The effects of open and closed suctioning systems on neonatal pain and vital signs in neonatal intensive care units.

BACKGROUND: Endotracheal suctioning is a procedure used by neonatal intensive care unit nurses to maximize oxygenation and clear airways of secretions, and is one of the most common painful procedures causing stress in intubated newborns. AIM: This aim of this study is to compare the effects of open and closed endotracheal suctioning on pain, peak heart rate and oxygen saturation in neonates on mechanicalventilation. MATERIALS AND METHODS: This experimental-design study was conducted on 30 newborns who were mechanically ventilated in the tertiary neonatal intensive care unit of a public hospital. First, closed suctioning and then open suctioning was performed on patients during the day. Pain, peak heart rate and oxygen saturation levels were evaluated before, during and 30 min after each suctioning procedure. RESULTS: Of the newborns included in the study, 53.3 % were male and 36.6 % were admitted to intensive care unit due to a heart defect. No statistically significant differences were found in pain, peak heart rate, or oxygen saturation between the open and closed suctioning methods. However, oxygen saturation levels during suctioning were lower compared to levels before and 30 min after the procedure. Additionally, peak heart rate was lower during suctioning compared to 30 min afterward. CONCLUSIONS: The study concludes that there is no significant difference between open and closed suctioning techniques concerning pain, peak heart rate, and oxygen saturation. IMPLICATIONS TO PRACTICE: Given its sterility and ease of use, the closed suction method may be preferable in clinical settings.

A scoping review of pain resulting from the endotracheal suctioning of paediatric intensive care patients.

BACKGROUND: This scoping review was conducted to summarise and map studies on pain resulting from endotracheal suctioning in paediatric intensive care patients. METHOD: This scoping review conducted in June 2022 was performed by screening articles published in English. Scopus, PubMed, Cochrane, Web of Science, MedLine and Ovid databases were used for screening. The keywords 'endotracheal suctioning', 'pain', 'paediatric intensive care' and their synonyms were used in the search. RESULTS: During the review, 280 articles were accessed, and the full texts of 14 articles were evaluated for suitability. After some of the articles were excluded from the study, abstracts of nine articles were given below. CONCLUSION: It is recommended that a greater number of randomised controlled studies should be conducted, because the number of studies with a high level of evidence on the effect of endotracheal suctioning on the pain levels of patients in the paediatric intensive care unit is very few.

Determination of pain experienced by children during intravenous bolus treatments and its causes.

OBJECTIVE: The present study aimed to determine the pain experienced by children during intravenous bolus treatment and to identify what causes it. METHOD: In the first stage of the study, the first 40 observations were performed by two researchers. The study was continued by a single observer after the Kappa test was performed. In this study, 101 drug treatments were administered by intravenous bolus in patients aged between 1 month and 6 years. The pain experienced during treatment was assessed using pain scales according to the age group the patient was in. RESULTS: Pain was observed in 63.4% (n = 64) of the treatments. There was a significant relationship between the type of medication administered and pain experienced during drug administration. There was also a significant correlation between the age of the children and their pain experiences. Given the location of the catheter, there was no significant difference among the children who experienced pain during intravenous treatment. CONCLUSION: Intravenous drug therapy may cause pain in children. To minimize such pain, it is recommended to determine the drugs that cause pain during intravenous treatment and to develop application protocols to minimize pain caused by these drugs.