Dyspnea and peak inspiratory pressure in mechanically ventilated adults post tracheal suction

2.50
Hdl Handle:
http://hdl.handle.net/10755/149538
Type:
Presentation
Title:
Dyspnea and peak inspiratory pressure in mechanically ventilated adults post tracheal suction
Abstract:
Dyspnea and peak inspiratory pressure in mechanically ventilated adults post tracheal suction
Conference Sponsor:Sigma Theta Tau International
Conference Year:1991
Author:Crihfield, Patsy, MSN/MN/MNSc/MNE
P.I. Institution Name:Baptist Memorial Hospital East
Title:Clinical Nurse Specialist
Dyspnea is associated with mortality and delayed weaning from a

mechanical ventilator in intensive care patients. The most

frequently initial treatment for dyspnea in this population is

tracheal suction. However, this intervention is hazardous and the

effectiveness in treating dyspnea has only been examined by one

previous study. In that study, dyspnea was decreased at 5 minutes

and further reduced at 10 minutes post suction. The trend of

continual dyspnea reduction the longer after suctioning may

indicate that the maximal effect of suctioning has not been

reached. Thompson's model of dyspnea from increased mucus

secretion (which combines Killian's theory of dyspnea and

Poiseuille's Law) served as the conceptual framework for this

study. This model supports the common practice of using peak

inspiratory pressure as an indication of dyspnea and the need to

suction but this relationship has not been tested. The purpose of

this study is to determine if there is a significant reduction in

dyspnea and peak inspiratory pressure by twenty minutes post

tracheal suction. A convenience sample of adult, mechanically

ventilated, intensive care patients rated their dyspnea surrounding

three suctioning episodes (N = 51 total suctionings). Dyspnea and

peak inspiratory pressure were measured immediately before,

immediately after, and at 5, 10, 15, and 20 minutes post suction.

Dyspnea was measured by a vertical visual analog scale (a pencil

and paper test) with established reliability, validity, and

sensitivity. Peak inspiratory pressure was measured by a gauge on

the ventilator which has been shown to have an accuracy of +or- 1

percent. By twenty minutes after suction dyspnea was decreased from

63.7 to 59. (on scale of 100) but this change was not significant by

T-test. Likewise, the peak inspiratory pressure was reduced from

43.1 to 41.7 which also was not significant. Dyspnea and peak

inspiratory pressure (PIP) were not significantly correlated.

However, the change in PIP was significantly correlated with

dyspnea from immediately before to 20-minutes post suction (r =

-.62, p < .05) which supports Thompson's model. This study

suggests that by twenty minutes post suction, insufficient change

in dyspnea and peak inspiratory pressure have occurred to either

use suctioning to treat dyspnea or to continue using PIP as an

indication of the need to suction. Since these preliminary

findings do not support current common practice regarding

suctioning, further study is indicated exploring time frames beyond

twenty minutes post suctioning and examining subpopulations of

mechanically ventilated intensive care patients.



Support: University of Tennessee, Memphis; Baptist Memorial

Hospital



Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleDyspnea and peak inspiratory pressure in mechanically ventilated adults post tracheal suctionen_GB
dc.identifier.urihttp://hdl.handle.net/10755/149538-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Dyspnea and peak inspiratory pressure in mechanically ventilated adults post tracheal suction</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">1991</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Crihfield, Patsy, MSN/MN/MNSc/MNE</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Baptist Memorial Hospital East</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Nurse Specialist</td></tr><tr><td colspan="2" class="item-abstract">Dyspnea is associated with mortality and delayed weaning from a<br/><br/>mechanical ventilator in intensive care patients. The most<br/><br/>frequently initial treatment for dyspnea in this population is<br/><br/>tracheal suction. However, this intervention is hazardous and the<br/><br/>effectiveness in treating dyspnea has only been examined by one<br/><br/>previous study. In that study, dyspnea was decreased at 5 minutes<br/><br/>and further reduced at 10 minutes post suction. The trend of<br/><br/>continual dyspnea reduction the longer after suctioning may<br/><br/>indicate that the maximal effect of suctioning has not been<br/><br/>reached. Thompson's model of dyspnea from increased mucus<br/><br/>secretion (which combines Killian's theory of dyspnea and<br/><br/>Poiseuille's Law) served as the conceptual framework for this<br/><br/>study. This model supports the common practice of using peak<br/><br/>inspiratory pressure as an indication of dyspnea and the need to<br/><br/>suction but this relationship has not been tested. The purpose of<br/><br/>this study is to determine if there is a significant reduction in<br/><br/>dyspnea and peak inspiratory pressure by twenty minutes post<br/><br/>tracheal suction. A convenience sample of adult, mechanically<br/><br/>ventilated, intensive care patients rated their dyspnea surrounding<br/><br/>three suctioning episodes (N = 51 total suctionings). Dyspnea and<br/><br/>peak inspiratory pressure were measured immediately before,<br/><br/>immediately after, and at 5, 10, 15, and 20 minutes post suction.<br/><br/>Dyspnea was measured by a vertical visual analog scale (a pencil<br/><br/>and paper test) with established reliability, validity, and<br/><br/>sensitivity. Peak inspiratory pressure was measured by a gauge on<br/><br/>the ventilator which has been shown to have an accuracy of +or- 1<br/><br/>percent. By twenty minutes after suction dyspnea was decreased from<br/><br/>63.7 to 59. (on scale of 100) but this change was not significant by<br/><br/>T-test. Likewise, the peak inspiratory pressure was reduced from<br/><br/>43.1 to 41.7 which also was not significant. Dyspnea and peak<br/><br/>inspiratory pressure (PIP) were not significantly correlated.<br/><br/>However, the change in PIP was significantly correlated with<br/><br/>dyspnea from immediately before to 20-minutes post suction (r =<br/><br/>-.62, p &lt; .05) which supports Thompson's model. This study<br/><br/>suggests that by twenty minutes post suction, insufficient change<br/><br/>in dyspnea and peak inspiratory pressure have occurred to either<br/><br/>use suctioning to treat dyspnea or to continue using PIP as an<br/><br/>indication of the need to suction. Since these preliminary<br/><br/>findings do not support current common practice regarding<br/><br/>suctioning, further study is indicated exploring time frames beyond<br/><br/>twenty minutes post suctioning and examining subpopulations of<br/><br/>mechanically ventilated intensive care patients.<br/><br/><br/><br/>Support: University of Tennessee, Memphis; Baptist Memorial<br/><br/>Hospital<br/><br/><br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T10:04:25Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T10:04:25Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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