A Comparative Study to Assess the Effectiveness of Endotracheal Suctioning with and without Normal Saline Instillation in Terms of Physiological Parameters and Patient Outcome Measures among Mechanically Ventilated Patients in Selected Hospital of New Delhi

Abstract

Intubated patients are unable to cough sufficiently to remove pulmonary secretion. Nurses occasionally encounter thick and tenacious secretions during endotracheal (ET) suctioning. To manage these secretions, normal saline instillation (NSI) is used throughout the world. The use of NSI before endotracheal suctioning is intended to lubricate the catheter, liquefy and soften secretions, and stimulate coughing. The objectives of the study were to assess the effectiveness of endotracheal suctioning with normal saline instillation in terms of physiological parameters and patient outcome among mechanically ventilated patients; to assess the effectiveness of endotracheal suctioning without normal saline instillation in terms of physiological parameters and patient outcome among mechanically ventilated patients; and to compare the effectiveness in terms of physiological parameters and patient outcome in mechanically ventilated patients with and without normal saline instillation. Methods: A quantitative research approach with comparative descriptive design was used for the study. The study was conducted in Max Super specialty Hospital, Saket and New Delhi. Purposive sampling was used for selecting 60 mechanically ventilated patients, from which 30 had undergone ET suctioning with normal saline instillation and 30 had undergone ET suctioning without normal saline instillation. Physiological parameters were assessed by using an observation checklist. Patient outcomes were assessed through observations made at 0–72 hours. Results: The significant findings of the study revealed that mechanically ventilated patients, who had undergone ET suctioning with NSI in comparison to patients who had undergone ET suctioning without NSI, were significant in terms of ventilator tidal volume at 18 hours, p value was 0.005 (p1), similarly systolic blood pressure at 6 hours and 12 hours were 0.001 and 0.049 respectively, significant at 0.05 level of significance. p value of temperature at 12 hours was 0.031, p values of ABG PaO2 at 0 hour, 6 hours,12 hours and 18 hours were 0.036, 0.005, 0.022 and 0.043 respectively, significant at 0.05 level of significance, p values of ABG Na+ at 6 hours and 12 hours were 0.003 and 0.001 respectively, significant at 0.05 level of significance, p values of ABG K+ at 6 hours were 0.046, p values of ABG Ca++ at 0 hour and 12 hours were 0.044 and 0.045 which were significant at 0.05 level respectively; however, the p2 value calculated by ANOVA test from 0–72 hours of patient outcome was not significant at 0.05 level of significance. Conclusion: The findings of the present study conclude that normal saline instillation while ET suctioning was effective in comparison to ET suctioning without normal saline instillation among mechanically ventilated patients in terms of respiratory parameters.