Pain and Comfort During Endotracheal Suction in Premature Neonates

Summary

Most of the preterm babies in neonatal units are followed up with invasive mechanical ventilation support. For this reason, endotracheal suction is needed repeatedly in preterm babies in order to open the airway obstruction caused by secretions and to maintain the airway patency. Endotracheal aspiration, which is one of the invasive procedures in which pain is felt most in newborns, is performed by nurses.

Endotracheal suction, which causes pain and discomfort in intensive care units, negatively affects the comfort of patients. Studies emphasize that comfort is an indicator of pain and stress, and the comfort scale is also used in pain and distress assessments.

Effective pain management and the development of pain-related care standards to reduce pain in preterm newborn infants improve clinical and neurodevelopmental outcomes. For this reason, it is necessary to reduce the pain that has an effect on the development of preterm babies.

In pediatric nursing, studies on non-pharmacological methods have increased in recent years in order to increase the comfort of infants and reduce pain and stress, especially during painful and stressful procedures in infants followed in neonatal intensive care units. When the literature is examined, there are few studies measuring the effectiveness of non-pharmacological methods used in reducing pain due to endotracheal suction. There are differences in the effectiveness of the methods applied in the existing studies. Therefore, more observation, research and scientific studies by neonatal nurses are needed to reduce the pain associated with endotracheal suction in preterm newborns.

In this study, swaddling and oropharyngeal colostrum, which are two non-pharmacological methods, will be applied during endotracheal suction to preterm newborns receiving invasive mechanical ventilation support. This experimental study was planned to determine the effect of these two non-pharmacological methods on procedural pain and comfort and to contribute to evidence-based nursing practices.

Conditions

• Premature

Interventions

OTHER

Swaddling

* Babies in this group were wrapped with a white cheesecloth 2 minutes before ES in addition to incubator cover and nesting. * Common procedure steps: * Legal representatives of the infants will sign an informed consent form. * İncubator cover and nesting * Endotracheal suction(ES) was performed in the supine position. * ES was done at the time of care the baby needed. * No painful procedure was applied until 2 hours before ES and 15 minutes after ES. * Aspiration was performed sterile at 80 mmHg pressure. * A second nurse assisted in the suction process and the procedure took no more than 15 seconds. * The amount of oxygen taken by the baby was increased by 10% 30 seconds before the suction procedure and returned to its original value 60 seconds after the procedure. * Beginning 3 minutes before the ES procedure, during the procedure and until 15 minutes after the procedure, the infants' behaviors and bedside monitor indicators were video recorded.

OTHER

Oropharyngeal colostrum

* Common procedure steps * In addition to incubator cover and nesting, babies in this group were given 0.4 ml of colostrum with an insulin injector on the inside of the cheeks and on the tongue.

Sponsors & Collaborators

• Istanbul Aydın University

  lead OTHER

Principal Investigators

• Birsen Mutlu, Ass. Prof. · Istanbul University - Cerrahpasa

Study Design

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

1 Day

Max Age

5 Days

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2019-07-01

Primary Completion

2020-10-01

Completion

2020-10-01

Countries

• Turkey (Türkiye)

Study Locations