Effects of suppression of endotracheal suctioning in the incidence of pulmonary complications on the postoperative cardiac surgery

Authors

DOI:

https://doi.org/10.17267/2238-2704rpf.v10i3.3008

Keywords:

Suction. Pulmonary atelectasis. Thoracic Surgery. Health care costs. Physiotherapy.

Abstract

INTRODUCTION: Endotracheal suction is routinely used after cardiac surgery to ensure adequate ventilation. OBJECTIVE: To verify if that the absence of endotracheal suctioning before extubation in patients without signs of bronchial secretion have influence on the incidence of pulmonary complications, beyond hemodynamic and ventilatory repercussions of the procedure and costs. METHODS: Patients were evaluated between August/2012 and July/2014, divided equally into ASP Group (tracheal aspiration prior to extubation) and NASP (without prior aspiration). Individuals with: first cardiac surgery, age between 18 and 75 years, BMI ? 30 kg / m² and without previous lung disease were included. Individuals with ECC time > 120 minutes, need for mechanical circulatory assistance, PaO2 / FiO2 ratio <200, SpO2 <92%, intubation time> 12 hours, MBP <60 mmHg and signs of pulmonary secretion were excluded. Hemodynamic, ventilatory variables, pulmonary complications and hospital costs were assessed. RESULTS: 228 patients were analyzed (ASP = 114 NASP = 114). HR, SBP, DBP and MBP increased after aspiration and post extubation in the groups, returning to baseline values over time. There was no statistical difference in RR and SpO2. Pulmonary complications accounted for 7.8%, with no difference between groups. CONCLUSION: The suppression of tracheal suctioning in patients in the immediate postoperative period of cardiac surgery did not influence the incidence of pulmonary complications and postoperative clinical evolution. During aspiration, there were hemodynamic and respiratory changes, with no clinical repercussions, but these same changes occurred in the NASP group after extubation, to a lesser extent. Endotracheal suctioning without indication proved to be costly and wasted professionals' time.

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Author Biographies

  • Andressa Campos, Instituto do Coração do Hospital das Clínicas da Universidade de São Paulo
    Fisioterapeuta do Coração do Hospital das Clínicas da Universidade de São Paulo
  • Amanda Braga de Louredo Rabelo, Instituto do Coração do Hospital das Clínicas da Universidade de São Paulo
    Fisioterapeuta do Instituto do Coração da Universidade de São Paulo
  • Juliana Oliveira Barros, Instituto do Coração do Hospital das Clínicas da Universidade de São Paulo
    Fisioterapeuta do Instituto do Coração do Hospital das Clínicas da Universidade de São Paulo
  • Emilia Nozawa, Instituto do Coração do Hospital das Clínicas da Universidade de São Paulo
    Fisioterapeuta Chefe do Instituto do Coração do Hospital das Clínicas da Universidade de São Paulo

Published

08/10/2020

Issue

Section

Original Articles

How to Cite

1.
Campos A, Rabelo AB de L, Barros JO, Nozawa E, Hajjar LA, Gallas FRBG, et al. Effects of suppression of endotracheal suctioning in the incidence of pulmonary complications on the postoperative cardiac surgery. Rev Pesq Fisio [Internet]. 2020 Aug. 10 [cited 2024 Nov. 21];10(3):417-26. Available from: https://journals.bahiana.edu.br/index.php/fisioterapia/article/view/3008

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