Zusammenfassung
Die tracheobronchiale Absaugung stellt eine wichtige Maßnahme im Intensivbereich im Rahmen der Bronchialtoilette als auch im rehabilitativen Bereich im Falle von Aspiration dar. Nachdem die Absaugung nach Tracheotomie immer wieder Diskussionen aufwirft, wer, wann, wie oft und wie lange absaugen darf, wurde diesem Thema ein eigenes Kapitel gewidmet. Es werden Grundlagen zur Absaugung, zu Absaugungssystemen, zu Absaugkathetern und Absaugvorgängen vermittelt. Dieses Kapitel gibt einen Überblick über die theoretischen Grundlagen sowie praktischen Aspekte zum Thema Absaugmanagement beim kritisch kranken tracheotomierten Patienten im Setting einer Intensivstation. Beleuchtet werden zwei Arten der Absaugung: das Absaugen von Atemwegssekret über die Trachealkanüle (endotracheales Absaugen) sowie das Absaugen von Sekret oberhalb vom Cuff mithilfe spezieller Trachealkanülen (subglottische Absaugung).
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Literatur
AARC Clinical Practice Guidelines (2010) Endotracheal suctioning of mechanically ventilated patients with artificial airways. Respiratory Care 55(6):758–764
Afshari A, Safari M, Oshvandi K, Soltanian AR (2014) The effect of the open and closed system suctions on cardiopulmonary parameters: time and costs in patients under mechanical ventilation. Nursing and Midwifery Studies 3(2):e14097
Banfi P, Robert D (2013) Early tracheostomy or prolonged translaryngeal intubation in the ICU: a long running story. Respiratory Care 58(11):1995–1996
Berra L, De Marchi L, Panigada M, Yu ZX, Baccarelli A, Kolobow T (2004) Evaluation of continuous aspiration of subglottic secretion in an in vivo study. Critical Care Medicine 32(10):2071–2078
Bouza E, Pérez MJ, Muñoz P, Rincón C, Barrio JM, Hortal J (2008) Continuous aspiration of subglottic secretions in the prevention of ventilator-associated pneumonia in the postoperative period of major heart surgery. Chest 134(5):938–946
Caparros AC (2014) Mechanical ventilation and the role of saline instillation in suctioning adult intensive care unit patients: an evidence-based practice review. Dimens of Crit Care Nursing 33(4):246–253
Celik SA, Kanan N (2006) A current conflict: use of isotonic sodium chloride solution on endotracheal suctioning in critically ill patients. Dimens Crit Care Nursing 25(1):1–14
Coffman HM, Rees CJ, Sievers AE, Belafsky PC (2008) Proximal suction tracheotomy tube reduces aspiration volume. Otolaryngology–Head and Neck Surgery 138(4):441–445
Day T, Farnell S, Wilson-Barnett J (2002) Suctioning: a review of current research recommendations. Intensive and Critical Care Nursing 18(2):79–89
Delaney A, Bagshaw SM, Nalos M (2006) Percutaneous dilatational tracheostomy versus surgical tracheostomy in critically ill patients: a systematic review and meta-analysis. Journal of Critical Care 10(2): R55
De Leyn P, Bedert L, Delcroix M, Depuydt P, Lauwers G, Sokolov Y, Van Meerhaeghe A, Van Schil P (2007) Belgian Association of Pneumology and Belgian Association of Cardiothoracic Surgery. Tracheotomy: clinical review and guidelines. European Journal of Cardio-Thoracic Surgery 32(3):412–421
Demir F, Dramali A (2005) Requirement for 100% oxygen before and after closed suction. Journal of Advanced Nursing 51(3):245–251
Dragoumanis CK, Vretzakis GI, Papaioannou VE, Didilis VN, Vogiatzaki TD, Pneumatikos IA (2007) An investigating the failure to aspirate subglottic secretions with the Evac endotracheal tube. Anesthesia & Analgesia 105(4):1083–1085
Fernández MD, Piacentini E, Blanch L, Fernández R (2004) Changes in lung volume with three systems of endotracheal suctioning with and without pre-oxygenation in patients with mild-to-moderate lung failure. Intensive Care Medecine 30 (12):2210–2215
Gillies D, Spence K (2011) Deep versus shallow suction of endotracheal tubes in ventilated neonates and young infants. Cochrane Database Syst Rev 6(7):CD003309
Higgins KM, Punthakee X (2007) Meta-analysis comparison of open versus percutaneous tracheostomy. Laryngoscope, 117(3):447–454
Isfort M, Weidner F, Gehlen D. Pflege-Thermometer (2012) Eine bundesweite Befragung von Leitungskräften zur Situation der Pflege und Patientenversorgung auf Intensivstationen im Krankenhaus. Deutsches Institut für angewandte Pflegeforschung e.V. (dip) (Hrsg.), Köln. Online verfügbar unter: http://www.dip.de (Abgerufen am: 10.06.2017)
Irajpour P, Abbasinia M et al. (2014) Effects of shallow and deep sediment disturbance on whole-stream metabolism in experimental sand-bed flumes. Iranian Journal of Nursing and Midwifery Research 19(4):366–370
Jung R, Gottlieb L (1976) Comparison of tracheobronchial suction catheters in humans. Visualization by fiberoptic bronchoscopy. Chest 69(2):179–181
Larsen R, Ziegenfuß T (2013) Beatmung. Indikationen – Techniken – Krankheitsbilder. Springer, Berlin
Ledgerwood LG, Salgado MD, Black H, Yoneda K, Sievers A, Belafsky PC (2013) Tracheotomy tubes with suction above the cuff reduce the rate of ventilator-associated pneumonia in intensive care unit patients. Annals of Otology, Rhinology & Laryngology 122(1):3–8
