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  • Title: [Does directed bronchoscopic bronchial cleansing have an advantage over conventional suctioning? A prospective study of hemodynamics, gas exchange and suction-induced mucosal lesions in long-term ventilated patients].
    Author: Konrad F, Wiedeck H, Deller A, Diatzko J, Schmitz JE.
    Journal: Anaesthesist; 1988 Jul; 37(7):413-9. PubMed ID: 3414953.
    Abstract:
    Hypoxic complications and epithelial damage to the trachea and bronchi during conventional blind suctioning have been described in the literature. Fiberoptic suctioning and examination of the trachea of each long-term ventilator patient as a routine method has been recommended in recent studies. We investigated the effect of a conventional tracheal suction technique compared to precise fiberbronchoscopic suction on cardiocirculatory function and gas exchange in mechanically ventilated patients. METHOD. In 40 long-term ventilator patients tracheobronchial toilet was performed either conventionally (group I; n = 20; 15 s of endotracheal suction with no mechanical ventilation during suctioning) or bronchoscopically (group II; n = 20; bronchoscope Olympus 1 T 10; mechanical ventilation during suctioning). Measurements were performed before, immediately after, and 1, 2, 5, and 15 min after suctioning. FIO2 was not changed before or after suctioning. In 12 long-term ventilator patients (greater than or equal to 8 days) we looked for tracheal mucosal lesions produced by conventional suctioning. RESULTS. There was no effect on cardiocirculatory function in either group (Figs. 1 and 2), but we found a decrease in arterial PO2 after suctioning in all patients (group I from 99 +/- 25 to 81 +/- 19 mmHg, group II from 104 +/- 23 to 80 +/- 17 mmHg [Fig. 3]). The time needed to re-establish the initial PaO2 after suctioning was significantly different in both groups. Whereas the PaO2 returned to the initial value within 2 min after conventional suctioning, we found a decrease in PaO2 in the bronchoscopic group even after 15 min.(ABSTRACT TRUNCATED AT 250 WORDS)
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