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Journal of Korean Academy of Fundamentals of Nursing 2003;10(1): 96
심장수술 환아에게 기도흡인과 기관지 확장제의 투여 방법이 활력징후 및 폐기능에 미치는 효과
송효숙1, 전태국2, 박표원3, 김경은4, 정지혜5
1삼성서울병원 흉부외과 중환자실
2삼성서울병원 흉부외과
3삼성서울병원 흉부외과
4삼성서울병원 흉부외과 중환자실
5삼성서울병원 흉부외과 중환자실
Effects of Tracheal Suction and Method of Bronchodilator Inhalation on Vital Signs and Pulmonary functions in Patients with Open Heart Surgery(OHS)
Hyo-Sook Song1, Tae-Gook Jun2, Pyo-Won Park3, Kyoung-Eun Kim4, Ji-Hye Chung5
1Samsung Medical Center
2Samsung Medical Center
3Samsung Medical Center
4Samsung Medical Center
5Samsung Medical Center
Objective: The purpose of this study was to identify the effects of tracheal suction and the effects of different methods of bronchodilator inhalation (Ultrasonic nebulizer: MDI puff, MDI puff with spacer) in VSD surgery patients. Material &
Method: From June 2001 to March 2002, sixty consecutive patients were randomly assigned to a control group (n= 15), ultrasonic nebulizer group (n=15), metered dose inhalation (MDI) puff group (n=15) and MDI with spacer group (n=15). Vital signs (HR, BP, CVP), ABGA and pulmonary functions were measured before suction (baseline for suction), after suction, 15 minutes after suction (base of bronchodilator inhalation), 30 minutes after bronchodilator inhalation, and 2 hours after bronchodilator inhalation. Stastistical analysis was performed using SPSS software. Repeated measure ANOVA was used to examine the effects of tracheal suction. One way ANOVA with Bonferroni's correction and multiple range test (the least significant difference test) were used to examine the effects of albuterol inhalation. Result: 1. Heart .ate increased significantly immediately after suction (p<.01) and recovered 15 minutes after suction. 2. $PaO_2$ and PH decreased significantly immediately after suction (p<.05) and $PaO_2$ recovered 15 minutes after suction. $PaCO_2$ increased immediately after suction and significantly 15 minutes after suction (p<.01). But changes in vital signs and ABGA were within the normal range. 3. Tidal volume decreased significantly 15 minutes after suction (p<.05). 4. Changes of HR and tidal volume were greater in the nebuizer group compared to the other groups (p<.05) 30 minutes after bronchodilator inhalation and recovered 2 hours after bronchodilator inhalation. 5. Changes of airway deadspace was greater in the nebulizer group compared to the control group and MDI puff group 30 minutes after albuterol inhalation (p<.05) and at 2 hours (p<.01).
Conclusion: Tracheal suction did not have significant effect on vital signs and pulmonary functions after OHS. Although the methods of bronchodilator inhalation did not showed any significant difference on pulmonary function, the nebulizer method increased $PaO_2$ (20%) and tidal volume transiently. If the patient needs bronchodilator inhalation with bronchospasm after OHS, the nebulizer method is the best choice. More study on the effects of bronchodilator inhalation in bronchospasm group is needed.
Key words: Endotracheal suction | Bronchodilator inhalation methods | Vital signs | Pulmonary function
주요어: 기도흡인 | 기관지 확장제 투여 방법 | 활력징후 | 폐기능