Endotracheal Suctioning, Nurses Challenge in Intensive Care Units

Endotracheal tube placement is one of the most important invasive procedures for patients in the intensive care unit, to keep the airway open and mechanical ventilation. Suctioning the airways through an endotracheal tube, is a typical method to management the patients under mechanical ventilation, mechanically drain mechanically lung secretions and prevent airway obstruction, but if it isn’t done correctly it will have complications. The aim of this study is evaluating the qualification of endotracheal suctioning and its standard criterion.

This study is a review article which is based on collecting data from library and electronic sources such as SID, Elsevier, PubMed, Google scholar in 2001-2016 with keywords critical care, endotracheal suctioning, hemodynamic changes and mechanical ventilation. 

Now in most clinical centers, an evidence-based method for endotracheal suctioning is not used. Suctioning only if necessary, choose the appropriate suction catheter size, suction pressure, the depth of the inlet, runtime, removing suction catheter on a rotating basis, Preoxygenation beforehand, using aseptic techniques, using close system instead of open system, non-use of normal saline and the use of N-acetyl cysteine, if needed, are important to prevent and minimize the physiological problems associated with endotracheal suctioning. Retraining periods play an important role in standard suctioning and reduces its complications.

Despite the widespread side effects of this procedure, suctioning is still the only acceptable way to drain the lung secretions and airway clearance. To prevent side effects, identification of the accurate and timely indications can help the patient survival.