Abstract
Aims: Endotracheal suctioning in patients after coronary artery bypass grafting and under mechanical ventilation can be performed to remove endotracheal secretions with two open and closed methods. The aim of this study was to compare the effect of open and closed endotracheal suctioning on hemodynamic factors of patients after coronary artery bypass grafting under mechanical ventilation.
Materials & Methods: This study is a single-blind clinical trial which was done in the intensive care unit of open heart surgery of Imam Reza Hospital of Mashhad on 130 patients after coronary artery bypass grafting under mechanical ventilation who met the criteria of the study in 2013. Subjects were randomly divided into two open and closed suctioning groups with two-stage method after convenience sampling method. Mean arterial pressure and heart rate were compared at baseline, immediately after suctioning, and at one minute interval after suctioning for five minutes between the two groups. For data analysis, repeated measures ANOVA, independent T and paired T tests were used through SPSS 16 software.
Findings: Heart rate and mean arterial pressure did not change significantly between the two groups during and after open and closed suction system. No significant difference observed with regards to heart rhythm in both suction system groups as well.
Conclusion: Changes in mean arterial pressure, heart rate and heart rhythm in patients with coronary artery bypass grafting under open and closed suctioning are the same and one system could not be preferred over the other.
Hamzeyi A., Basiri Moghaddam M., Mohammadpour A., Talayi A.r., Volume 20, Issue 4 (1-2015)
Abstract
Aims: Endotracheal intubation can increase sympathetic reflex activity result in blood pressure increase, arrhythmia and tachycardia. This study aimed to compare the effects of Clonidine premedication and Fentanyl on hemodynamic factors (heart rate, systolic and diastolic blood pressure) in opium-dependent patients under endotracheal intubation.
Materials & Methods: This single-blind clinical trial was done on 60 opium-dependent patients undergoing elective surgery under general anesthesia with endotracheal intubation in 2013 at operating room of 15 Khordad hospital. The samples were divided randomly into two equal groups receiving Clonidine and Fentanyl. Systolic and diastolic blood pressure and heart rate were compared before, immediately and 5min after intubation. Data were analyzed using Independent-T, ANOVA and Pearson correlation coefficient tests by SPSS 16 Software.
Findings: The mean heart rate, systolic and diastolic blood pressure before endotracheal intubation in both groups was not statistically different (p>0.05) but the mean heart rate, systolic and diastolic blood pressure, immediately after intubation in both groups was maximum and showed significant difference statistically (p<0.001). Systolic and diastolic blood pressure in Clonidine group, 5min after intubation significantly decreased compared with prior to intubation and showed significant difference to the Fentanyl group statistically (p<0.001).
Conclusion: Using Fentanyl as a premedication before laryngoscopy and endotracheal intubation is less effective than Clonidine to control of hemodynamic parameters in opium-dependent patients.
