Evaluating the Effects of Post-Intubation Endotracheal Suctioning Before Surgery on Respiratory Parameters in Children with Airway Secretion.

BACKGROUND: Endotracheal suctioning (ETS) is a common procedure in intubated patients for the clearance of secretions and improvement of oxygenation. OBJECTIVES: Owing to the controversies in previous studies, we studied the effects of open ETS before surgery on respiratory parameters in children with pulmonary crackles. METHODS: In this clinical trial, 100 children with pulmonary crackles, candidates for surgery were randomly assigned into two groups. After intubation, in the group A (n = 50), deep and open suction was done until the crackle was cleared and in the group B (n = 50), anesthesia without suctioning was continued. Hemodynamic and respiratory parameters were compared. RESULTS: The patients in group A had higher oxygen saturation with a statistically significant difference in 15th to 75th minutes of the operation (P < 0.001) and in post-anesthetic care unit (P = 0.004). After suction, before and after extubation, there was a statistically significant reduction of crackles in the group A in comparison to the group B (P < 0.001). There was no statistically significant difference in the end-tidal CO2, airway pressure and respiratory rate between the two groups (P > 0.05). Relevant complications and the emergence of anesthesia time were statistically lower in the group A (P < 0.001). There was no statistically significant change in terms of blood pressure in the two groups (P > 0.05). The heart rate in the 15th, 30th, and 45th minutes of surgery was statistically lower in the group B (P < 0.05). CONCLUSIONS: This study indicates positive effects of open and deep suction in improving oxygen saturation and reducing complications and emergence time. Pulmonary auscultation of the group A before and after weaning was statistically better than group B. However, this study found no positive effect of ETS on airway pressure, ETCO2, blood pressure, and respiratory rate. Meanwhile, increased heart rate in the group A might introduce the potential risk of dysrhythmia and hemodynamic instability.

Nasogastric tube placement errors and complications in pediatric intensive care unit: a case report.

UNLABELLED: Nasal ala pressure sores are among complications of nasogastric tube in Pediatric Intensive Care Unit (PICU). The severity of the injury is usually minor and easily ignored. However, the complication could be easily avoided. This is a case of nasal ala sore after the placement of nasal enteral tube in a pediatric intensive care unit in our center. A 5-month-old female with pulmonary hypertension secondary to bronchiectasis with nasal ala pressure sore were reported. She was hospitalized in pediatric intensive care unit at Tabriz Children Hospital in 2010.After 53 days of PICU hospitalization she had nasal ala sore. CONCLUSION: We know that nasal ala pressure sores could easily be avoided when preventive procedures were performed during nasogastric tube insertion.