Download PDF
intensiv 2010; 18(5): 261-267
DOI: 10.1055/s-0030-1264130
Intensivpflege|Intensivmedizin
© Georg Thieme Verlag KG Stuttgart · New York

Evidenzbasierter Leitfaden zur naso-oropharyngealen und endotrachealen Absaugung Früh- und Termingeborener

Norbert Lutsch
Further Information

Publication History

Publication Date:
31 August 2010 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Der folgende Artikel beschäftigt sich mit den verschiedenen naso-oropharyngealen und endotrachealen Absaugtechniken sowie deren Indikationen und Gefahren. Die „erfolgreiche Absaugung” von Kindern auf der Intensivstation setzt gewisse (patho-)physiologische Kenntnisse voraus, die ebenfalls Gegenstand dieses Leitfadens sein werden.

Literatur

  • 01 Merenstein G B, Gardner S . Handbook of Neonatal Care6th Edition. Mosby- Elsevier; St. Louis; 2006: 606-610
    Google Scholar
  • 02 Blackburn S . Maternal, Fetal & Neonatal Physiology. Saunders W. B.; Oxford; 2003: 351
    Google Scholar
  • 03 Bailey C , Kattwinkel J , Teja K  et al.. Shallow versus deep endotracheal suctioning in young rabbits: Pathological effects on the tracheobronchial wall.  Pediatrics. 1988;  82 746-751
    Google Scholar
  • 04 Gardner D L, Shirland L . Evidence- Based Guideline for Suctioning the Intubated Neonate and Infant.  Neonatal Netw. 2009;  28 281-302
    Google Scholar
  • 05 Textbook of neonatal resuscitation . 5th Edition American Academy of Pediatrics; Elk Grove Village, IL; 2007: 2-9
    Google Scholar
  • 06 Glass C , Grap M . Ten tips for safe suctioning.  The American Journal of Nursing. 1995;  5 51-53
    Google Scholar
  • 07 Morrow B M, ARGENT A C. A comprehensive review of pediatric endotracheal suctioning: Effects, indications, and clinical practice.  Pediatr. Crit. Care Med. 2008;  9 465-477
    Google Scholar
  • 08 American Association of Respiratory Care . AARC clinical practice guideline: Endotracheal suctioning of mechanically ventilated adults and children with artificial airways.  Respiratory Care. 1993;  38 502
    Google Scholar
  • 09 Wilson G  et al.. Evaluation of two endotracheal suction regimes in Babies ventilated for respiratory distress syndrome.  Early Hum. Dev. 1991;  25 87
    Google Scholar
  • 10 Wright J . Closed-suctioning procedure in neonates.  Neonatal Netw. 1996;  15 85
    Google Scholar
  • 11 Wood C . Endotracheal suctioning: A literature review.  Intensive and Critical Care Nursing. 1998;  14 124-136
    CrossrefGoogle Scholar
  • 12 Knox A M. Performing endotracheal suction on children: a literature review and implications for nursing practice.  Int. Crit. Care Nurs. 1993;  9 48
    Google Scholar
  • 13 Tolles C L, Stone K S. National survey of neonatal endotracheal suctioning practices.  Neonatal Netw. 1990;  9 7-14
    Google Scholar
  • 14 Cordero L , Sananes M , Ayers L W. A comparison of two airway suctioning frequencies in mechanically ventilated, very-low-birthweight infants.  Respiratory Care. 2001;  46 783-788
    Google Scholar
  • 15 Thomas M , Fothergill-Bourbonnais F. Clinical judgements about endotracheal suctioning: What cues do expert pediatric critical care nurses consider?.  Crit. Care Nurs. Clin. North Am. 2005;  17 329-340
    CrossrefGoogle Scholar
  • 16 Pritchard M , Flenady V , Woodgate P . Preoxygenation for tracheal suctioning in intubated, ventilated newborn infants.  The Cochrane Database of Systemic Reviews 2001;  (3) CD000427
    Google Scholar
  • 17 Oh H , Seo W . A meta-analysis of the effects of various interventions in preventing endotracheal suction- induced hypoxemia.  J. Clin. Nurs. 2003;  12 912-924
    CrossrefGoogle Scholar
  • 18 Rothen H U, Sporre B , Engberg G  et al.. Influence of gas composition on recurrence of atelectasis after a reexpansion maneuver during general anesthesia.  Anesthesiology. 1995;  82 832-842
    CrossrefGoogle Scholar
  • 19 Gannon C M, Wisswell T E, Spitzer A R. Volutrauma, PaCO2 levels, and neurodevelopmental sequelae following assisted ventilation.  Clinics in Perinatology. 1998;  25 159-175
    Google Scholar
  • 20 Dreyfuss D , Soler P , Basset G . High inflation pressure pulmonary edema. Respective effects of high airway pressure, high tidal volume, and positive end-expiratory pressure.  The American Review of Respiratory Disease. 1988;  137 1159-1164
    Google Scholar
  • 21 Carlton D P, Cummings J J, Scheerer R G. Lung overexpansion increases pulmonary microvascular protein permeability in young lambs.  Journal of Applied Physiology. 1990;  69 577-583
    Google Scholar
  • 22 The Acute Respiratory Distress Syndrome Network . Ventilation with Lower Tidal Volumes as Compared with Traditional Tidal Volumes for Acute Lung Injury and the Acute Respiratory Distress Syndrome.  N. Engl. J. Med. 2000;  342 1301-1308
    CrossrefGoogle Scholar
  • 23 Czarnik R E, Stone K S, Everhart C C et al.. Differential effects of continuous versus intermittent suction on tracheal tissue.  Heart & Lung. 1991;  20 144-151
    Google Scholar
