Close suction for endotracheal tubes, also known as in-line suctioning, is a technique used to clear airway secretions while maintaining continuous mechanical ventilation and oxygenation. This method is preferred over open suctioning due to its safety and effectiveness in reducing adverse events.
Here are the key points about close suction for endotracheal tubes:
Technique: In-line suctioning involves using a catheter that is attached as part of the ventilator circuit connected to the patient. This allows for continuous ventilation without disconnecting the patient from the ventilator.
Safety: Closed suctioning is considered safer and has been associated with fewer adverse events compared to open suctioning. It reduces the risk of airway collapse and hypoxia that can occur when a patient is disconnected from the ventilator.
Procedure: The catheter is inserted through a special diaphragm attached to the end of the endotracheal tube. Sterile technique is used when suctioning with a flexible (single-use) suction catheter.
Catheter Size: The size of the suction catheter should be one half the inner diameter of the artificial airway, providing a lumen diameter ratio of 0.5. For an adult patient, the catheter size should be less than 50% of the internal diameter of the endotracheal tube.
Pressure: Suction pressure should be kept at less than 200 mmHg in adults and 80 mmHg to 120 mmHg in neonates.
Duration: Each pass should be less than 15 seconds in duration, and the patient should be allowed to recover between suction passes.
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