Endotracheal suctioning in intubated newborns: an integrative literature review.

Publisher: Associação de Medicina Intensiva Brasileira Country of Publication: Brazil NLM ID: 9506692 Publication Model: Print Cited Medium: Internet ISSN: 1982-4335 (Electronic) Linking ISSN: 0103507X NLM ISO Abbreviation: Rev Bras Ter Intensiva Subsets: MEDLINE

Original Publication: [Rio de Janeiro] : Associação de Medicina Intensiva Brasileira,

Intensive Care Units, Neonatal*; Intubation, Intratracheal/*methods ; Suction/*methods; Evidence-Based Medicine ; Humans ; Infant, Newborn ; Oxygen/administration & dosage ; Suction/standards ; Time Factors

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.

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S88TT14065 (Oxygen)

Date Created: 20151015 Date Completed: 20160505 Latest Revision: 20181113

20231215

PMC4592124

10.5935/0103-507X.20150048

26465249