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The Effect of the Duration of Pre-Oxygenation before Endotracheal Suction on Hemodynamic Symptoms.

BACKGROUND
Hypoxia and hypoxemia are among the most common complications of endotracheal suctioning. These complications are often mitigated by the administration of oxygen 100% prior to endotracheal suction. Although several studies have supported the application of this method, none have yet specified the exact duration of pre-oxygenation required to be performed before endotracheal suction. The present study was therefore conducted to determine the effect of the duration of pre-oxygenation before endotracheal suction on heart rate and arterial oxygen saturation in patients in intensive care units.


OBJECTIVES
This prospective clinical trial conducted on 63 eligible ICU patients under mechanical ventilator. Subjects randomly divided into three groups. Pre-oxygenation was carried out for 30 seconds in the first group, for one minute in the second group and for two minutes in the third group. All three groups were then hyper-oxygenated for one minute. Arterial oxygen saturation and heart rate were recorded on different occasions in the three groups. The data obtained were analyzed using the ANOVA, the one-way ANOVA, the post-hoc test and the repeated measure ANOVA.


RESULTS
The results obtained showed a greater reduction in the mean O2sat during the suctioning episodes in the 30-second pre-oxygenation group compared to in the one-minute (P=0.046) and two-minute (P=0.001) pre-oxygenation groups. This mean reduction was also observed immediately after suctioning (P=0.001). The mean O2sat was lower in the 30-second pre-oxygenation group than in the one-minute pre-oxygenation group in minutes 5 (P=0.002) and 20 (P=0.001) of the suctioning. Similarly, the mean O2sat was lower in the 30-second pre-oxygenation group than in the two-minute pre-oxygenation group in minutes 5 (P=0.001) and 20 (P=0.001) of the suctioning. The results obtained through the ANOVA showed the lack of significant differences between the three groups in the mean variation in heart rate in the different stages of suctioning.


CONCLUSIONS
According to the results obtained, one-minute and two-minute pre-oxygenations cause less disruption in arterial oxygen saturation compared to a 30-second pre-oxygenation. To achieve stability in arterial oxygen saturation and avoid hypoxemia caused by endotracheal suctioning, one-minute or two-minute pre-oxygenation is recommended in ICUs depending on the patient's clinical conditions.