title: Oropharyngeal secretion volume in intubated patients: the importance of oral suctioning.
abstract: BACKGROUND
  Aspiration of secretions that accumulate above the cuff of the endotracheal tube is a risk factor for ventilator-associated pneumonia. Routine suctioning of oropharyngeal secretions may reduce this risk; the recommended frequency for suctioning is unknown.
  
  
  OBJECTIVE
  To quantify the volume of secretions suctioned from the oropharynx of critically ill patients at 2 different intervals to assist in identifying a recommended frequency for oropharyngeal suctioning.
  
  
  METHODS
  A prospective, repeated measure, single-group design was used. Twenty-eight patients who were orally intubated and treated with mechanical ventilation were enrolled; 2 were extubated during data collection, yielding a sample of 26 patients. The patients were suctioned at baseline with a deep suction catheter, and the volume and weight of secretions were recorded. The procedure was repeated at 2-hour and 4-hour intervals.
  
  
  RESULTS
  Most of the patients were male (mean age, 49 years). Three suctioning passes were needed to clear secretions, with a mean time of 48.1 seconds. The mean volume of secretions at the 2-hour interval was 7.5 mL. Five patients required suctioning before the 4-hour interval. For the remaining 21 patients, the volume retrieved was 6.5 mL at the 2-hour interval and 7.5 mL at the 4-hour interval (P = .27). The 5 patients who required extra suctioning had significantly more secretions at the 2-hour interval (11.6 mL vs 6.5 mL; P = .05).
  
  
  CONCLUSIONS
  A minimum frequency of oropharyngeal suctioning every 4 hours is recommended. However, more frequent suctioning may be needed in a subset of patients.
authors: College of Nursing, University of Central Florida, Orlando, USA. msole@mail.ucf.edu
authors: Mary Lou
authors: ML
authors: Sole
authors: Daleen Aragon
authors: DA
authors: Penoyer
authors: Melody
authors: M
authors: Bennett
authors: Jill
authors: J
authors: Bertrand
authors: Steven
authors: S
authors: Talbert
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D009055:Mouth; D009960:Oropharynx / Q000378:metabolism*; D053717:Pneumonia, Ventilator-Associated / Q000517:prevention & control; D011446:Prospective Studies; D015144:Southeastern United States; D013396:Suction / Q000379:methods* / Q000706:statistics & numerical data; D055815:Young Adult