Endotracheal suctioning versus minimally invasive airway suctioning in intubated patients: a prospective randomised controlled trial

Johannes P Van de Leur, Jan H Zwaveling, Bert G Loef, Cees van der Schans

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

STUDY OBJECTIVE: Endotracheal suctioning in intubated patients is routinely applied in most ICUs but may have negative side effects. We hypothesised that on-demand minimally invasive suctioning would have fewer side effects than routine deep endotracheal suctioning, and would be comparable in duration of intubation, length of stay in the ICU, and ICU mortality.

DESIGN: Randomised prospective clinical trial.

SETTING: In two ICUs at University Hospital Groningen, the Netherlands.

PATIENTS: Three hundred and eighty-three patients requiring endotracheal intubation for more than 24 h.

INTERVENTIONS: Routine endotracheal suctioning (n=197) using a 49-cm suction catheter was compared with on-demand minimally invasive airway suctioning (n=186) using a suction catheter only 29 cm long.

MEASUREMENTS AND RESULTS: No differences were found between the routine endotracheal suctioning group and the minimally invasive airway suctioning group in duration of intubation [median (range) 4 (1-75) versus 5 (1-101) days], ICU-stay [median (range) 8 (1-133) versus 7 (1-221) days], ICU mortality (15% versus 17%), and incidence of pulmonary infections (14% versus 13%). Suction-related adverse events occurred more frequently with RES interventions than with MIAS interventions; decreased saturation: 2.7% versus 2.0% (P=0.010); increased systolic blood pressure 24.5% versus 16.8% (P<0.001); increased pulse pressure rate 1.4% versus 0.9% (P=0.007); blood in mucus 3.3% versus 0.9% (P<0.001).

CONCLUSIONS: This study demonstrated that minimally invasive airway suctioning in intubated ICU-patients had fewer side effects than routine deep endotracheal suctioning, without being inferior in terms of duration on intubation, length of stay, and mortality.

Original languageEnglish
Pages (from-to)426-432
JournalIntensive care medicine
Volume29
Issue number3
DOIs
Publication statusPublished - Mar 2003

Keywords

  • cost-benefit analysis
  • intubation, intratracheal
  • respiration, artificial
  • statistics, nonparametric
  • suction

Cite this

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title = "Endotracheal suctioning versus minimally invasive airway suctioning in intubated patients: a prospective randomised controlled trial",
abstract = "STUDY OBJECTIVE: Endotracheal suctioning in intubated patients is routinely applied in most ICUs but may have negative side effects. We hypothesised that on-demand minimally invasive suctioning would have fewer side effects than routine deep endotracheal suctioning, and would be comparable in duration of intubation, length of stay in the ICU, and ICU mortality.DESIGN: Randomised prospective clinical trial.SETTING: In two ICUs at University Hospital Groningen, the Netherlands.PATIENTS: Three hundred and eighty-three patients requiring endotracheal intubation for more than 24 h.INTERVENTIONS: Routine endotracheal suctioning (n=197) using a 49-cm suction catheter was compared with on-demand minimally invasive airway suctioning (n=186) using a suction catheter only 29 cm long.MEASUREMENTS AND RESULTS: No differences were found between the routine endotracheal suctioning group and the minimally invasive airway suctioning group in duration of intubation [median (range) 4 (1-75) versus 5 (1-101) days], ICU-stay [median (range) 8 (1-133) versus 7 (1-221) days], ICU mortality (15{\%} versus 17{\%}), and incidence of pulmonary infections (14{\%} versus 13{\%}). Suction-related adverse events occurred more frequently with RES interventions than with MIAS interventions; decreased saturation: 2.7{\%} versus 2.0{\%} (P=0.010); increased systolic blood pressure 24.5{\%} versus 16.8{\%} (P<0.001); increased pulse pressure rate 1.4{\%} versus 0.9{\%} (P=0.007); blood in mucus 3.3{\%} versus 0.9{\%} (P<0.001).CONCLUSIONS: This study demonstrated that minimally invasive airway suctioning in intubated ICU-patients had fewer side effects than routine deep endotracheal suctioning, without being inferior in terms of duration on intubation, length of stay, and mortality.",
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author = "{Van de Leur}, {Johannes P} and Zwaveling, {Jan H} and Loef, {Bert G} and {van der Schans}, Cees",
year = "2003",
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doi = "10.1007/s00134-003-1639-9",
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Endotracheal suctioning versus minimally invasive airway suctioning in intubated patients : a prospective randomised controlled trial. / Van de Leur, Johannes P; Zwaveling, Jan H; Loef, Bert G; van der Schans, Cees.

