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Limpeza e descontaminação da cânula de traqueostomia interna em ambiente hospitalar : Revisão scoping
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Introdução: O cuidado eficaz na limpeza e desinfeção da cânula interna de traqueostomia é fundamental na prevenção de complicações nomeadamente infeção ou obstrução da via aérea. Contudo, constata-se que a evidência científica sobre o tema é escassa, fragmentada e pouco sistematizada. Objetivo: Identificar e mapear a evidência científica disponível sobre as intervenções a administrar para a limpeza da cânula interna da traqueostomia em ambiente hospitalar, que possibilite realizar uma síntese descritiva sobre o estado de arte deste procedimento.
Metodologia: A presente revisão scoping avaliou as intervenções, produtos e periodicidade do procedimento a aplicar na limpeza da cânula interna de traqueostomia em ambiente hospitalar. Foram incluídos estudos em inglês, francês, espanhol e português, sem restrição de tempo. Dois revisores realizaram de forma independente a triagem dos estudos de acordo com os critérios de inclusão e extraíram os dados utilizando o instrumento de extração previamente definido. As bases de dados consultadas incluíram a MEDLINE (PubMed), CINAHL (EBSCO), B-On, Scopus, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials e o repositório científico de acesso aberto de Portugal (RCAAP).
Resultados: Cumpriram critérios de elegibilidade um total de onze estudos. Três ensaios clínicos randomizados investigaram a eficácia dos produtos na descontaminação da cânula interna, um estudo quase experimental e um estudo de série observacional correlacionaram condições clínicas do utente com a frequência de troca da cânula interna e os restantes estudos qualitativos, incluindo uma tese académica e uma revisão tipo scoping, descrevem os cuidados inerentes ao doente com cânula de traqueostomia interna.
Conclusão: Os produtos a utilizar devem ser individualizados de acordo com o material da cânula, o contexto de prestação de cuidados e as recomendações do fabricante. A periodicidade da intervenção é essencialmente ditada pela quantidade e consistência das secreções.
Palavras-chave: Traqueostomia; manejo da via aérea; descontaminação; cuidados críticos;
Abstract Background: Effective care in cleaning and decontamination of the tracheostomy inner cannula is essential to prevent complications, particularly infection or airway obstruction. However, the scientific evidence on the subject remains limited, fragmented, and insufficiently systematized Objective: To identify and map the available scientific evidence regarding the interventions for cleaning the tracheostomy inner cannula in the hospital setting, thereby enabling the development of a descriptive synthesis of the state of the art on this procedure. Methods: This scoping review assessed the interventions, products and frequency of the procedure used for cleaning the tracheostomy inner cannula in the hospital setting. Studies published in English, French, Spanish, and Portuguese were included, with no time restrictions. Two reviewers screened the studies independently according to the predefined inclusion criteria and extracted data using a previously developed data extraction tool. The databases consulted included MEDLINE (PubMed), CINAHL (EBSCO), B-On, Scopus, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and the Portuguese Open Access Scientific Repository (RCAAP). Results: A total of eleven studies met the eligibility criteria. Three randomized clinical trials investigated the effectiveness of different products in the decontamination of the inner cannula. One quasi-experimental study and one observational case series examined the association between patients’ clinical conditions and the frequency of the inner cannula replacement. The remaining qualitative studies, including an academic thesis and a scoping review, describe the care practices associated with patients with an tracheostomy inner cannula. Conclusion: The products to be used should be individualized according to the cannula material, the care setting, and the manufacturer’s recommendations. The frequency of the intervention is primarily determined by the volume and consistency of secretions. Keywords: tracheostomy; airway management; decontamination; critical care;
Abstract Background: Effective care in cleaning and decontamination of the tracheostomy inner cannula is essential to prevent complications, particularly infection or airway obstruction. However, the scientific evidence on the subject remains limited, fragmented, and insufficiently systematized Objective: To identify and map the available scientific evidence regarding the interventions for cleaning the tracheostomy inner cannula in the hospital setting, thereby enabling the development of a descriptive synthesis of the state of the art on this procedure. Methods: This scoping review assessed the interventions, products and frequency of the procedure used for cleaning the tracheostomy inner cannula in the hospital setting. Studies published in English, French, Spanish, and Portuguese were included, with no time restrictions. Two reviewers screened the studies independently according to the predefined inclusion criteria and extracted data using a previously developed data extraction tool. The databases consulted included MEDLINE (PubMed), CINAHL (EBSCO), B-On, Scopus, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and the Portuguese Open Access Scientific Repository (RCAAP). Results: A total of eleven studies met the eligibility criteria. Three randomized clinical trials investigated the effectiveness of different products in the decontamination of the inner cannula. One quasi-experimental study and one observational case series examined the association between patients’ clinical conditions and the frequency of the inner cannula replacement. The remaining qualitative studies, including an academic thesis and a scoping review, describe the care practices associated with patients with an tracheostomy inner cannula. Conclusion: The products to be used should be individualized according to the cannula material, the care setting, and the manufacturer’s recommendations. The frequency of the intervention is primarily determined by the volume and consistency of secretions. Keywords: tracheostomy; airway management; decontamination; critical care;
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Cânula Competência profissional Descontaminação Desinfeção Enfermagem médico cirúrgica Hospitais Revisão scoping Traqueostomia Cannula Decontamination Disinfection Hospitals Medical surgical nursing Professional competence Scoping review Tracheostomy