Side effects of endotracheal suction in pressure- and volume-controlled ventilation.

Publisher: Elsevier Country of Publication: United States NLM ID: 0231335 Publication Model: Print Cited Medium: Print ISSN: 0012-3692 (Print) Linking ISSN: 00123692 NLM ISO Abbreviation: Chest Subsets: MEDLINE

Publication: 2016- : New York : Elsevier
Original Publication: Chicago : American College of Chest Physicians

Intubation, Intratracheal/*adverse effects ; Respiration, Artificial/*methods ; Suction/*adverse effects; Animals ; Lung Compliance ; Pulmonary Gas Exchange ; Swine ; Tidal Volume

Study Objectives: 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).
Design: Randomized comparison.
Setting: Animal research laboratory.
Patients: Twelve healthy anesthetized pigs.
Interventions: 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.
Measurements and 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.

Date Created: 20040310 Date Completed: 20040401 Latest Revision: 20190514

20240628

10.1378/chest.125.3.1077

15006972