Related Experiment Videos
Impact of closed-system suctioning on self-reported dyspnea in mechanically ventilated patients: a prospective
Lijun Liang1, Simei Wang1, Zhenghua Liang1
1Intensive Care Unit, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, China.
Background:
Endotracheal suctioning is an essential airway care procedure in mechanically ventilated patients, yet its acute impact on subjective respiratory distress has not been systematically quantified.
Methods:
In this prospective self-controlled observational study conducted from May to October 2025 in a tertiary intensive care unit (ICU) in Sichuan Province, China, awake mechanically ventilated adults with a Richmond Agitation-Sedation Scale (RASS) score of 0 to +1 requiring closed-system suctioning were enrolled. Dyspnea intensity was assessed using the Dyspnea Visual Analog Scale (D-VAS, 0-10) before suctioning (T0), immediately after suctioning (T1), and 5 min post-suctioning (T2). Peripheral oxygen saturation (SpO2) and heart rate (HR) were recorded simultaneously.
Results:
Fifty-three suctioning procedures from 42 patients were included. D-VAS scores increased significantly from 2.8 ± 1.9 at T0 to 6.4 ± 2.1 at T1 (mean increase 3.6, 95% CI: 3.1-4.1, P < 0.001), then decreased to 3.2 ± 1.7 at T2 (P < 0.001 vs. T1). Dyspnea worsened in 92.5% of procedures at T1, and 15.1% had not returned to baseline at T2. Despite SpO2 increasing from 97.2 ± 2.1% to 99.1 ± 1.3% at T1, dyspnea worsened substantially, suggesting a potential dissociation between oxygenation status and subjective respiratory distress. These findings should be interpreted within the context of a single-center convenience sample without prospective sample size calculation and the use of a unidimensional dyspnea instrument.
Conclusion:
These findings suggest that closed-system suctioning may induce clinically significant but transient worsening of dyspnea that appears independent of oxygenation status. Individual dyspnea assessment during routine suctioning care warrants attention, and confirmatory multicenter studies with prospective power calculations are needed.
Related Concept Videos
Suctioning the Nasopharyngeal Airway
Equipment Required
Tracheostomy Suctioning I: Pre-Procedural Steps
Equipment Required
First, gather all necessary equipment: a sterile suction catheter, a sterile disposable container, sterile gloves, a towel or...
Tracheostomy Suctioning II: Procedure
Suctioning the Oropharyngeal Airway
After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the...
Mechanical Ventilation II: Invasive Ventilation
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
Endoscopic Studies II: Thoracocentesis
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...