Endotracheal suctioning versus minimally invasive airway suctioning in intubated patients: a prospective randomised controlled trial.
OBJECTIVE
Endotracheal suctioning in intubated patients is routinely applied in most ICUs but may have negative side effects. We hypothesised that on-demand minimally invasive suctioning would have fewer side effects than routine deep endotracheal suctioning, and would be comparable in duration of intubation, length of stay in the ICU, and ICU mortality.


METHODS
Randomised prospective clinical trial.


METHODS
In two ICUs at University Hospital Groningen, the Netherlands.


METHODS
Three hundred and eighty-three patients requiring endotracheal intubation for more than 24 h.


METHODS
Routine endotracheal suctioning (n=197) using a 49-cm suction catheter was compared with on-demand minimally invasive airway suctioning (n=186) using a suction catheter only 29 cm long.


RESULTS
No differences were found between the routine endotracheal suctioning group and the minimally invasive airway suctioning group in duration of intubation [median (range) 4 (1-75) versus 5 (1-101) days], ICU-stay [median (range) 8 (1-133) versus 7 (1-221) days], ICU mortality (15% versus 17%), and incidence of pulmonary infections (14% versus 13%). Suction-related adverse events occurred more frequently with RES interventions than with MIAS interventions; decreased saturation: 2.7% versus 2.0% (P=0.010); increased systolic blood pressure 24.5% versus 16.8% (P<0.001); increased pulse pressure rate 1.4% versus 0.9% (P=0.007); blood in mucus 3.3% versus 0.9% (P<0.001).


CONCLUSIONS
This study demonstrated that minimally invasive airway suctioning in intubated ICU-patients had fewer side effects than routine deep endotracheal suctioning, without being inferior in terms of duration on intubation, length of stay, and mortality.
Van de Leur
Johannes P
JP
Centre for Rehabilitation, University Hospital Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands. j.p.van.de.leur@rev.azg.nl
Zwaveling
Jan H
JH
Loef
Bert G
BG
Van der Schans
Cees P
CP
D003362:Cost-Benefit Analysis; D003422:Critical Care; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012121:Respiration, Artificial; D018709:Statistics, Nonparametric; D013396:Suction / Q000009:adverse effects / Q000191:economics / Q000379:methods*