Biomaterial Database

Physiological responses to endotracheal and oral suctioning in paediatric patients: the influence of endotracheal tube sizes and suction pressures. 1991

N C Singh, and N Kissoon, and T Frewen, and N Tiffin

Departments of Pediatrics, Children's Hospital of Western Ontario, London, Canada.

OBJECTIVE To study the influence of varying outer suction catheter (SC) diameter (OD) to inner endotracheal tube (ETT) diameter (ID) and suction pressures (SP) on heart rate (HR), respiratory rate (RR), mean arterial pressure (MAP), arterial oxygen saturation (SaO 2) and intracranial pressure (ICP) during ETT and oral suctioning. An additional aim was to define an optimal suction catheter size that would prove easy to introduce and be rapidly effective in clearing secretions with the least physiological alteration. METHODS Prospective study. METHODS Paediatric intensive care unit. METHODS Ventilated paediatric patients. METHODS Patients had ETT suctioning performed in a random fashion using suction catheters with SC outer diameter to inner ETT diameter of approximately 0.4, 0.7 and 0.9 using varying pressures (80, 100, 120 mmHg). Using the medium size suction catheter (OD/ID = 0.7) at 100 mmHg of suction pressure, oral suctioning was compared to ETT suctioning. RESULTS Seventeen patients were studied (age 6.5 + 5 months). All suction catheters at varying pressures resulted in similar transient alterations in HR, RR, MAP, SaO 2 and ICP following ETT suctioning. Significant changes were seen in SaO 2, HR and ICP, irrespective of the catheter diameter or suction pressure. Oral suctioning resulted in similar trends and magnitude of changes as for ETT suctioning in MAP, RR, HR, and ICP, but less change occurred in the SaO 2 (p less than 0.05). The catheters with OD/ID of 0.7 were easiest to introduce and most effective in clearing secretions. CONCLUSIONS Our study suggests that: 1. Tracheal toilet using variations in OD/ID ratios and SP within limits tested resulted in similar significant adverse changes in HR, ICP and SaO 2 and similar trends in RR and MAP. 2. Based on the ease of introduction and the effectiveness of clearing secretions, a medium SC (OD/ID = 0.7) is most appropriate for infants and children. 3. Oral suctioning also results in adverse physiological changes, therefore similar precautions to those taken during tracheal suctioning should be followed for oral suctioning.

UI	MeSH Term	Description	Entries
D007427	Intracranial Pressure	Pressure within the cranial cavity. It is influenced by brain mass, the circulatory system, CSF dynamics, and skull rigidity.	Intracerebral Pressure,Subarachnoid Pressure,Intracerebral Pressures,Intracranial Pressures,Pressure, Intracerebral,Pressure, Intracranial,Pressure, Subarachnoid,Pressures, Intracerebral,Pressures, Intracranial,Pressures, Subarachnoid,Subarachnoid Pressures
D007442	Intubation, Intratracheal	A procedure involving placement of a tube into the trachea through the mouth or nose in order to provide a patient with oxygen and anesthesia.	Intubation, Endotracheal,Endotracheal Intubation,Endotracheal Intubations,Intratracheal Intubation,Intratracheal Intubations,Intubations, Endotracheal,Intubations, Intratracheal
D008297	Male		Males
D011446	Prospective Studies	Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.	Prospective Study,Studies, Prospective,Study, Prospective
D012119	Respiration	The act of breathing with the LUNGS, consisting of INHALATION, or the taking into the lungs of the ambient air, and of EXHALATION, or the expelling of the modified air which contains more CARBON DIOXIDE than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (	Breathing
D001794	Blood Pressure	PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS.	Systolic Pressure,Diastolic Pressure,Pulse Pressure,Pressure, Blood,Pressure, Diastolic,Pressure, Pulse,Pressure, Systolic,Pressures, Systolic
D002319	Cardiovascular System	The HEART and the BLOOD VESSELS by which BLOOD is pumped and circulated through the body.	Circulatory System,Cardiovascular Systems,Circulatory Systems
D002648	Child	A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL.	Children
D002675	Child, Preschool	A child between the ages of 2 and 5.	Children, Preschool,Preschool Child,Preschool Children
D004867	Equipment Design	Methods and patterns of fabricating machines and related hardware.	Design, Equipment,Device Design,Medical Device Design,Design, Medical Device,Designs, Medical Device,Device Design, Medical,Device Designs, Medical,Medical Device Designs,Design, Device,Designs, Device,Designs, Equipment,Device Designs,Equipment Designs