Setting a Regulated Suction Pressure for Endotracheal Suctioning; A Systematic Review.

Review Objective The principle objective of this review will be to critically appraise and present the best available evidence for setting different levels of vacuum / suction pressures when patients are receiving endotracheal suctioning. Specifically the review will seek to answer the following questions. What is the best evidence for regulating vacuum pressure in the performance of endotracheal suctioning? What is the best evidence for regulating vacuum pressure for endotracheal suction as opposed to setting no regulated pressure in the performance of endotracheal suctioning? What is the best evidence for a limit to which vacuum should be regulated for endotracheal suction? To what extent does the developed airflow impact on the safety and effectiveness of the suction apparatus? Inclusion Criteria Types of Participants Patients receiving mechanical ventilator support through endotracheal tube or tracheostomy in the acute care setting. Participants may present with a variety of pathologies but studies will not be excluded on the bases of diagnosis. Patients may require intubation and endotracheal suctioning at any age; vacuum applied in the performance of suction may have health implications and be of interest to the clinician. Papers regarding either spontaneously breathing and/or machine ventilated subjects will be also included so long as the participants require endotracheal suctioning in the acute stage of their hospitalisation. Types of intervention / Phenomena of interest The setting of a level of vacuum / suction pressure, taking into account the developed flow, to facilitate safe endotracheal suctioning in the acute care setting of the Intensive Care unit, High Dependency or Emergency Area will be examined. Types of outcomes Outcomes related to mortality, morbidity, and health benefits of regulating suction / vacuum pressure as opposed to having no regulation, i.e. Using the unguarded wall outlet, will be sought. The effects of negative pressure within the tracheo-bronchial tree including Atelectasis; Reported and shown by radiological exam as early as the 1940’s Pulmonary haemorrhage has been seen with rapid decompression of segmental lung, with mechanical trauma from catheter impaction or sudden explosive decompression. TRUNCATED AT 350 WORDS