title: Endotracheal suctioning in children with severe traumatic brain injury: a literature review.
abstract: OBJECTIVE
  This paper aims to present an overview of the literature relating to the effects of endotracheal suctioning (ETS) in children and adults with severe traumatic brain injury (TBI).
  
  
  BACKGROUND
  TBI is the leading cause of death in children worldwide and continues to result in widespread mortality and morbidity. In intensive care, ETS is an essential nursing procedure that is undertaken but is known to produce some adverse effects in children.
  
  
  METHODS
  A comprehensive literature search was undertaken using a Parahoo and quality of reporting of meta-analyses (QUOROM) approach. A range of databases was searched to identify published papers with key search terms. The databases searched included Cochrane Library, Medline, PubMed Central, CINAHL, Proquest and Science Direct.
  
  
  RESULTS
  This review is based on 21 papers (with 433 patients in total), but specific papers in paediatric head injury children were extremely limited, and the evidence was largely dated and inconclusive. Although the majority of papers demonstrate an increase in intracranial pressure (ICP) with ETS, there are contradictory results with regard to recovery times.
  
  
  CONCLUSIONS
  Further research is needed specifically into the effect of ETS on ICP and cerebral perfusion pressure of children with severe TBI, taking into account all the known confounding variables.
authors.affiliation: Royal Liverpool Children's Hospital, Liverpool John Moores University, Liverpool, UK. lyvonne.tume@rlc.nhs.uk
authors.forename: Lyvonne
authors.initials: L
authors.lastname: Tume
authors.forename: Annette
authors.initials: A
authors.lastname: Jinks
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000451:nursing* / Q000628:therapy; D002648:Child; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology; D015278:Intensive Care Units, Pediatric; D007427:Intracranial Pressure / Q000187:drug effects; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000451:nursing*; D012121:Respiration, Artificial / Q000451:nursing; D012143:Respiratory Physiological Phenomena; D013396:Suction
chemical_list: D006993:Hypnotics and Sedatives