The effects of shallow and deep endotracheal suctioning applied to neurosurgery intensive care patients on hemodynamic parameters and pain

In spite of being therapeutic, postoperative endotracheal intubation and mechanical ventilation applied to neurosurgery patients increase complication risk. Of nursing services applied to ventilated neurosurgery patients, especially patient positioning and deep endotracheal suctioning may lead intracranial pressure(ICP) in patients to increase. Therefore, during and after shallow and deep endotracheal suctioning, probable changes in patients hemodynamic symptoms must be examined closely and results must be evaluated comparingly. This research was conducted as a randomized controlled experimental trial to determine the effects of postoperative shallow and deep endotracheal suctioning applied to ventilated neurosurgery patients on arterial blood pressure, pulse rate, body temperature, respiration rate, oxygen saturation level and pain. In the research, between the dates of 09/01/2015 and 11/01/2016 with the method of open system suctioning shallow endotracheal suctioning was performed in 37 patients and deep endotracheal suctioning was also performed in 37 patients. At the 1st, 5th and 30th minutes of pre and post endotracheal suctioning arterial blood pressure, pulse rate, body temperature, respiration rate, SpO2 levels and pain status of patients were compared evaluatingly. Findings were evaluated with SPSS 16.0 program in addition to t-test for independent variables and two way ANOVA for repeated measurements. The results obtained were interpreted in accordance with 0.05 significance level. In the research, there wasn't detected any clinically and statistically significant difference between performed shallow and deep endotracheal suctioning methods. Yet, when patients' 30 minutes pre and post endotracheal suctioning values were compared, it was found that shallow endotracheal suctioning slightly causes less changes in patients' systolic and diastolic arterial blood pressures and pulse rates, has more postive impact on oxygenation level, is less traumatic and causes less pain in patients compared to deep endotracheal suctioning. Furthermore, at the 1st minute after deep endotracheal suctioning, it was observed that patients' systolic and diastolic arterial blood pressures, pulse rates, respiration rates and the pain experienced increased more.