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Cochrane Database Syst Rev. 2011 Jul 06;(7):CD003309. doi: 10.1002/14651858.CD003309.pub2.

Deep versus shallow suction of endotracheal tubes in ventilated neonates and young infants.

The Cochrane database of systematic reviews

Donna Gillies, Kaye Spence

Affiliations

  1. Sydney West Area Mental Health Service, Cumberland Hospital, Locked Bag 7118, Parramatta, NSW, Australia, 2150.

PMID: 21735391 PMCID: PMC8713166 DOI: 10.1002/14651858.CD003309.pub2

Abstract

BACKGROUND: Mechanical ventilation is commonly used in Neonatal Intensive Care Units to assist breathing in a variety of conditions. Mechanical ventilation is achieved through the placement of an endotracheal tube (ETT) which is left in-situ. The ETT is suctioned to prevent a build-up of secretions and blockage of the airway. Methods of suctioning the endotracheal tube vary according to institutional practice and the individual clinician performing the task. The depth of suctioning is one of these variables. The catheter may be passed to the tip of the ETT or beyond the tip into the trachea or bronchi to facilitate removal of secretions. However, trauma to the lower airways may result from the suction catheter being passed into the airway beyond the tip of the endotracheal tube.

OBJECTIVES: To compare the effectiveness and complications of deep (catheter passed beyond the tip of the ETT) versus shallow (catheter passed to length of ETT only) suctioning of the endotracheal tube in ventilated infants.

SEARCH STRATEGY: In this first update the searches were expanded to the Cochrane Central Register of Controlled Trials (The Cochrane Library, March 30), MEDLINE (from January 1966 to May 30 2011), CINAHL (from 1982 to May 30 2011) and EMBASE (1980 to May 2011) using text words and subject headings relevant to endotracheal suctioning. There were no language restrictions.

SELECTION CRITERIA: Controlled trials using random or quasi-random allocation of neonates receiving ventilatory support via an endotracheal tube to either deep or shallow endotracheal suctioning.

DATA COLLECTION AND ANALYSIS: The updated search resulted in 149 potentially relevant references. Two of the studies from this search were identified as potentially relevant. We included one of the potentially relevant studies and the other was excluded because it did not fit the inclusion criteria.

MAIN RESULTS: One small crossover trial (n = 27) of shallow versus deep suctioning met the criteria for inclusion in this review. The reported outcomes were oxygen saturation and heart rate, during and after suctioning. There were no significant differences when shallow and deep suctioning methods were compared.

AUTHORS' CONCLUSIONS: There is no evidence from randomised controlled trials concerning the benefits or risks of deep versus shallow suctioning of endotracheal tubes in ventilated neonates and infants. Further high quality research is required.

References

  1. Crit Care Med. 1989 Jun;17(6):506-10 - PubMed
  2. Am J Dis Child. 1986 May;140(5):462-5 - PubMed
  3. Radiology. 1981 Mar;138(3):589-92 - PubMed
  4. Pediatr Crit Care Med. 2008 Sep;9(5):465-77 - PubMed
  5. Pediatr Clin North Am. 1979 Aug;26(3):481-501 - PubMed
  6. Am J Crit Care. 1995 Mar;4(2):100-5 - PubMed
  7. Br J Anaesth. 1966 Jun;38(6):459-62 - PubMed
  8. Cochrane Database Syst Rev. 2003;(3):CD003309 - PubMed
  9. Int J Nurs Stud. 2003 Feb;40(2):97-104 - PubMed
  10. Neonatal Netw. 1990 Sep;9(2):7-14 - PubMed
  11. Acta Paediatr. 1996 Dec;85(12):1422-5 - PubMed
  12. Pediatrics. 1988 Nov;82(5):746-51 - PubMed
  13. Pediatr Pulmonol. 1997 Mar;23(3):217-21 - PubMed
  14. Int J Pediatr Otorhinolaryngol. 1987 Nov;14(1):1-14 - PubMed
  15. Neonatal Netw. 2009 Sep-Oct;28(5):281-302 - PubMed
  16. J Pediatr Surg. 1984 Apr;19(2):200-1 - PubMed
  17. Respir Care. 2010 Jun;55(6):758-64 - PubMed
  18. Zhonghua Yi Xue Za Zhi (Taipei). 1991 Oct;48(4):313-7 - PubMed
  19. Pediatr Nurs. 1992 Mar-Apr;18(2):115-8 - PubMed
  20. Neonatal Netw. 1991 Feb;9(5):7-15 - PubMed
  21. Arch Dis Child. 1981 May;56(5):326-30 - PubMed
  22. Neonatal Netw. 1999 Feb;18(1):51-5 - PubMed
  23. Respiration. 2003 Mar-Apr;70(2):172-8 - PubMed
  24. Intensive Crit Care Nurs. 1993 Mar;9(1):48-54 - PubMed
  25. J Obstet Gynecol Neonatal Nurs. 1991 Nov-Dec;20(6):464-9 - PubMed

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