title: Controlled trial of a continuous irrigation suction catheter vs conventional intermittent suction catheter in clearing bronchial secretions from ventilated patients.
abstract: Continuous irrigation-suction catheter (Irri-cath) is a double-lumen device that allows for simultaneous saline solution infusion and aspiration. This system may theoretically be more effective than conventional dry intermittent suction due to its vortex principle. To test this hypothesis, we performed 200 suction maneuvers in 20 ventilated patients. Identically shaped catheters were used in a randomized sequence. For the same individual, we used equal instilled saline solution volume (40 ml), vacuum pressure (-180 cm H2O), and ventilatory parameters. Effectiveness of suction was determined by measuring the total aspirated volume, the dry lyophilized weight of secretion, the corrected dry weight (dry weight-weight of instilled salt), and protein concentration. No difference in heart rate, respiratory frequency, O2 saturation, systemic blood pressure, peak inspiratory pressure, or patient discomfort was found when the two modalities were compared; however, the total volume of secretions collected, the dry weight, the corrected dry weight, and the protein concentration were significantly higher with continuous irrigation suction catheter when compared with the conventional method (p < 0.05). The suction time was shorter with the Irri-cath (p < 0.05). We conclude that the Irri-Cath is more effective than conventional intermittent suction catheter in clearing bronchial secretions in patients on mechanical ventilation.
authors.affiliation: Department of Veterans Affairs Medical Center, Boston University School of Medicine 02118.
authors.forename: J O
authors.initials: JO
authors.lastname: Isea
authors.forename: D
authors.initials: D
authors.lastname: Poyant
authors.forename: C
authors.initials: C
authors.lastname: O'Donnell
authors.forename: L J
authors.initials: LJ
authors.lastname: Faling
authors.forename: J
authors.initials: J
authors.lastname: Karlinsky
authors.forename: B R
authors.initials: BR
authors.lastname: Celli
mesh_terms: D001980:Bronchi / Q000378:metabolism*; D002404:Catheterization / Q000295:instrumentation*; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial; D012965:Sodium Chloride / Q000008:administration & dosage; D013396:Suction / Q000295:instrumentation*; D007507:Therapeutic Irrigation / Q000295:instrumentation*
chemical_list: D012965:Sodium Chloride