Preventing hypoxemia and hemodynamic compromise related to endotracheal suctioning.
OBJECTIVE
To help the clinician bridge the gap between research and practice in determining ways to minimize side effects of endotracheal suctioning.


METHODS
This article summarizes four previous reviews of research and studies published between 1984 and 1991 related to oxygenation techniques before, during and after endotracheal suctioning, and hemodynamic consequences of the suctioning procedure.


METHODS
Studies were reviewed by type of subject: animals, human subjects with normal lung function, and human subjects with abnormal lung function. Research of pediatric and head-injured populations was excluded from this review.


METHODS
Oxygenation protocol, endotracheal suction characteristics, outcomes and measurement times, sample and setting, and findings were presented.


CONCLUSIONS
Conclusions relate to the effectiveness of various endotracheal suction protocols on prevention of hypoxemia and hemodynamic compromise in intubated patients.


RESULTS
An algorithm to guide clinical decision making is presented based on the conclusions of this review of the research.
Mancinelli-Van Atta
J
J
University of Utah, Salt Lake City.
Beck
S L
SL
D000465:Algorithms; D000818:Animals; D001784:Blood Gas Analysis; D015400:Clinical Nursing Research; D002985:Clinical Protocols; D002986:Clinical Trials as Topic; D003663:Decision Trees; D004285:Dogs; D006439:Hemodynamics; D006801:Humans; D000860:Hypoxia / Q000097:blood / Q000209:etiology / Q000451:nursing / Q000503:physiopathology / Q000517:prevention & control*; D007442:Intubation, Intratracheal / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods / Q000451:nursing; D010102:Oxygen Inhalation Therapy / Q000295:instrumentation / Q000379:methods* / Q000451:nursing; D012756:Sheep; D013396:Suction / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods / Q000451:nursing; D016896:Treatment Outcome