[The Effects of Tracheal Suction on Respiratory Impedance]

Tracheal suctioning is performed just before extubation to remove sputum from the trachea. Although it is an invasive procedure, its adverse effect on the airway has not been investigated because this is difficult to achieve using conventional tests or monitoring. We performed a study using the forced oscillation technique to investigate whether tracheal suctioning affects respiratory impedance (consisting of respiratory resistance and respiratory reactance).

This prospective observational study was conducted in 43 patients undergoing transurethral resection of bladder tumors under general anesthesia. Respiratory impedance (R5, R20, and X5) was measured the day before surgery and just after surgery. R5 and R20 are representative values of respiratory resistance, while X5 is representative of respiratory reactance. Participants were divided into two groups: those with or without tracheal suctioning.

There were no significant differences in patient backgrounds or preoperative respiratory impedance parameters. In the suctioning group, post- operative R5 and R20 were significantly higher than in the non-suctioning group (P=0.002 and 0.063, respec- tively). There was no significant difference in postop- erative X5 between the two groups.

Tracheal suctioning caused an increase in respiratory resistance in this cohort of patients, sug- gesting that unnecessary suctioning should be avoided during surgery.