• Lyvonne N Tume, Paul Baines, Rafael Guerrero, Robert Johnson, Paul Ritson, Elaine Scott, Philip Arnold, and Laura Walsh.
• Lyvonne N. Tume was a nurse scientist at PICU Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom, when the study was done. She is now an associate professor in child health and a nurse scientist at the University of the West of England, Bristol, United Kingdom. Paul Baines is a consultant in pediatric intensive care, Rafael Guerrero is a consultant pediatric cardiac surgeon, Robert Johnson is a consultant pediatric cardiologist, Paul Ritson is a specialist physiotherapist, Elaine Scott is a data manager, Philip Arnold is a consultant pediatric anesthetist, and Laura Walsh is a research nurse at PICU Alder Hey Children's NHS Foundation Trust. Lyvonne.tume@uwe.ac.uk.
• Am. J. Crit. Care. 2017 Sep 1; 26 (5): 388-394.

BackgroundIn infants with single-ventricle physiology, endotracheal suctioning poses risks because of the instability between pulmonary and systemic blood flow.ObjectiveTo examine processes and adverse events associated with endotracheal suctioning in the first 48 hours after 3 surgical procedures: the Norwood or Norwood-Sano procedure, pulmonary artery banding, and the modified Blalock-Taussig shunt.MethodsProspective observational study in a pediatric intensive care unit.ResultsBedside nurses collected data from 211 episodes of endotracheal suctioning in 24 infants. Most (62%,130/211) suction episodes were unplanned; 38% (81/211) were planned. The most common reason for unplanned suctioning was arterial desaturation (48%, 62/130 episodes). The infants' oxygen saturation levels before suctioning ranged from 27% to 86%. Serious adverse events occurred in 9% (19/211) of suction episodes. In 8 (42%) of the episodes involving a serious adverse event, the patient received no additional intravenous bolus of analgesic or muscle relaxant before suctioning; in 8 episodes (42%), the patient received both an analgesic and a relaxant; in 3 episodes (16%), the patient received either an analgesic or a relaxant but not both. More adverse events occurred with open suctioning (68%, 13/19) than with closed suctioning (32%, 6/19). Most adverse events (68%, 13/19) occurred during the night shift.ConclusionsSignificant hemodynamic instability and adverse events occur during routine suctioning in infants with single-ventricle physiology after surgical palliation.©2017 American Association of Critical-Care Nurses.

24 keywords...

hide…