Abstract
AbstractEndotracheal suctioning is performed regularly in ventilated infants and children to remove obstructive secretions. The effect of suctioning on respiratory mechanics is not known. This study aimed to determine the immediate effect of endotracheal suctioning on dynamic lung compliance, tidal volume and airway resistance in mechanically ventilated paediatric patients by means of a prospective observational clinical study. Lung mechanics were recorded for 5 min before and 5 min after a standardized suctioning procedure in 78 patients intubated with endotracheal tubes of ≤4·0 mm internal diameter. Twenty‐four patients with endotracheal tube leaks ≥20% were excluded from analysis. There was a significant overall decrease in dynamic compliance (p < 0·001) and mechanical expired tidal volume (p = 0·03) following suctioning with no change in the percentage of endotracheal tube leak (p = 0·41). The change in dynamic compliance was directly related to both endotracheal tube and catheter sizes. There was no significant change in expiratory or inspiratory airway resistance following suctioning (p > 0·05). Although most of the patients (68·5%) experienced a drop in dynamic compliance following suctioning, dynamic compliance increased in 31·5% of patients after the procedure. This study demonstrates that endotracheal suctioning frequently causes an immediate drop in dynamic compliance and expired tidal volume in ventilated children with variable lung pathology, intubated with small endotracheal tubes, probably indicating loss of lung volume caused by the suctioning procedure. There is no evidence that suctioning reduces airway resistance. Abstract reprinted from the Australian Journal of Physiotherapy volume 52, Morrow B et al., ‘Effect of endotracheal suction on lung dynamics in mechanically‐ventilated paediatric patients’, pages 121–126. © 2006, reproduced with permission from the Australian Physiotherapy Association.
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