Abstract

Intratracheal aspiration in a patient on ventilation is generally performed using a catheter. Of late, closed suction systems have been used more frequently than open systems. To remove tracheal secretions through the intratracheal tube, catheter suction is used, and the suction catheter may be of the closed- or open-type. The catheters are cleaned by flushing with sterile 0.9% saline, resulting in dropping of dew. This phenomenon is caused by some factors: influence of flow, clogging of the suction tube, problem of manipulation of flushing and angle between the intubation tube and the connection port. But this dropping has not yet been investigated. In this study, we focused at this angle and we used the test lung which is simulated machine on behalf of patient. We consider two situations adult and child, also two types of catheters Eco-Cath and Ty-care. In child case we consider elbow-type suction catheters and Y-connector type. The angle was set at 0°, 20°, 40°, 60°, and 90°, and we observed the difference between Eco-Cath and Ty-care. In adults difference is significant (p 0.001), In 90° between Tracheal intubation and Tracheotomy (p ≈ 0.26). In child difference is significant (p 0.001), In 90° between Tracheal intubation and Tracheotomy (p ≈ 0.15). In child case we observed dependency of angle on various conditions too. The relation of the angle and dew was clarified.

Highlights

  • Dew droppings were observed in 67 of all 1440 times in volume control continuous mandatory ventilation (VC-CMV) and 93 of all 1440 times in positive control continuous mandatory ventilation (PC-CMV); the dropping was more frequent in PC-CMV

  • Our results showed a significant relationship between the number of droppings and the angle between the intubation tube and the connection port of the test lung (P < 0.001, chi-squared test)

  • We believe that dropping in this study occurred partially due to influence of flow, clogging of suction tube, and problems related to the procedure

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Summary

Introduction

It has been reported that the closed suction system limits loss in lung volume and oxygenation compared to the open suction system [6] [7] For these and other reasons, the American Association for Respiratory Care (AARC) created and reported guidelines regarding suction methods in home-care patients [8]. Another set of guidelines generated by the Centers for Disease Control and Prevention (CDC) does not specify any preference for the multiuse closed system suction catheter or the single-use open system suction catheter for the prevention of pneumonia [9]. Considering the cost, the former (closed suction catheter) is generally used in medical facilities as well as in home-care patients

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