the effect of expiratory rib – cage compression before endotracheal suctioning on blood pressure in patients under mechanical ventilation

the effect of expiratory rib – cage compression before endotracheal suctioning on blood pressure in patients under mechanical ventilation    shrvani y [1] *, piami bosary m [2] , agha hasan kashani s3, mosavi nasab n4, ghafouri fard m5     received: 21 apr , 2013 accepted: 12 jul , 2013   abstract   background & aims : in patients undergoing mechanical ventilation because of an endotracheal tube, mucus production and secretion is high. because endotracheal suction in these patients is essential, chest physiotherapy techniques such as expiratory rib cage compression before endotracheal suctioning can be used as a means to facilitate mobilizing and removing airway secretion and improving alveolar ventilation. this study was carried out to determine the effect of expiratory rib cage compression before endotracheal suctioning on arterial blood pressure in patients receiving mechanical ventilation.   materials & methods : this study was a clinical trial study with a crossover design. the study sample included 50 mechanically ventilated patients hospitalized in intensive care wards of hospitals of valiasr and ayatollah mousavi educational hospitals in zanjan. subjects were selected with consecutive sampling and randomly allocated to grope 1 or 2. the patients received endotracheal suctioning with or without rib cage compression with a minimum 3 hours interval between the two interventions. blood pressure was measured 5 minutes before, and 15, 25 minutes after endotracheal suctioning. the 2 measurement periods were carried out on the same day. we measured the blood pressure 5 min before suctioning, 15 and 25 min after suctioning. to analyze the data, spss16 was used.   results: there was significant differences in the mean blood pressure between 5 minutes before as compared with 15 and 25 min after endotracheal suctioning in rib cage compression method (p<0.05). there was no significant difference in other method (p>0.05). moreover, there was significant differences in the mentioned variables (p=0.00).   conclusion: according to the findings, the expiratory rib cage compression before endotracheal suctioning improves blood pressure in patients under mechanical ventilation. so, expiratory rib cage compression before endotracheal suctioning is recommended in the patients.   key words: mechanical ventilation, endotracheal suctioning, expiratory rib cage compression, blood pressure     address : zanjan university of medical sciences, faculty of nursing and midwifery.   tel:(98) 9124425468 email : [email protected]   [1] msc in critical care nursing, faculty of nursing and midwifery, zanjan university of medical sciences (corresponding author)   2 assistant professor, faculty of nursing and midwifery , zanjan university of medical sciences.  3 internist - pulmonologist, zanjan university of medical sciences and health services.  4 associated professor, phd in statistics, zanjan university of medical sciences. 5 msc in nursing, dept. of nursing, faculty of nursing and midwifery, zanjan university of medical sciences, zanjan, iran