Determining the Effect of Two Different Methods in Children to Maintain Drain Patency After Cardiac Surgery
Condition: Infant ALL; Congenital Heart Disease
MeSH terms: Heart Diseases; Heart Defects, Congenital
Study type: Interventional

Summary: 
      In this study, it was aimed to determine the effect of the use of milking and sucking methods
      on bleeding amount, vital signs and oxygen saturation in children with chest and mediastinal
      drains after cardiac surgery.
    

Detailed description: 
      The patient admitted to the post-operative Cardiovascular Surgery Intensive Care Units
      primarily meets two nurses and is responsible for the arrangement of medical equipment,
      monitoring, monitoring, maintaining, recording, and performing the necessary treatments. Then
      the nurse positions the drain after checking the drain connections, checks the level of the
      drain and records it in the nurse follow-up note. Then, the method to be used in maintaining
      the drain opening is decided in cooperation with the physician.

      Three different methods are currently used in the unit. The first method; There is no
      application in maintaining the drain opening, but if there are necessary medical indications
      such as clot formation, blood accumulation in the drainage connections, lack of drainage,
      this group is intervened by milking method. In our study, this group will be taken as a
      control group, there will be a situation that requires intervention in the first 6 hours, and
      if the milking method is used, it will be excluded from the sample.

      The second method used to maintain the drain opening is the suction method. In this study,
      this group will be taken as the first experimental group. The suction method is a continuous
      use until the patient's drainage requirement and the physician's request is terminated by
      ensuring that the pressure is between 5 and 15 kPa (kilopascals) or 10-20 cm H20 after the
      appropriate negative pressure tracking system of the patient, who is accepted with intensive
      care under water drainage system, is established. system.

      The third method is milking. In our study, this group will be taken as the 2nd experimental
      group. In the milking method, the process starts from the area close to the drain entry
      point. The latex tube is folded into 12 cm long pieces and gripped with two hands. The nurse
      repeats the process 3 times by compressing the parts gripped by the hand. This process is
      then used at intervals every hour to repeat the distal part.

      After the applications related to the method to be used are performed, the patient's vital
      signs, Sp02 and bleeding amount are generally monitored every hour.

      In this study, the data for each group will be collected before and after the procedure for 6
      hours after surgery, from the moment the patient is admitted to the intensive care unit.
    

Intervention name(s): Control; Experimental Group (Absorption Group); Experimental Group (Milking Group)
Intervention type(s): Other; Other; Other
Intervention description(s): Common Process Steps:
Informed consent forms will be signed by those who wish to take part in the research.
The form in which individual characteristics are questioned will be filled.
Hands will be washed, gloves will be worn.
Before the procedure, body temperature, heart rate, respiratory rate, blood pressure, oxygen saturation and bleeding amount will be recorded.
Drains will be kept parallel to the ground and upright.
Drainage hoses will not be bent and in-bed position will be provided in accordance with gravity.
It will be ensured that all connections between the chest tubes and drainage unit are tight and secure.
Dressings of the chest and mediastinum drains will be fixed on the patient's skin, so as not to interfere with drainage.
To prevent the tubes from coming out, they will be fixed to the patient bed.
Vital signs, Sp02 and bleeding amount will be recorded every hour for 6 hours after surgery; Common process steps
Appropriate negative pressure monitoring system of the patient, who is admitted to the intensive care unit with underwater drainage system, will be established.
The suction control room combined with the vacuum regulator will be filled with sterile distilled water up to the specified level (20 cm H2O).
From the vacuum regulator, the drain or drains will be connected tightly and by preventing the crimping, from the aspirator receptor hoses.
Suction will begin with a low level and gradually increase the suction until a slight bubble is noticed in the suction control room.
Suction pressure will be maintained between 5 and 15 kPa (kilopascals) or 10-20 cm H20.
The application will continue without interruption until the patient's drain need and the doctor's request is ended.
During the application, the patient's vital signs, Sp02 and bleeding amount will be recorded every hour without using an additional manipulation method.; Common process steps will be applied
Operation will start from the area near the drain entrance point
Latex tube will be folded into 12 cm long pieces and will be gripped with two hands
The procedure will be repeated 3 times by compressing the parts gripped by the nurse hand.
This process will be repeated in the distal part.
After the application, the patient's vital signs, Sp02 and bleeding amount will be recorded every hour without using an additional manipulation method.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: infant; congenital heart disease; drain patency; nursing