As-needed endotracheal suctioning protocol vs a routine endotracheal suctioning in Pediatric Intensive Care Unit: A randomized controlled trial.

Publisher: Universidad del Valle, Facultad de Salud Country of Publication: Colombia NLM ID: 9212578 Publication Model: Electronic Cited Medium: Internet ISSN: 1657-9534 (Electronic) Linking ISSN: 01208322 NLM ISO Abbreviation: Colomb Med (Cali) Subsets: MEDLINE

Publication: enero/marzo 2009- : Cali, Colombia : Universidad del Valle, Facultad de Salud
Original Publication: [Cali, Colombia : Universidad del Valle

Intubation, Intratracheal/*methods ; Pneumonia, Ventilator-Associated/*epidemiology ; Respiration, Artificial/*methods ; Suction/*methods; Child ; Child, Preschool ; Colombia ; Female ; Hospitals, University ; Humans ; Incidence ; Infant ; Intensive Care Units, Pediatric ; Male ; Time Factors ; Treatment Outcome

Objective: To compare two endotracheal suctioning protocols according to morbidity, days of mechanical ventilation, length of stay in the Pediatric Intensive Care Unit (PICU), incidence of Ventilator-Associated Pneumonia (VAP) and mortality.
Methods: A Pragmatic randomized controlled trial performed at University Hospital Pablo Tobón Uribe, Medellin-Colombia. Forty-five children underwent an as-needed endotracheal suctioning protocol and forty five underwent a routine endotracheal suctioning protocol. Composite primary end point was the presence of hypoxemia, arrhythmias, accidental extubation and heart arrest. A logistic function trough generalized estimating equations (GEE) were used to calculate the Relative Risk for the main outcome.
Results: Characteristics of patients were similar between groups. The composite primary end point was found in 22 (47%) of intervention group and 25 (55%) children of control group (RR= 0.84; 95% CI: 0.56-1.25), as well in 35 (5.8%) of 606 endotracheal suctioning performed to intervention group and 48 (7.4%) of 649 performed to control group (OR= 0.80; 95% CI: 0.5-1.3).
Conclusions: There were no differences between an as-needed and a routine endotracheal suctioning protocol.
Trial Registration: ClinicalTrials.gov identifier NCT01069185.
Competing Interests: Conflict of interest: The authors declare no conflicts of interest.

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Keywords: Intubation; Suction; adverse effects; arrhythmias, cardiac; endotraqueal; hypoxia; pediatric; randomized controlled trial
Local Abstract: [Publisher, Spanish; Castilian] Comparar dos protocolos de aspiración endotraqueal con respecto a morbilidad, días de ventilación mecánica, duración de la estancia en la Unidad de Cuidados Intensivos Pediátrica (UCIP), incidencia de neumonía asociada al ventilador (NAV) y mortalidad. [Publisher, Spanish; Castilian] Ensayo clínico controlado pragmático realizado en el Hospital Universitario Pablo Tobón Uribe, Medellín-Colombia. Cuarenta y cinco niños tratados con un protocolo de aspiración endotraqueal a necesidad y 45 con un protocolo de aspiración endotraqueal rutinaria. El desenlace primario compuesto fue la presencia de hipoxemia, arritmias, extubación accidental y paro cardiorrespiratorio. Se utilizó un modelo de ecuaciones estimables generalizadas (GEE) para calcular el riesgo relativo para el desenlace principal. [Publisher, Spanish; Castilian] Las características basales fueron similares entre los grupos. El desenlace primario compuesto estuvo presente en 22 (47%) niños del grupo de intervención y 25 (55%) niños del grupo control (RR= 0.84; IC 95%: 0.56-1.25), así como en 35 (5.8%) de las 606 aspiraciones endotraqueales realizadas al grupo de intervención y en 48 (7.4%) de las 649 realizadas al grupo control, (OR= 0.80; IC 95%: 0.5-1.3). [Publisher, Spanish; Castilian] No existen diferencias entre un protocolo de aspiración endotraqueal y uno a necesidad. [Publisher, Spanish; Castilian] ClinicalTrials.gov identifier NCT01069185.

ClinicalTrials.gov NCT01069185

Date Created: 20180815 Date Completed: 20181211 Latest Revision: 20220330

20231215

PMC6084919

10.25100/cm.v49i2.2273

30104806