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Endotracheal suctioning with or without instillation of isotonic sodium chloride solution in critically ill children

Debra A Ridling1, Lynn D Martin, Susan L Bratton

  • 1Children's Hospital and Regional Medical Center, Seattle, Wash., USA.

American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses
|May 20, 2003
PubMed

Insights

Instilling saline during endotracheal suctioning in children may cause significant oxygen desaturation. This practice is not beneficial and could be harmful, with no observed impact on tube occlusion or pneumonia rates.

Area of Science:

  • Pediatric Critical Care Medicine
  • Respiratory Therapy
  • Clinical Nursing

Background:

  • The use of isotonic sodium chloride solution during endotracheal tube suctioning is a debated practice.
  • Existing research primarily focuses on adult populations, leaving a gap in pediatric evidence.

Purpose of the Study:

  • To investigate the impact of isotonic sodium chloride solution instillation on oxygen saturation levels in pediatric patients undergoing endotracheal suctioning.
  • To assess the incidence of endotracheal tube occlusion and nosocomial pneumonia in relation to this intervention.

Main Methods:

  • A randomized study involving 24 critically ill children (10 weeks to 14 years) was conducted.
  • Patients were divided into two groups: one receiving saline instillation before suctioning, the other not.
  • Oxygen saturation was monitored, and rates of tube occlusion and nosocomial pneumonia were compared between groups.

Main Results:

  • Children who received isotonic sodium chloride solution experienced significantly greater oxygen desaturation post-suctioning compared to those who did not.
  • No instances of endotracheal tube occlusion or nosocomial pneumonia were reported in either group.

Conclusions:

  • The findings suggest that instilling isotonic sodium chloride solution during endotracheal suctioning in children may be detrimental, potentially causing harm.
  • This study adds to the evidence questioning the benefit and highlighting the risks of this procedure in pediatric care.
Abstract

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