| Subglottic secretion viscosity and evacuation efficiency. | |
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MedLine Citation:
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PMID: 17172319 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Ventilator-associated pneumonia (VAP) is a common nosocomial pneumonia that occurs in critically ill patients and results in mortality rates as high as 71%. Subglottic secretions (SSs) are a known risk factor. Several clinical trials have shown that continuous aspiration of subglottic secretions (CASS) reduces the risk of VAP by nearly half. Optimal suction pressure levels needed to efficiently evacuate viscous SSs are unknown. The purpose of this study was to describe SSs and the effective suction pressure (20 mmHg, 30 mmHg, 40 mmHg, and 50 mmHg) needed to maximize evacuation efficiency based on SS volume (2 ml, 4 ml, and 6 ml) and viscosity (watery, thick, and gel-like). A laboratory model was designed to replicate a human trachea. Thick secretions had the highest percentage of mean recovery representative of evacuation efficiency of SSs (mean recovery of 86%). The suction pressure of 30 mmHg had the highest overall mean of secretion recovery (83%) across all viscosity types and amounts. This study demonstrated that higher viscosity secretions were easier to evacuate than lower viscosity secretions when 30-mmHg suction pressure was applied. Management of secretion viscosity may assist in secretion removal and delay VAP development. With increased understanding of the molecular structure of SSs, there is the potential that clinicians will be able to manipulate secretion viscoelastic properties to maximize evacuation efficiency of the secretions. Further research is needed to identify safe suction pressures for optimal evacuation of SSs in human subjects. |
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Authors:
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Pamela V O'Neal; Cindy L Munro; Mary Jo Grap; Sarah M Rausch |
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Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Biological research for nursing Volume: 8 ISSN: 1099-8004 ISO Abbreviation: Biol Res Nurs Publication Date: 2007 Jan |
Date Detail:
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Created Date: 2006-12-18 Completed Date: 2007-01-19 Revised Date: 2007-12-03 |
Medline Journal Info:
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Nlm Unique ID: 9815758 Medline TA: Biol Res Nurs Country: United States |
Other Details:
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Languages: eng Pagination: 202-9 Citation Subset: IM; N |
Affiliation:
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College of Nursing, University of Alabama, Huntsville, AL 35899, USA. onealp@uah.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Clinical Nursing Research Critical Care / methods Female Glottis Humans Male Middle Aged Models, Anatomic Mucociliary Clearance Nursing Evaluation Research Pneumonia, Ventilator-Associated / etiology, physiopathology, prevention & control* Pressure Rheology Risk Factors Saliva* / physiology Sputum* / physiology Suction / instrumentation, methods*, nursing Treatment Outcome Viscosity |
| Grant Support | |
ID/Acronym/Agency:
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IF31 NR07491-01/NR/NINR NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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