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Abstract
During the period of critical illness, many of the critically ill patients may require intubation by the placement of an endotracheal or tracheostomy tube. In intubated patients, the principal goal of airway management is to establish and maintain a patent airway in order to ensure adequate alveolar ventilation and oxygenation. Thus, tracheal suctioning is periodically warranted in intubated patients and is considered as one of the most frequently performed nursing tasks in ICUs (Johnson et al., 2006). Instillation of normal saline prior to suction in patients with an artificial airway is a traditional nursing intervention. Nurses routinely instill 3-10 ml of normal saline solution into the airway prior to suction thought to loosen secretions, lubricate the suction catheter and increase secretions clearance; lacking empirical evidence to support this practice (Ji et al., 2002). The present study was conducted to determine the effect of using normal saline instillation on oxygenation for mechanically ventilated patients undergoing endotracheal suctioning. The current study was conducted at the critical care units of Menoufyia university hospital, Egypt. Data collection for this study was extended from the first of August 2005 to the middle of March 2006. The sample of this study consisted of 30 critically ill patients selected according to the following criteria: 1. In early stage of mechanical ventilation within 1 to 7 days. 2. They were in clinical need for tracheal suctioning. 3. Have an oral endotracheal tube. 4. Electronically monitored. 5. Have a normal body temperature (36.5C-37.5C). 6. Have a radial artery cannula until the end of data collection. Patients with the following conditions were excluded from the study as these factors may affect heart rate and arterial blood gases results. 1. Patients with atrial fibrillation or pacemaker therapy. 2. Patients with chronic diseases. 3. Patients with low hemoglobin (less than 10 for females and less than 12 for males).