Effects of open and closed suction systems on the haemodynamic parameters in cardiac surgery patients

Abstract

Aims: This study was carried out to determine the effects of open and closed suction systems on haemodynamic parameters of the patients who underwent open heart surgery.

Background: Nurses should work meticulously and carefully as many complications may develop if the method used to perform suctioning is not appropriate.

Design: The quasi-experimental study design was used.

Method: The study sample comprised 120 patients who underwent open heart surgery in the cardiovascular surgery intensive care unit of a state hospital in Turkey. Haemodynamic parameters were determined just before, right after, at the 5th and 15th minute after suctioning. The data were evaluated with the One-Way Analysis of Variance (ANOVA) for Repeated Measures, independent t-test and Bonferroni's test for further analysis (post hoc).

Results: The difference between heart rate (HR) and mean blood pressure, mean PaO2 and PaCO2 , SaO2 and pH values measured before, right after and at the 5th and 15th minute after suctioning was found to be significant in patients who underwent the open suctioning procedure. It was determined that the difference between mean PaO2 values was not significant and that SaO2 versus SpO2 values increased in patients who underwent the closed suctioning procedure. When the open and closed suction systems were compared, statistically significant difference was determined in terms of MAP, SpO2 .

Conclusion: It was determined that HR, arterial blood pressure and arterial blood gases of the patients who underwent open heart surgery were negatively affected by the open suction system but did not increase significantly as soon as suctioning was over during the closed suctioning procedure. The data obtained indicate that closed system suctioning, compared with open system suctioning, can be used safely on this patient group.

Relevance to clinical practice: The closed suction system is recommended since it contributes to the enhancement of patient safety and the quality of nursing care.

Keywords: Arterial blood pressure; Critical care; Endotracheal intubation; Haemodynamic status; Nursing; Suctioning.