Evaluation of a novel endotracheal tube suctioning system incorporating an inflatable sweeper

Abstract

Introduction: Accumulation of secretions in an endotracheal tube can increase the resistance to flow resulting in an increased patient work of breathing when the patient is interacting with the ventilator. Retained secretions can also serve as an infection risk. Standard suction catheters are limited in their ability to keep the lumen of the endotracheal tube clear. A novel closed-suction catheter has been introduced that incorporates a balloon at its distal end that, when inflated, physically scrapes secretions out of the endotracheal tube (CleanSweep catheter (CSC), Teleflex, Morrisville NC). We hypothesized that the CSC would be more efficient at removing secretions from inside the endotracheal tube than a standard suction catheter (SSC). Methods: We performed a bench study examining resistive pressures across different sizes of endotracheal tubes when cleaned by the CSC as compared with an SSC. This study was followed by a prospective crossover study again comparing the CSC with an SSC in intubated intensive care unit patients receiving mechanical ventilation and requiring frequent suctioning. Results: For the bench study the CSC was significantly better in reducing airway resistive pressures (P < 0.001). In the prospective crossover study the CSC over 2 h also removed significantly more secretions than the SSC (P < 0.05). Conclusion: Both our bench and crossover clinical study demonstrated improved clearance of secretions with the CSC vs an SSC. Further research is needed to ascertain the clinical outcome benefits of enhanced secretion removal.

Cardiothoracic Care Nurses' Practice and Beliefs toward Endotracheal Suction Post Coronary Artery Bypass Graft at Teaching Hospital

“…On the other hand (Table 2) gives a description of this procedure., a statistically significant link (p value ≤0.05) was found between the nurses' beliefs score and their practice score, according to the results of the Pearson correlation coefficient test in this investigation, Yilmaz, et al, and Ncube, C that reported in a similar direction that most of the nurses under the study held a high degree of belief about the use of endotracheal suction on critically ill patients during the study phase [18][19][20]. In contrast, the study participants' attitudes and beliefs about endotracheal suctioning were found to be low among the nurses under the study, according to Bulbul, et al, and Davies, et al [19][20][21][22][23][24][25]. From the researchers' points of view, a technical institute may have influenced most of the nurses' views on this subject, as well as the study sample's characteristics and the lack of experience toward endotracheal suction.…”

The Performance Level of Critical Care Nurses Toward Two Systems of Endotracheal Suction among Mechanically Ventilated Patients

“…The suction system consists of two open suction techniques: first, the patient is customarily disconnected from the ventilator, and second, an endotracheal tube is fitted with a suction catheter. As an alternative, a ventilatory circuit with a closed suctioning system can be used, allowing the suction catheter to be inserted into the patient's airways without removing it from the ventilator [14][15][16][17][18][19][20][21][22][23][24][25].…”

“…Following the procedure, it is important to pay attention to any complaints the patient may have, as symptoms like lightheadedness, breathing problems, a racing heart, and harsh breathing, among others, may indicate suction-related issues and document the procedure. So, the current study was conducted to compare intensive care nurses' performance and self-efficacy about open versus closed endotracheal suction on critically ill patients [13][14][15][16][17][18][19][20][21][22][23][24][25].…”

“…The total score varies from zero to sixteen in the used section; it is described as a satisfactory level of practice if it is more than or equal to 75%. [20,21].…”