At an intensive care unit, endotracheal intubation has been performed in association with aseptic aspiration as an independent nursing procedure. This study measured the contamination of specimen in the aspiration catheter 2 times, i.e., at hour 0 and hour 8, in patients who underwent endotracheal i...
At an intensive care unit, endotracheal intubation has been performed in association with aseptic aspiration as an independent nursing procedure. This study measured the contamination of specimen in the aspiration catheter 2 times, i.e., at hour 0 and hour 8, in patients who underwent endotracheal intubation and thereby were indicated in aseptic aspiration. The objective of this chronological study is to determine whether it is reliable and feasible to exchange aspiration catheter after an 8-hour use, by analyzing the number, species and bacterial status in the aspiration catheter; and to present the optimal time scale for catheter exchange in the field of clinical practice. To fulfill the above objectives, this study enrolled a total of 30 patients (n=30) indicated in aseptic aspiration who underwent endotracheal intubation in oral route at an intensive care unit of University Hospital between July 2002 and January 2003. This study did not consider the following factors: age, sex, diagnosis, oxygen administration, mental status, antibiotic medication, duration of artificial ventilator, duration of endotracheal intubation and length of hospital stay at an intensive care unit. To collect specimen in the aspiration catheter, catheter was rinsed with a saline 2-3 times at hour 0 and hour 8; and 3-5 mm of portion around the orifice was cut with disinfected scissor and was transferred to a special medium. Collected specimen was stored at 4C in a refrigerator and was transferred to a microbiology laboratory within 8 hours. Using blood agar and McConkey media, collected specimen was cultured by a clinical pathologist at microbiology laboratory in this hospital. Statistical analysis was performed using SAS 6.12 system. At hour 0 and hour 8, the number of bacteria was described as real and percentile numbers. To determine the correlation of the type and species of bacteria with contamination, t-test and ANOVA were used; and to analyze the correlation of patients baseline characteristics with contamination, t-test and ANOVA were also used. The results were as follows: 1. As time progressed, the number of patients with bacteria cultured in the aspiration catheter was 19 (63.2%) at hour 0 and 30 (100%) at hour 8. 2. As time progressed, the number of gram positive bacteria was significantly greater at hour 8 (24.5×10^(3)/mL) than at hour 0 (10.29×10^(3)/mL) (t=2.65, p=0.0157); and the number of gram negative bacteria was significantly greater at hour 8 (17.2×10^(3)/mL) than at hour 0 (12×10^(3)/mL) (t=3.19, p=0.0110). 3. As time progressed, mean number of bacteria in the catheter was (18×10^(3)/mL) at hour 0 and (82.5×10^(3)/mL) at hour 8, where the significant difference was noted (t=3.65, p=0.0137). This study showed that various types of bacteria were detected even at hour 0 and a long-term, repetitive use of aspiration catheter abruptly increased the contamination. In conclusion, nursing intervention should be performed on the basis of aseptic principle where disposable aspiration catheter should be used.
At an intensive care unit, endotracheal intubation has been performed in association with aseptic aspiration as an independent nursing procedure. This study measured the contamination of specimen in the aspiration catheter 2 times, i.e., at hour 0 and hour 8, in patients who underwent endotracheal intubation and thereby were indicated in aseptic aspiration. The objective of this chronological study is to determine whether it is reliable and feasible to exchange aspiration catheter after an 8-hour use, by analyzing the number, species and bacterial status in the aspiration catheter; and to present the optimal time scale for catheter exchange in the field of clinical practice. To fulfill the above objectives, this study enrolled a total of 30 patients (n=30) indicated in aseptic aspiration who underwent endotracheal intubation in oral route at an intensive care unit of University Hospital between July 2002 and January 2003. This study did not consider the following factors: age, sex, diagnosis, oxygen administration, mental status, antibiotic medication, duration of artificial ventilator, duration of endotracheal intubation and length of hospital stay at an intensive care unit. To collect specimen in the aspiration catheter, catheter was rinsed with a saline 2-3 times at hour 0 and hour 8; and 3-5 mm of portion around the orifice was cut with disinfected scissor and was transferred to a special medium. Collected specimen was stored at 4C in a refrigerator and was transferred to a microbiology laboratory within 8 hours. Using blood agar and McConkey media, collected specimen was cultured by a clinical pathologist at microbiology laboratory in this hospital. Statistical analysis was performed using SAS 6.12 system. At hour 0 and hour 8, the number of bacteria was described as real and percentile numbers. To determine the correlation of the type and species of bacteria with contamination, t-test and ANOVA were used; and to analyze the correlation of patients baseline characteristics with contamination, t-test and ANOVA were also used. The results were as follows: 1. As time progressed, the number of patients with bacteria cultured in the aspiration catheter was 19 (63.2%) at hour 0 and 30 (100%) at hour 8. 2. As time progressed, the number of gram positive bacteria was significantly greater at hour 8 (24.5×10^(3)/mL) than at hour 0 (10.29×10^(3)/mL) (t=2.65, p=0.0157); and the number of gram negative bacteria was significantly greater at hour 8 (17.2×10^(3)/mL) than at hour 0 (12×10^(3)/mL) (t=3.19, p=0.0110). 3. As time progressed, mean number of bacteria in the catheter was (18×10^(3)/mL) at hour 0 and (82.5×10^(3)/mL) at hour 8, where the significant difference was noted (t=3.65, p=0.0137). This study showed that various types of bacteria were detected even at hour 0 and a long-term, repetitive use of aspiration catheter abruptly increased the contamination. In conclusion, nursing intervention should be performed on the basis of aseptic principle where disposable aspiration catheter should be used.
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#기도 흡인 카테터 오염도 Contamination
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