clinical effectiveness and safety of suction tubes with markings in mechanically ventilated pediatric patients. Materials and Methods: A randomized assignment was carried out on a cohort of 52 pediatric patients who underwent mechanical ventilation in the Pediatric Intensive Care Unit at the Third Affiliated Hospital of Sun Yat-sen University, covering the period from January 2022 to December 2022. These patients were divided into two groups: an improved group (n = 26) utilizing marked suction tubes, and a regular group (n = 26) employing conventional suction tubes. The objective of our study was to evaluate the clinical effectiveness of marked suction tubes. Results: The effects of the improved group on the vital signs of children undergoing mechanical ventilation were small and statistically significant compared with the regular group (p < 0.05). Additionally, the improved group exhibited a reduced frequency of sputum suction, shorter mechanical ventilation duration, and fewer days of hospitalization in the PICU compared to the regular group during the ventilation period. Notably, the difference in the duration of PICU hospitalization was statistically significant (p < 0.05). Moreover, the incidence of adverse reactions in the improved group was notably lower, with statistically significant differences observed in airway mucous membrane damage and irritating cough when compared to the regular group (p < 0.05). Conclusion: The utilization of marked suction tubes provides clinical nurses with clear guidance for performing suctioning with ease, efficiency and safety. Consequently, advocating for the widespread implementation of marked suction tubes in clinical practice is a commendable pursuit.

Effect of Closed Suctioning on Reducing the Contamination Released into the Environment

With the development of critical care medicine,mechanical ventilation is extensively used in the Intensive Care Units （ICUs）.Patients receiving invasive mechanical ventilation require sputum suctioning either regularly or as required to clear secretions from the airway and maintain airway patency.Accordingly,the requirement to disconnect the breathing loop tube for sputum suctioning is determined by the use of open or closed modes ofsuctioning.At present,the open suctioning system is most commonly used for clearing airway secretions.Since resistance to bacterial strains is rapidly increasing,the possibility of open suctioning in contaminating the ICU environment is often questioned,which was investigated in this study.