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Side effects of endotracheal suction in pressure- and volume-controlled ventilation
Birgitta Almgren1, Carl-Johan Wickerts, Erkki Heinonen
1Section of Integrative Physiology, Department of Medical Cell Biology, Uppsala University, Sweden. birgitta.almgren@ane.ds.sll.se
Study Objectives:
To investigate the effects of endotracheal suction in volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) with an open suction system (OSS) or a closed suction system (CSS).
Design:
Randomized comparison.
Setting:
Animal research laboratory.
Patients:
Twelve healthy anesthetized pigs.
Interventions:
The effects of endotracheal suction during VCV and PCV with tidal volume (VT) of 14 mL/kg were compared. A 60-mm inner-diameter endotracheal tube was used. Ten-second suction was performed using OSS and CSS with 12F and 14F catheters connected to - 14 kPa vacuum.
Measurements And Results:
Thirty minutes after suction in PCV, VT was still decreased by 27% (p < 0.001), compliance (Crs) by 28% (p < 0.001), and PaO(2) by 26% (p < 0.001); PaCO(2) was increased by 42% (p < 0.0001) and venous admixture by 158% (p = 0.003). Suction in VCV affected only Crs (decreased by 23%, p < 0.001) and plateau pressure (increased by 24%, p < 0.001). The initial impairment of gas exchange following suction in VCV was no longer statistically significant after 30 min.
Conclusions:
In conclusion, endotracheal suction causes lung collapse leading to impaired gas exchange, an effect that is more severe and persistent in PCV than in VCV.
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