Deep versus shallow suction of endotracheal tubes in ventilated neonates and young infants

Kittredge Lecture: Airway Safety in Neonatal and Pediatrics

“…71 Advancing the suction catheter deeply or beyond the tip of the ETT may promote mucosal trauma, airway bleeding, and can also cause major alveolar collapse and hypoxemia. 73 Additionally, no evidence exists to support more effective secretion removal when the suction catheter is advanced beyond the ETT tip. 74 Therefore, shallow suctioning depths were adopted as measure to minimize the propensity for harm during the suctioning procedure for pediatric patients across a range of ages, from neonates to older children.…”

Kittredge Lecture: Airway Safety in Neonatal and Pediatrics

“…71 Advancing the suction catheter deeply or beyond the tip of the ETT may promote mucosal trauma, airway bleeding, and can also cause major alveolar collapse and hypoxemia. 73 Additionally, no evidence exists to support more effective secretion removal when the suction catheter is advanced beyond the ETT tip. 74 Therefore, shallow suctioning depths were adopted as measure to minimize the propensity for harm during the suctioning procedure for pediatric patients across a range of ages, from neonates to older children.…”

Endotracheal Suctioning of Mechanically Ventilated Patients With Artificial Airways 2010

“…3.2 Deep suctioning has not shown superior benefit over shallow suction 43 and may be associated with more adverse events. 44–46…”

“…Each pass of the suction catheter into the artificial airway is considered a suctioning event. 42 3.1 Shallow suctioning is recommended to prevent trauma to the tracheal mucosa. 3.2 Deep suctioning has not shown superior benefit over shallow suction 43 and may be associated with more adverse events. 44–46 3.3 The duration of each suctioning event should be no more than 15 seconds.…”

Management of the Artificial Airway

“…Attempts at suctioning the left main bronchus have been described and range from simple maneuvers to use of specially designed catheters. [81][82][83][84] A simple method for suctioning the left main bronchus is turning the patient's head to the right in an attempt to increase the likelihood of passage of the catheter into the left main bronchus. The same effect may be gained by placing the patient in the left lateral position and using gravity to further the catheter's passage.…”

“…84 Ahn and Hwang 85 examined secretions from neonates following deep and shallow suctioning and found evidence of detached ciliated airway cells only after deep suctioning. There was no increase in secretions removed during deep suctioning compared to shallow suctioning.…”

Kittredge Lecture: Airway Safety in Neonatal and Pediatrics

“…71 Advancing the suction catheter deeply or beyond the tip of the ETT may promote mucosal trauma, airway bleeding, and can also cause major alveolar collapse and hypoxemia. 73 Additionally, no evidence exists to support more effective secretion removal when the suction catheter is advanced beyond the ETT tip. 74 Therefore, shallow suctioning depths were adopted as measure to minimize the propensity for harm during the suctioning procedure for pediatric patients across a range of ages, from neonates to older children.…”

Endotracheal Suctioning of Mechanically Ventilated Patients With Artificial Airways 2010

“…3.2 Deep suctioning has not shown superior benefit over shallow suction 43 and may be associated with more adverse events. 44–46…”

“…Each pass of the suction catheter into the artificial airway is considered a suctioning event. 42 3.1 Shallow suctioning is recommended to prevent trauma to the tracheal mucosa. 3.2 Deep suctioning has not shown superior benefit over shallow suction 43 and may be associated with more adverse events. 44–46 3.3 The duration of each suctioning event should be no more than 15 seconds.…”

Management of the Artificial Airway

“…Attempts at suctioning the left main bronchus have been described and range from simple maneuvers to use of specially designed catheters. [81][82][83][84] A simple method for suctioning the left main bronchus is turning the patient's head to the right in an attempt to increase the likelihood of passage of the catheter into the left main bronchus. The same effect may be gained by placing the patient in the left lateral position and using gravity to further the catheter's passage.…”

“…84 Ahn and Hwang 85 examined secretions from neonates following deep and shallow suctioning and found evidence of detached ciliated airway cells only after deep suctioning. There was no increase in secretions removed during deep suctioning compared to shallow suctioning.…”

Kittredge Lecture: Airway Safety in Neonatal and Pediatrics

“…71 Advancing the suction catheter deeply or beyond the tip of the ETT may promote mucosal trauma, airway bleeding, and can also cause major alveolar collapse and hypoxemia. 73 Additionally, no evidence exists to support more effective secretion removal when the suction catheter is advanced beyond the ETT tip. 74 Therefore, shallow suctioning depths were adopted as measure to minimize the propensity for harm during the suctioning procedure for pediatric patients across a range of ages, from neonates to older children.…”

Endotracheal Suctioning of Mechanically Ventilated Patients With Artificial Airways 2010

“…3.2 Deep suctioning has not shown superior benefit over shallow suction 43 and may be associated with more adverse events. 44–46…”

“…Each pass of the suction catheter into the artificial airway is considered a suctioning event. 42 3.1 Shallow suctioning is recommended to prevent trauma to the tracheal mucosa. 3.2 Deep suctioning has not shown superior benefit over shallow suction 43 and may be associated with more adverse events. 44–46 3.3 The duration of each suctioning event should be no more than 15 seconds.…”

Management of the Artificial Airway

“…Attempts at suctioning the left main bronchus have been described and range from simple maneuvers to use of specially designed catheters. [81][82][83][84] A simple method for suctioning the left main bronchus is turning the patient's head to the right in an attempt to increase the likelihood of passage of the catheter into the left main bronchus. The same effect may be gained by placing the patient in the left lateral position and using gravity to further the catheter's passage.…”

“…84 Ahn and Hwang 85 examined secretions from neonates following deep and shallow suctioning and found evidence of detached ciliated airway cells only after deep suctioning. There was no increase in secretions removed during deep suctioning compared to shallow suctioning.…”