Document Detail


AARC Clinical Practice Guidelines. Endotracheal suctioning of mechanically ventilated patients with artificial airways 2010.
MedLine Citation:
PMID:  20507660     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
An electronic literature search for articles published between January 1990 and October 2009 was conducted by using MEDLINE, CINAHL, and Cochrane Library databases. The update of this clinical practice guideline is the result of reviewing a total of 114 clinical trials, 62 reviews and 6 meta-analyses on endotracheal suctioning. The following recommendations are made following the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria: (1) It is recommended that endotracheal suctioning should be performed only when secretions are present, and not routinely; (2) It is suggested that pre-oxygenation be considered if the patient has a clinically important reduction in oxygen saturation with suctioning; (3) Performing suctioning without disconnecting the patient from the ventilator is suggested; (4) Use of shallow suction is suggested instead of deep suction, based on evidence from infant and pediatric studies; (5) It is suggested that routine use of normal saline instillation prior to endotracheal suction should not be performed; (6) The use of closed suction is suggested for adults with high F(I)O2, or PEEP, or at risk for lung de-recruitment, and for neonates; (7) Endotracheal suctioning without disconnection (closed system) is suggested in neonates; (8) Avoidance of disconnection and use of lung recruitment maneuvers are suggested if suctioning-induced lung de-recruitment occurs in patients with ; (9) It is suggested that a suction catheter is used that occludes less than 50% the lumen of the endotracheal tube in children and adults, and less than 70% in infants; (10) It is suggested that the duration of the suctioning event be limited to less than 15 seconds.
Authors:
Publication Detail:
Type:  Journal Article; Practice Guideline    
Journal Detail:
Title:  Respiratory care     Volume:  55     ISSN:  0020-1324     ISO Abbreviation:  Respir Care     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-28     Completed Date:  2010-09-16     Revised Date:  2012-11-13    
Medline Journal Info:
Nlm Unique ID:  7510357     Medline TA:  Respir Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  758-64     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Humans
Intubation, Intratracheal / standards*
Oxygen Inhalation Therapy / standards
Respiration, Artificial*
Suction / standards
Investigator
Investigator/Affiliation:
Ruben D Restrepo / ; Joel M Brown / ; John M Hughes /

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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