Premium
Endotracheal suctioning causes right upper lobe collapse in intubated children
Author(s) -
Boothroyd AE,
Murthy BVS,
Darbyshire A,
Petros AJ
Publication year - 1996
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1996.tb13946.x
Subject(s) - medicine , suction , pneumothorax , intensive care unit , incidence (geometry) , anesthesia , surgery , resuscitation , intubation , pediatric intensive care unit , pediatrics , intensive care medicine , mechanical engineering , physics , optics , engineering
Objective: Right upper lobe collapse is a common radiographic finding in intubated children. We hypothesized that deep suctioning and uncontrolled negative pressures during endotracheal tube suctioning were significant contributory factors. Methods : The incidence of right upper lobe (RUL) collapse in intubated, ventilated children on a paediatric cardiac intensive care unit was determined over a 3‐month period ( n = 102). Graduated suction catheters and suction vacuums of < 165 cm H 2 O were then introduced. Another prospective audit was carried out 3 months later ( n = 60). Results : We found that 24% developed RUL collapse and 4 developed an apical pneumothorax. Following the introduction of graduated catheters and controlled vacuums pressures, a significant reduction in the incidence of RUL collapse, to 7%, was observed ( p < 0.05). Conclusions : We conclude that high negative pressure and deep‐suctioning causes RUL collapse in children. Any lobar collapse not only prolongs the child's stay in intensive care, but can be associated with further morbidity which may have a serious implication. By improving suctioning technique this morbidity can be significantly reduced.