Endotracheal suctioning of the adult intubated patient--what is the evidence?

TY - JOUR

T1 - Endotracheal suctioning of the adult intubated patient--what is the evidence?

AU - Pedersen, Carsten M

AU - Rosendahl-Nielsen, Mette

AU - Hjermind, Jeanette

AU - Egerod, Ingrid

N1 - Keywords: Adult; Asepsis; Equipment Design; Evidence-Based Nursing; Humans; Hygiene; Infection Control; Instillation, Drug; Intubation, Intratracheal; Irrigation; Nursing Assessment; Nursing Evaluation Research; Oxygen Inhalation Therapy; Patient Selection; Practice Guidelines as Topic; Pressure; Research Design; Risk Factors; Sodium Chloride; Suction

PY - 2008

Y1 - 2008

N2 - Intubated patients may be unable to adequately cough up secretions. Endotracheal suctioning is therefore important in order to reduce the risk of consolidation and atelectasis that may lead to inadequate ventilation. The suction procedure is associated with complications and risks including bleeding, infection, atelectasis, hypoxemia, cardiovascular instability, elevated intracranial pressure, and may also cause lesions in the tracheal mucosa. The aim of this article was to review the available literature regarding endotracheal suctioning of adult intubated intensive care patients and to provide evidence-based recommendations The major recommendations are suctioning only when necessary, using a suction catheter occluding less than half the lumen of the endotracheal tube, using the lowest possible suction pressure, inserting the catheter no further than carina, suctioning no longer than 15s, performing continuous rather than intermittent suctioning, avoiding saline lavage, providing hyperoxygenation before and after the suction procedure, providing hyperinflation combined with hyperoxygenation on a non-routine basis, always using aseptic technique, and using either closed or open suction systems.

AB - Intubated patients may be unable to adequately cough up secretions. Endotracheal suctioning is therefore important in order to reduce the risk of consolidation and atelectasis that may lead to inadequate ventilation. The suction procedure is associated with complications and risks including bleeding, infection, atelectasis, hypoxemia, cardiovascular instability, elevated intracranial pressure, and may also cause lesions in the tracheal mucosa. The aim of this article was to review the available literature regarding endotracheal suctioning of adult intubated intensive care patients and to provide evidence-based recommendations The major recommendations are suctioning only when necessary, using a suction catheter occluding less than half the lumen of the endotracheal tube, using the lowest possible suction pressure, inserting the catheter no further than carina, suctioning no longer than 15s, performing continuous rather than intermittent suctioning, avoiding saline lavage, providing hyperoxygenation before and after the suction procedure, providing hyperinflation combined with hyperoxygenation on a non-routine basis, always using aseptic technique, and using either closed or open suction systems.

U2 - 10.1016/j.iccn.2008.05.004

DO - 10.1016/j.iccn.2008.05.004

M3 - Journal article

C2 - 18632271

SN - 0964-3397

VL - 25

SP - 21

EP - 30

JO - Intensive and Critical Care Nursing

JF - Intensive and Critical Care Nursing

IS - 1

ER -