The effect of suction method, catheter size, and suction pressure on lung volume changes during endotracheal suction...

We aimed to identify the effect of suction pressure and catheter size on change in lung volume during open and closed endotracheal suction. Anesthetized piglets (n = 12) were intubated with a 4.0-mm endotracheal tube. Lung injury was induced with saline lavage. Three suction methods (open, closed in-line, and closed with a side-port adaptor) were performed in random order using 6, 7, and 8 French gauge (FG) catheters, at vacuum pressures of 80, 140, and 200 mm Hg. Lung volume change was measured with respiratory inductive plethysmography. Overall, open suction resulted in greater lung volume loss during and at 60-s postsuction than either closed method (p < 0.001). When open and closed methods were analyzed separately, volume change was independent of catheter size and suction pressure with open suction. With closed suction, volume loss increased with larger catheter sizes and higher suction pressures (p < 0.001). With an 8-FG catheter and suction pressure of 140 or 200 mm Hg, volume loss was equivalent with open and closed suction. Lung volume changes are influenced by catheter size and suction pressure, as well as suction method. With commonly used suction pressures and catheter sizes, closed suction has no advantage in preventing loss of volume in this animal model.