Evidence-Based Suctioning Guideline

Gardner DL & Shirland L. Evidence-Based Guideline for Suctioning the Intubated Neonate and Infant. Neonatal Network (September/October, 2009); 28:281-302. PDF

Abstract: The endotracheal tube (ETT) is the most common artificial airway used in NICUs. Suctioning of the ETT is imperative to maintain patency and prevent complications. An extensive review of the literature revealed a lack of standardized criteria or guidelines for suctioning the ETT of neonates and infants in the NICU. The purpose of this article is to report the implementation of an evidence based guideline that can be utilized in NICU care.

Comments: This is a very detailed review of the available literature regarding endotrachel tube suctioning and includes an Evidence-Based guideline that lists the level of evidence supporting each recommendation. The authors note a lack of neonatal randomized studies and encourage further extensive study. A previous review (9-008) describes the cerebral effects of suctioning, with a take home message recommending no routine suctioning. NICQ PBPs include avoidance of saline with suctioning and use of in-line suction catheters and can be found within the respiratory tool kits Respiratory Care NICQ 2005 TLC and Chronic Lung Disease Resource Kit NICQ 2002. The Reducing Pain Resource Kit NICQ 2002 also includes a PBP directed at reducing pain by avoidance of unnecessary suctioning. Mindy Morris