El-Hady Mona Mohamed, Babkair Lisa, Alharazi Ruba M, Noorsaeed Sohad Mohammad Wally, Mehrez Mahmoud Ali Marwa
Emergency and Critical Care Nursing Department, Faculty of Nursing, Mansoura University, Mansoura, Egypt.
Critical Care Nursing Department, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia.
SAGE Open Nurs. 2025 Aug 29;11:23779608251374140. doi: 10.1177/23779608251374140. eCollection 2025 Jan-Dec.
Tracheal suctioning is a critical component of care for mechanically ventilated patients' treatment. The effectiveness and associated complications of suctioning can vary depending on the depth of catheter insertion. Although several guidelines assist nurses in selecting the appropriate suctioning technique, while the optimal suctioning depth remains uncertain.
This study aimed to evaluate the impact of implementing shallow (insertion of the suction catheter to a depth limited to the end of the endotracheal tube) versus deep tracheal suctioning (insertion of the suction catheter approximately 1 cm above carina) techniques on cardiovascular indices and suction-induced complications among mechanically ventilated patients.
A randomized controlled trial (RCT) with two parallel groups at a 1:1 ratio was carried out in Intensive care units of a tertiary hospital. Adult mechanically ventilated patients requiring tracheal suctioning were randomly assigned to either the shallow tracheal suctioning group (intervention) or the deep tracheal suctioning group (control). Cardiovascular indices (such as heart rate, blood pressure, respiratory rate, and oxygen saturation) and suction-induced complications (as hypoxemia, cardiac dysrhythmia, tracheal tissue injury, and increased intracranial pressure) were assessed at four specific times: before suctioning, immediately after suctioning, 5 min postsuctioning, and 10 min postsuctioning.
A total of 120 patients were enrolled in the study. Cardiovascular indices increased significantly following tracheal suctioning in the deep suctioning group compared to the shallow suctioning group ( < .05). Additionally, the incidence of suction-related complications was significantly lower in the shallow suctioning group ( < .05).
Shallow tracheal suctioning results in less pronounced alterations in cardiovascular indices and fewer suction-induced complications compared to deep suctioning. These findings support the adoption of shallow suctioing as a safer and more favorable technique for managing mechanically ventilated patients.
气管吸痰是机械通气患者治疗护理的关键环节。吸痰的效果及相关并发症会因吸痰管插入深度的不同而有所差异。尽管有多项指南帮助护士选择合适的吸痰技术，但最佳吸痰深度仍不明确。
本研究旨在评估采用浅部（将吸痰管插入深度限制在内气管导管末端）与深部气管吸痰（将吸痰管插入隆突上方约1厘米处）技术对机械通气患者心血管指标及吸痰引起的并发症的影响。
在一家三级医院的重症监护病房进行了一项1:1比例的两组平行随机对照试验（RCT）。需要气管吸痰的成年机械通气患者被随机分配到浅部气管吸痰组（干预组）或深部气管吸痰组（对照组）。在四个特定时间点评估心血管指标（如心率、血压、呼吸频率和血氧饱和度）以及吸痰引起的并发症（如低氧血症、心律失常、气管组织损伤和颅内压升高）：吸痰前、吸痰后即刻、吸痰后5分钟和吸痰后10分钟。
共有120名患者纳入研究。与浅部吸痰组相比，深部吸痰组气管吸痰后心血管指标显著升高（<0.05）。此外，浅部吸痰组吸痰相关并发症的发生率显著更低（<0.05）。
与深部吸痰相比，浅部气管吸痰导致心血管指标的变化较小，且吸痰引起的并发症较少。这些发现支持采用浅部吸痰作为管理机械通气患者更安全、更有利的技术。