Leur J, Zwaveling J, Loef B, Schans C (2003) Endotracheal suctioning versus minimally invasive airway suctioning in intubated patients: a prospective randomised controlled. Intensive Care Medicine 29:426–432
Link WJ, Spaeth EE, Wahle WM, Penny W, Glover JL (1976) The influence of suction catheter tip design on tracheobronchial trauma and fluid aspiration efficiency. Anesthesia & Analgesia 55(2):290–297
Lorente L, Blot S, Rello J. New issues and controversies in the prevention of ventilator-associated pneumonia.American Journal of Respiratory and Critical Care Medicine182(7): 870–876
Maggiore SM, Lellouche F, Pigeot J, Taille S, Deye N, Durrmeyer X, Richard JC, Mancebo J, Lemaire F, Brochard L (2003) Prevention of endotracheal suctioning-induced alveolar derecruitment in acute lung injury. American Journal of Respiratory and Critical Care Medicine 167(9):1215–1224
Muscedere J, Rewa O, McKechnie K, JiangX, Laporta D, Heyland DK (2011) Subglottic secretion drainage for the prevention of ventilator-associated pneumonia: a systematic review and meta-analysis. Critical Care Medicine 39(8):1985–1991
Morris L, Whitmer A, McIntosh E (2013) Tracheostomy care and complications in the intensive care unit. Critical Care Nursing 33:18–30
Özden D, Görgülü S (2012) Development of standard practice guidelines for open and closed system suctioning. Journal of Clinical Nursing 21(9–10):1327–1338
Overend TJ, Anderson CM et al. (2009), Updating the evidence base for suctioning adult patients: A systematic review. Canadian Respiratory Journal 6(3):e6–17
Paratz JD, Stockton KA (2009) Efficacy and safety of normal saline instillation: a systematic review. Physiotherapy 95(4):241–250
Paulus F, Binnekade JM, Middelhoek P, Schultz MJ, Vroom MB (2009) Manual hyperinflation of intubated and mechanically ventilated patients in dutch intensive care units – a survey into current practice and knowledge. Intensive and Critical Care Nursing 25(4):199–207
Pederson C, Rosendahl-Nielsen M, Hjermind J, Egerod I (2009) Endotracheal suctioning of the adult intubated patient –What is the evidence? Intensive and Critical Care Nursing 25:21–30
Rees J, McCartney R, Saha S, Wickrama T (2014) National UK survey: a review of percutaneous tracheostomy and auxiliary subglottic suction port use. Journal of Critical Care 18(Suppl1):P328
Richter T, Sutarski S (2009) Tracheostoma – handling and complications. Anaestesist 8(12):1261–1274
Robert-Koch-Institut [RKI] (2013) Prävention der nosokomialen beatmungsassoziierten Pneumonie. Empfehlung der Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert Koch-Institut, Bundesgesundheitsblatt 56:1578–1590
Roberts FE (2009) Consensus among physiotherapists in the United Kingdom on the use of normal saline instillation prior to endotracheal suction: a Delphi study. Physiotherapy Cana 61(2):107–115
Rogge JA, Bunde L, Baun MM (1989) Effectiveness of oxygen concentrations of less than 100% before and after endotracheal suction in patients with chronic obstructive pulmonary disease. Heart & Lung 18(1):64–71
Sackner MA, Landa JF, Greeneltch N, Robinson MJ (1973) Pathogenesis and prevention of tracheobronchial damage with suction procedures. Chest 64(3):284–290
Savian C, Paratz J, Davies A (2006) Comparison of the effectiveness of manual and ventilator hyperinflation at different levels of positive end-expiratory pressure in artificially ventilated and intubated intensive care patients. Heart & Lung 35(5):334–341
Shah S, Fung K, Brim S, Rubin BK (2005) An in vitro evaluation of the effectiveness of endotracheal suction catheters. Chest 128(5):3699–3704
Siempos II, Ntaidou TK, Filippidis FT, Choi AM (2015) Effect of early versus late or no tracheostomy on mortality and pneumonia of critically ill patients receiving mechanical ventilation: a systematic review and meta-analysis. The Lancet Respiratory Medicine 3(2):150–158
Souza CR, Santana VT (2012) Impact of supra-cuff suction on ventilator-associated pneumonia prevention. The Revista Brasileira de Terapia Intensiva 24(4):401–406
Stenqvist O, Lindgren S, Kárason S, Söndergaard S, Lundin S (2001) Warning! Suctioning. A lung model evaluation of closed suctioning systems. Acta Anaesthesiologica Scandinavica 45(2):167–172
Subirana M, Sola I, Benito S (2007) Closed tracheal suction systems versus open tracheal suction systems for mechanically ventilated adult patients (Review). Cochrane Database Syst Rev 17(4):CD004581
Ullrich L et al. (2010) Intensivpflege und Anästhesie, 2. Aufl. Thieme, Stuttgart
Yazdannik AR, Haghighat S, Saghaei M, Eghbali M (2013) Comparing two levels of closed system suction pressure in ICU patients: Evaluating the relative safety of higher values of suction pressure. Iranian Journal of Nursing and Midwifery Research 18(2):117–122
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Lippoldt, J. (2018). Absaugung nach Tracheostomie. In: Schneider-Stickler, B., Kress, P. (eds) Tracheotomie und Tracheostomaversorgung. Springer, Vienna. https://doi.org/10.1007/978-3-7091-4868-6_10
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DOI: https://doi.org/10.1007/978-3-7091-4868-6_10
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