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Normal saline instillation before suctioning: A meta-analysis of randomized controlled trials.
Chia-Hui Wang1, Jui-Chen Tsai1, Shu-Fen Chen1
1Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
Summary
Normal saline instillation before suctioning in intensive care unit (ICU) patients does not improve outcomes and may decrease oxygen saturation. Further large-scale studies are needed to confirm these findings regarding airway management.
Area of Science:
- Critical Care Medicine
- Respiratory Therapy
- Clinical Research Methodology
Background:
- Normal saline (NS) instillation is a common practice before suctioning in intubated ICU patients.
- This practice is associated with potential adverse events, including decreased oxygenation and hemodynamic instability.
Purpose of the Study:
- To systematically review and meta-analyze randomized controlled trials (RCTs).
- To evaluate the necessity and impact of NS instillation before suctioning in ICU patients.
Main Methods:
- Searched major databases (PubMed, Embase, Cochrane, Scopus) and ClinicalTrials.gov.
- Included RCTs comparing NS instillation versus no NS instillation before suctioning.
- Conducted a random-effects meta-analysis on oxygen saturation, heart rate, and blood pressure.
Main Results:
- Analyzed 5 RCTs with 337 patients.
- Oxygen saturation was significantly higher 5 minutes after suctioning in the group without NS instillation.
- No significant differences in heart rate or blood pressure were observed between groups.
Conclusions:
- Normal saline instillation before suctioning offers no benefit and may reduce post-suctioning oxygen saturation in ICU patients.
- Current evidence is based on low-quality studies.
- Large-scale RCTs are recommended to validate these findings.
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