In: Intensive care medicine, Vol. 29, No. 3, 03.2003, p. 426-432.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Endotracheal suctioning versus minimally invasive airway suctioning in intubated patients

T2 - a prospective randomised controlled trial

AU - Van de Leur, Johannes P

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AU - van der Schans, Cees

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N2 - STUDY OBJECTIVE: Endotracheal suctioning in intubated patients is routinely applied in most ICUs but may have negative side effects. We hypothesised that on-demand minimally invasive suctioning would have fewer side effects than routine deep endotracheal suctioning, and would be comparable in duration of intubation, length of stay in the ICU, and ICU mortality.DESIGN: Randomised prospective clinical trial.SETTING: In two ICUs at University Hospital Groningen, the Netherlands.PATIENTS: Three hundred and eighty-three patients requiring endotracheal intubation for more than 24 h.INTERVENTIONS: Routine endotracheal suctioning (n=197) using a 49-cm suction catheter was compared with on-demand minimally invasive airway suctioning (n=186) using a suction catheter only 29 cm long.MEASUREMENTS AND RESULTS: No differences were found between the routine endotracheal suctioning group and the minimally invasive airway suctioning group in duration of intubation [median (range) 4 (1-75) versus 5 (1-101) days], ICU-stay [median (range) 8 (1-133) versus 7 (1-221) days], ICU mortality (15% versus 17%), and incidence of pulmonary infections (14% versus 13%). Suction-related adverse events occurred more frequently with RES interventions than with MIAS interventions; decreased saturation: 2.7% versus 2.0% (P=0.010); increased systolic blood pressure 24.5% versus 16.8% (P<0.001); increased pulse pressure rate 1.4% versus 0.9% (P=0.007); blood in mucus 3.3% versus 0.9% (P<0.001).CONCLUSIONS: This study demonstrated that minimally invasive airway suctioning in intubated ICU-patients had fewer side effects than routine deep endotracheal suctioning, without being inferior in terms of duration on intubation, length of stay, and mortality.

AB - STUDY OBJECTIVE: Endotracheal suctioning in intubated patients is routinely applied in most ICUs but may have negative side effects. We hypothesised that on-demand minimally invasive suctioning would have fewer side effects than routine deep endotracheal suctioning, and would be comparable in duration of intubation, length of stay in the ICU, and ICU mortality.DESIGN: Randomised prospective clinical trial.SETTING: In two ICUs at University Hospital Groningen, the Netherlands.PATIENTS: Three hundred and eighty-three patients requiring endotracheal intubation for more than 24 h.INTERVENTIONS: Routine endotracheal suctioning (n=197) using a 49-cm suction catheter was compared with on-demand minimally invasive airway suctioning (n=186) using a suction catheter only 29 cm long.MEASUREMENTS AND RESULTS: No differences were found between the routine endotracheal suctioning group and the minimally invasive airway suctioning group in duration of intubation [median (range) 4 (1-75) versus 5 (1-101) days], ICU-stay [median (range) 8 (1-133) versus 7 (1-221) days], ICU mortality (15% versus 17%), and incidence of pulmonary infections (14% versus 13%). Suction-related adverse events occurred more frequently with RES interventions than with MIAS interventions; decreased saturation: 2.7% versus 2.0% (P=0.010); increased systolic blood pressure 24.5% versus 16.8% (P<0.001); increased pulse pressure rate 1.4% versus 0.9% (P=0.007); blood in mucus 3.3% versus 0.9% (P<0.001).CONCLUSIONS: This study demonstrated that minimally invasive airway suctioning in intubated ICU-patients had fewer side effects than routine deep endotracheal suctioning, without being inferior in terms of duration on intubation, length of stay, and mortality.

KW - cost-benefit analysis

KW - intubation, intratracheal

KW - respiration, artificial

KW - statistics, nonparametric

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KW - kosten-baten analyse

KW - zorg

KW - intubatie, intratracheal

KW - kunstmatige ademhaling

KW - suctie

KW - klinisch onderzoek

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