Impact of Deep Versus Shallow Tracheal Suctioning on Cardiovascular Indices and Suction Induced Complications Among Mechanically Ventilated Patients.

Background: 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.

Purpose of the research: 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.

Methods: 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.

Results: 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 (p < .05). Additionally, the incidence of suction-related complications was significantly lower in the shallow suctioning group (p < .05).

Conclusions: 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.