Suctioning in intubated and tracheotomized patients : Anarrative review

Abstract

Endotracheal suctioning in intubated or tracheotomized critically ill patients is adaily task of various professional groups in intensive and emergency medicine; however, aGerman language summary of current evidence is lacking. The aim is to develop anarrative overview of current evidence on endotracheal suctioning of intubated or tracheotomized patients in the clinical setting. Aliterature search was conducted in the databases Cinahl, Cochrane Library, Livivo, and Medline via PubMed by nurses with an academic degree. In addition, ahand search and applying the snowball principle were performed. Following asuccessful critical appraisal, all English and German language publications addressing endotracheal suctioning in the context of hospital care were included. Atotal of 23 full texts were included. After developing 6 main topics on endotracheal suction 19articles were considered in the reporting. The results showed, among others, that routine deep suctioning once per shift is contraindicated and that the catheter should be advanced no more than 0.5-1 cm beyond the distal end of the tube or tracheal cannula. Closed suction catheters offer advantages, especially for staff protection, although studies are heterogeneous. Further training of staff is obligatory. Few conclusive studies on endotracheal suction could be found; however, with the available evidence initial conclusions can be drawn which should be considered in, for example, internal standard operating procedures. Further research is needed.