Effectiveness of selected techniques during suctioning (randomised controlled trials only)
| Technique | Results (number of trials, number of patients) |
|---|---|
| Preoxygenation | Improved arterial oxygen saturation (Sa02) (2 trials, n=12 and n=17) |
| Hyperoxygenation | Maintained O2 levels in mechanically ventilated patients (4 trials, n=10–24) |
| Hyperoxygenation + hyperinflation | Added value of hyperinflation unclear in mechanically ventilated patients (4 trials, n=10–24) |
| Double lumen insufflation catheters | Maintained O2 levels throughout suctioning at flow rates of 10–15 l/min (4 of 5 trials, n=10–38) |
| Hyperinflation alone | Unclear benefits on O2 levels after cardiac surgery; increase in blood pressure (4 trials, n=8–34). Increase in volume may result in increased intracranial pressure in patients with head injury (2 trials, n=10–37) |
| Oxygenation using a manual resuscitation bag v ventilator | Ventilators were more effective for oxygen delivery (greater increases in PAO2) (3 of 4 trials, n=10–33) |
| Open v closed suctioning systems | No difference for nosocomial pneumonia (3 trials, n=20–84, all had insufficient power) or mortality (1 trial, n=84). Greater decrease in PaO2 (1 trial, n=8, not clinically significant) |
| Saline instillationy | No difference for oxygenation, gas exchange, heart rate, or blood pressure in ventilated and non-ventilated patients with tracheostomies (5 trials, n=15–45) |