title: Endotracheal suctioning in intubated newborns: an integrative literature review.
abstract: Evidence-based practices search for the best available scientific evidence to support problem solving and decision making. Because of the complexity and amount of information related to health care, the results of methodologically sound scientific papers must be integrated by performing literature reviews. Although endotracheal suctioning is the most frequently performed invasive procedure in intubated newborns in neonatal intensive care units, few Brazilian studies of good methodological quality have examined this practice, and a national consensus or standardization of this technique is lacking. Therefore, the purpose of this study was to review secondary studies on the subject to establish recommendations for endotracheal suctioning in intubated newborns and promote the adoption of best-practice concepts when conducting this procedure. An integrative literature review was performed, and the recommendations of this study are to only perform endotracheal suctioning in newborns when there are signs of tracheal secretions and to avoid routinely performing the procedure. In addition, endotracheal suctioning should be conducted by at least two people, the suctioning time should be less than 15 seconds, the negative suction pressure should be below 100 mmHg, and hyperoxygenation should not be used on a routine basis. If indicated, oxygenation is recommended with an inspired oxygen fraction value that is 10 to 20% greater than the value of the previous fraction, and it should be performed 30 to 60 seconds before, during and 1 minute after the procedure. Saline instillation should not be performed routinely, and the standards for invasive procedures must be respected.
authors.affiliation: Curso de Gradução em Fisioterapia, Faculdade de Educação Física e Fisioterapia, Universidade Federal do Amazonas, Manaus, AM, BR.
authors.forename: Roberta Lins
authors.initials: RL
authors.lastname: Gonçalves
authors.affiliation: Curso de Gradução em Fisioterapia, Faculdade de Educação Física e Fisioterapia, Universidade Federal do Amazonas, Manaus, AM, BR.
authors.forename: Lucila Midori
authors.initials: LM
authors.lastname: Tsuzuki
authors.affiliation: Serviço de Fisioterapia, Maternidade Balbina Mestrinho, Secretaria de Estado de Saúde do Amazonas, Manaus, AM, BR.
authors.forename: Marcos Giovanni Santos
authors.initials: MG
authors.lastname: Carvalho
mesh_terms: D019317:Evidence-Based Medicine; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007442:Intubation, Intratracheal / Q000379:methods*; D010100:Oxygen / Q000008:administration & dosage; D013396:Suction / Q000379:methods* / Q000592:standards; D013997:Time Factors
chemical_list: D010100:Oxygen