成人有创机械通气患者气道内吸引操作性疼痛的研究进展及启示

doi:10.3761/j.issn.2096-7446.2024.10.009

摘要/Abstract

摘要： 气道内吸引作为成人有创机械通气患者常用且必要的侵入性护理操作,其给患者带来的疼痛问题日益突出,目前国内少有学者关注此领域。鉴于此,该文对成人有创机械通气患者气道内吸引操作性疼痛发生现状、影响因素及评估工具进行综述,旨在为医护人员在实践中全面认识成人有创机械通气患者气道内吸引操作性疼痛并制订管理策略提供参考。

关键词: 危重病护理, 机械通气, 气道内吸引, 疼痛, 综述文献（主题）

Abstract: Endotracheal suctioning is a common and essential invasive nursing procedure for adult patients with invasive mechanical ventilation. However,it has increasingly been associated with pain,a problem that has received insufficient attention from scholars in China. In light of the aforementioned issues,this article aims to provide a comprehensive review of the current state of pain occurrence,influencing factors and assessment tools in adult invasive mechanical ventilation patients. This review is intended to serve as a reference for healthcare professionals seeking to gain a more nuanced understanding of the pain induced by airway suction experienced by adult invasive mechanical ventilation patients and to inform the development of more effective management strategies.

Key words: Critical Care Nursing, Mechanical Ventilation, Endotracheal Suctioning, Pain, Review Literature as Topic

于天灏, 陈香萍, 尹金瑜, 刘倩, 王涛, 李文丽. 成人有创机械通气患者气道内吸引操作性疼痛的研究进展及启示[J]. 中华急危重症护理杂志, 2024, 5(10): 920-925.

YU Tianhao, CHEN Xiangping, YIN Jinyu, LIU Qian, WANG Tao, LI Wenli. Research progress and insights into pain induced by airway suction in adult patients with invasive mechanical ventilation[J]. Chinese Journal of Emergency and Critical Care Nursing, 2024, 5(10): 920-925.

