Side effects of endotracheal suction in pressure- and volume-controlled ventilation.
OBJECTIVE
To investigate the effects of endotracheal suction in volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) with an open suction system (OSS) or a closed suction system (CSS).


METHODS
Randomized comparison.


METHODS
Animal research laboratory.


METHODS
Twelve healthy anesthetized pigs.


METHODS
The effects of endotracheal suction during VCV and PCV with tidal volume (VT) of 14 mL/kg were compared. A 60-mm inner-diameter endotracheal tube was used. Ten-second suction was performed using OSS and CSS with 12F and 14F catheters connected to - 14 kPa vacuum.


RESULTS
Thirty minutes after suction in PCV, VT was still decreased by 27% (p < 0.001), compliance (Crs) by 28% (p < 0.001), and PaO(2) by 26% (p < 0.001); PaCO(2) was increased by 42% (p < 0.0001) and venous admixture by 158% (p = 0.003). Suction in VCV affected only Crs (decreased by 23%, p < 0.001) and plateau pressure (increased by 24%, p < 0.001). The initial impairment of gas exchange following suction in VCV was no longer statistically significant after 30 min.


CONCLUSIONS
In conclusion, endotracheal suction causes lung collapse leading to impaired gas exchange, an effect that is more severe and persistent in PCV than in VCV.
Almgren
Birgitta
B
Section of Integrative Physiology, Department of Medical Cell Biology, Uppsala University, Sweden. birgitta.almgren@ane.ds.sll.se
Wickerts
Carl-Johan
CJ
Heinonen
Erkki
E
Högman
Marieann
M
D000818:Animals; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D008170:Lung Compliance; D011659:Pulmonary Gas Exchange; D012121:Respiration, Artificial / Q000379:methods*; D013396:Suction / Q000009:adverse effects*; D013552:Swine; D013990:Tidal Volume