Effect of different depth of aspiration on patients without effective cough response.

OBJECTIVE

To investigate the nursing effect of deep or shallow sputum suction in the treatment of patients without cough response.

METHODS

A total of 144 patients receiving mechanical ventilation without an effective cough reaction were randomly divided into two groups: deep suction group (n=73) and shallow suction group (n=71). Heart rate, breathing, blood pressure, analgesia and sedation score, residual sputum volume, frequency of suction, sputum volume, improvement of phlegm sound, airway bleeding and oxygen before and after intervention were observed. Partial pressure, partial pressure of carbon dioxide and oxygenation index were used to evaluate the effect of two sputum suction methods on patients without an effective cough response.

RESULTS

In our study, the fluctuation of vital signs in the deep suction group was significantly higher than that in the shallow suction group. There was a statistical significance between the two groups in the vital signs after nursing intervention (P < 0.05), this mainly manifested in the heart rate, breathing, pulse pressure and airway bleeding. On the other hand, there was no statistical significance between the two groups in pulse oxygen, the Behavioral Pain Scale (BPS score) and the Richmond Agitation-Sedation Scale (RASS score) after nursing intervention (P > 0.05). The sputum suction effect is obviously improved in the deep sputum suction group compared with the shallow sputum suction group after nursing intervention. The improvement score of phlegm sounds in the shallow sputum suction group was (1.8±0.8) points, and that in the deep sputum suction group was (2.2±0.7) points. The analysis of blood gas was significantly improved in the deep suction group compared with the shallow suction group. There was a statistical significance between two groups in blood gas analysis index, such as oxygenation index, PaCO2 and PaO2 (P < 0.05).

CONCLUSION

Deep sputum suction has a great effect on the vital signs of patients, but there is not a serious effect on the vital signs. Shallow sputum suction does not effectively clean the airway of patients without a cough response; therefore, patients with a weak cough response need deep sputum suction.