参考文献

[1] Alnajar MK,Shudifat R,Mosleh SM,et al.Pain assessment and management in intensive care unit:nurses‘ practices,perceived influencing factors,and educational needs[J]. Open Nurs J,2021,15(1):170-178.
[2] Skrobik Y,Chanques G.The pain,agitation,and delirium practice guidelines for adult critically ill patients:a post-publication perspective[J]. Ann Intensive Care,2013,3(1):9.
[3] Ayasrah SM.Pain among non-verbal critically Ill mechanically ventilated patients:prevalence,correlates and predictors[J]. J Crit Care,2019,49:14-20.
[4] 孟雪莲,陶诗琪,李娜,等. ICU成人患者操作性疼痛管理的最佳证据总结[J]. 中华现代护理杂志,2023,29(16):2138-2144.
Meng XL,Tao SQ,Li N,et al.Summary of best evidence for procedural pain management in adult patients in ICU[J]. Chin J Mod Nurs,2023,29(16):2138-2144.
[5] Pota V,Coppolino F,Barbarisi A,et al.Pain in intensive care:a narrative review[J]. Pain Ther,2022,11(2):359-367.
[6] Lee K,Oh H,Suh Y,et al.Patterns and clinical correlates of pain among brain injury patients in critical care assessed with the critical care pain observation tool[J]. Pain Manag Nurs,2013,14(4):259-267.
[7] Khayer F,Ghafari S,Saghaei M,et al.Effects of open and closed tracheal suctioning on pain in mechanically ventilated patients[J]. Iran J Nurs Midwifery Res,2020,25(5):426-430.
[8] Yaman AktaŞ Y Karabulut N. Relief of procedural pain in cri-tically ill patients by music therapy:a randomized controlled trial[J]. Complement Med Res,2019,26(3):156-165.
[9] Özsaban A,Üzen Cura Ş,Yılmaz Coşkun E,et al. Investigation of pain associated with endotracheal aspiration and affecting factors in an intensive care setting:a prospective observational study[J]. Aust Crit Care,2023,36(5):687-694.
[10] Ribeiro CJN,Bezerra DS,Lima AGCF,et al.Pain during tracheal aspiration in patients with traumatic brain injury un-dergoing mechanical ventilation[J]. Rev Dor,2017,18(4):332-337.
[11] 营晓,张海燕,路潜. 术后机械通气患者吸痰操作疼痛现状及影响因素研究[J]. 中华护理杂志,2018,53(5):537-542.
Ying X,Zhang HY,Lu Q.Endotracheal suctioning related pain and its influencing factors in postoperative patients with mechanical ventilation[J]. Chin J Nurs,2018,53(5):537-542.
[12] Lucchini A,Canesi M,Robustelli G,et al. An association between pain and American association of respiratory care 2010 guidelines during tracheal suctioning[J]. Dimens Crit Care Nurs,2016,35(5):283-290.
[13] Damico V,Macchi G,Murano L,et al.Incidence of pain at rest and during nursing procedures in ICU patients:a longitudinal observational study[J]. Ann Ig,2020,32(4):407-418.
[14] Kostikas K,Gogali A,Hillas G.Cardiovascular disease and chronic obstructive pulmonary disease:adding a third dimension to the ABE global initiative for chronic obstructive lung disease 2023 chronic obstructive pulmonary disease classification[J]. Am J Respir Crit Care Med,2023,208(4):502-504.
[15] Jackson T,Tian PP,Wang Y,et al.Toward identifying moderators of associations between presurgery emotional distress and postoperative pain outcomes:a meta-analysis of longitudinal studies[J]. J Pain,2016,17(8):874-888.
[16] Puntillo KA,Max A,Timsit JF,et al.Determinants of procedural pain intensity in the intensive care unit. The Europain study[J]. Am J Respir Crit Care Med,2014,189(1):39-47.
[17] Prommer E.Midazolam:an essential palliative care drug[J]. Palliat Care Soc Pract,2020,14:2632352419895527.
[18] Deng P,Hao LQ,Deng Y,et al.Pre-emptive remifentanil alleviates pain associated with tracheal suctioning in patients under mechanical ventilation and goal-directed sedation:a randomized controlled feasibility trial[J]. Int J Nurs Pract,2022,28(2):e12915.
[19] Dastdadeh R,Ebadi A,Vahedian-Azimi A.Comparison of the effect of open and closed endotracheal suctioning methods on pain and agitation in medical ICU patients:a clinical trial[J]. Anesth Pain Med,2016,6(5):e38337.
[20] American Association for Respiratory Care. AARC Clinical Practice Guidelines. Endotracheal suctioning of mechanically ventilated patients with artificial airways 2010[J]. Respir Care,2010,55(6):758-764.
[21] Blakeman TC,Scott JB,Yoder MA,et al.AARC clinical practice guidelines:artificial airway suctioning[J]. Respir Care,2022,67(2):258-271.
[22] Paymard A,Bargrizan S,Ramezani S,et al.Comparing Changes in Pain and level of consciousness in Open Endotracheal Suction Catheters with Two Sizes:12 and 14:a Randomized Clinical Trial[J]. Eurasian J Anal Chem,2017,12(5b):591-597.
[23] Al Darwish ZQ,Hamdi R,Fallatah S.Evaluation of pain assessment tools in patients receiving mechanical ventilation[J]. AACN Adv Crit Care,2016,27(2):162-172.
[24] Gulsoy Z,Ozdemir Kol I.The effect of endotracheal suctioning on pain in conscious adult patients in intensive care unit[J]. Dimens Crit Care Nurs,2024,43(2):72-79.
[25] Bublitz V,Jurth C,Kreuzer M,et al.Electroencephalogram-based prediction and detection of responsiveness to noxious stimulation in critical care patients:a retrospective single-centre analysis[J]. Br J Anaesth,2023,130(2):e339-e350.
[26] Ruetzler K,Montalvo M,Bakal O,et al.Nociception level index-guided intraoperative analgesia for improved postoperative recovery:a randomized trial[J]. Anesth Analg,2023,136(4):761-771.
[27] Shahiri TS,Richard-Lalonde M,Richebé P,et al.Exploration of the nociception level(NOL^TM) index for pain assessment during endotracheal suctioning in mechanically ventilated patients in the intensive care unit:an observational and feasibility study[J]. Pain Manag Nurs,2020,21(5):428-434.
[28] 关欣,杨慧,李栩亭,等. 成人有创机械通气气道分泌物吸引的现状调查[J]. 中华护理杂志,2020,55(6):922-927.
Guan X,Yang H,Li XT,et al.Investigation on the current situation of airway secretion aspiration of invasive mechanical ventilation in adults[J]. Chin J Nurs,2020,55(6):922-927.
[29] 中华护理学会. 成人有创机械通气气道内吸引技术操作[Z]. 中华护理学会T/CNAS 10-2020,2021.
Chinese Nursing Association.Endotracheal suctioning in adults receiving invasive mechanical ventilation[Z]. Chinese Nursing Association,T/CNAS 10-2020,2021.