Endotracheal suctioning in children with severe traumatic brain injury: a literature review.
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.
Tume
Lyvonne
L
Royal Liverpool Children's Hospital, Liverpool John Moores University, Liverpool, UK. lyvonne.tume@rlc.nhs.uk
Jinks
Annette
A
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
D006993:Hypnotics and Sedatives