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Effect of endotracheal suction on lung dynamics in mechanically-ventilated paediatric patients

Brenda Morrow1, Merle Futter, Andrew Argent

  • 1Physiotherapy Department, Red Cross War Memorial Children's Hospital, Cape Town, South Africa. bmorrow@ich.uct.ac.za

The Australian Journal of Physiotherapy
|June 13, 2006
PubMed

Insights

Endotracheal suctioning in ventilated children often decreases lung compliance and tidal volume, potentially causing lung volume loss. This common procedure does not appear to reduce airway resistance.

Area of Science:

  • Pediatric Critical Care Medicine
  • Respiratory Physiology
  • Mechanical Ventilation

Background:

  • Endotracheal suctioning is a routine procedure for ventilated infants and children to clear airway secretions.
  • The impact of endotracheal suctioning on respiratory mechanics in this population is not well understood.

Purpose of the Study:

  • To investigate the immediate effects of endotracheal suctioning on dynamic lung compliance, tidal volume, and airway resistance.
  • To assess changes in respiratory mechanics in mechanically ventilated pediatric patients following a standardized suctioning protocol.

Main Methods:

  • A prospective observational clinical study was conducted on 78 mechanically ventilated pediatric patients.
  • Lung mechanics were measured for five minutes before and after a standardized endotracheal suctioning procedure.
  • Patients with significant endotracheal tube leaks (>= 20%) were excluded from the analysis.

Main Results:

  • A significant decrease in dynamic lung compliance (p < 0.001) and expired tidal volume (p = 0.03) was observed post-suctioning.
  • No significant change in endotracheal tube leak percentage (p = 0.41) or airway resistance (p > 0.05) was found.
  • The reduction in dynamic compliance correlated with endotracheal tube and catheter sizes.

Conclusions:

  • Endotracheal suctioning frequently leads to an immediate reduction in dynamic compliance and tidal volume in ventilated children.
  • This suggests a potential loss of lung volume associated with the suctioning procedure.
  • The study found no evidence that endotracheal suctioning decreases airway resistance.

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