  • 24 Young, J . To help or hinder: Endotracheal suction and the intubated neonate.  Journal of Neonatal Nursing. Retrieved March 1, 2007, from http://www.neonatal-nursing.co.uk/pdf/ jul95thh.pdf 1995;  1 23-28
    Google Scholar
  • 25 Hodge D . Endotracheal suctioning and the infant: A nursing care protocol to decrease complications.  Neonatal Network. 1991;  9 7-15
    Google Scholar
  • 26 Ahn Y , Hwang T . The effects of shallow versus deep endotracheal suctioning on the cytological components of respiratory aspirates in high- risk infants.  Respiration. 2003;  70 172-178
    CrossrefGoogle Scholar
  • 27 Swartz K , Noonan D , Edwards-Beckett J . A national survey of endotracheal suctioning techniques in the pediatric population.  Heart & Lung. 1996;  25 52-60
    Google Scholar
  • 28 Wood C J. Endotracheal suctioning: A literature review.  Intensive and Critical Care Nursing. 1998;  14 124-136
    CrossrefGoogle Scholar
  • 29 Day T , Farnell S , Wilson-Barnett J . Suctioning: A review of current research recommendations.  Intensive and Critical Care Nursing. 2002;  18 79-89
    Google Scholar
  • 30 American Thoraric Society . Care of the Child with a Chronic Tracheostomy.  THIS OFFICIAL STATEMENT OF THE AMERICAN THORACIC SOCIETY WAS ADOPTED BY THE ATS BOARD OF DIRECTORS, JULY 1999 Am. J. Respir. Crit. Care Med. 2000;  161 297-308
    Google Scholar
  • 31 Morrow B , Futter M , Argent A . Effect of endotracheal suction on lung dynamics in mechanically-ventilated pediatric patients.  Aust. J. Physiother. 2006;  52 121-126
    CrossrefGoogle Scholar
  • 32 Young C S. Recommended guidelines for suction.  Physiotherapy. 1984;  70 106-108
    Google Scholar
  • 33 Runton N. Suctioning artificial airways in children: appropriate technique.  Pediatr. Nurs. 1992;  18 115-118
    Google Scholar
  • 34 Giganti A . Lifesaving tubes, lifetime scars?.  MCN. 1995;  20 192-197
    Google Scholar
  • 35 Woodgate P G, Flenady V . Tracheal suctioning without disconnection in intubated ventilated neonates.  Cochrane Review. In: The Cochrane Library, Oxford (3) 2005;  Update Software
    Google Scholar
  • 36 Kalyn A , Blatz S , Feuerstake S  et al.. Closed suctioning of intubated neonates maintains better physiologic stability: A randomized trial.  J. Perinatol. 2003;  23 218-222
    CrossrefGoogle Scholar
  • 37 Cordero L , Sananes M , Ayers L W. Comparison of a closed (Trach Care MAC) with an open endotracheal suction system in small premature infants.  J. Perinatol. 2000;  3 151-156
    Google Scholar
  • 38 Freytag C C, Thies F L, König W  et al.. Pronlonged application of closed in-line suction catheters increases microbial colonization of the lower respiratory tract and bacterial growth on catheter surface.  Infection. 2003;  31 31-37
    CrossrefGoogle Scholar
  • 39 Raymond S . Normal saline instillation before suctioning: helpful or harmful? A review of the literature.  Am. J. Crit. Care. 1995;  4 267-271
    Google Scholar
  • 40 Ackerman M H, Eckland M M, Abu-Jumah M . A review of normal saline instillation: Implication for practice.  Dimensions of Critical Care Nursing. 1996;  15 31-38
    Google Scholar
  • 41 Angell M . The quality of mercy.  NEJM. 1982;  306 98-99
    CrossrefGoogle Scholar
  • 42 Simons S H, Van Dijk M , Anand K S et al.. Do we still hurt newborn babies? A prospective study of procedural pain and analgesia in neonate.  Arch. Pediatr. Adolesc. Med. 2003;  157 1058-1064
    Google Scholar
  • 43 Cignacco E , Hamers J , Van Lingen R  et al.. Neonatal procedural pain exposure and pain management in ventilated preterm infants during the first 14 days of life.  Swiss Medical Weekly. 2009;  139 226-232
    Google Scholar
  • 44 Lutsch N . Grundlagen der Entwicklungsförderung Früh- und Neugeborener.  Kinderkrankenschwester. 2009;  7 282-287
    Google Scholar
  • 45 Grunau R E, Holsti L , Peters J W. Long-term consequences of pain in human neonates.  Semin. Fetal Neonatal Med. 2006;  11 268-275
    CrossrefGoogle Scholar
  • 46 Pokela M L. Pain relief can reduce hypoxemia in distressed neonates during routine treatment procedures.  Pediatrics. 1994;  93 379-383
    Google Scholar
  • 47 Cignacco E , Hamers J , Van Lingen R  et al.. Efficacy of non-pharmacological interventions for procedural pain in preterm and term neonates. A systematic literature review.  European Journal of Pain. 2006;  11 139-152
    Google Scholar
  • 48 Johnston C C et al.. Routine Sucrose Analgesia During the First Week of Life in Neonates Younger Than 31 Weeks’ Postconceptional Age.  Pediatrics. 2002;  110 523-528
    CrossrefPubMedGoogle Scholar
  • 49 Spence K , Gillies D , Waterworth L . Deep versus shallow suction of endotracheal tubes in ventilated neonates and young infants.  (Cochrane Review) Cochrane Database Syst. Rev (3)
    Google Scholar

Norbert Lutsch

Poststrasse 18a

9402 Mörschwil

Schweiz

Phone: +41 (0)71 2442149

Email: norbert.lutsch@edu.donau-uni.ac.at

Email: norbert.lutsch@intensivmedicus.de

      >