AARC Clinical Practice Guideline Endotracheal Suctioning of Mechanically Ventilated Adults and Children with Artificial Airways

Brown SE , Stansbury DW , Merrill EJ , Linden GS , Light RW . Prevention of suctioning-related arterial oxygen desaturation: comparison of off-ventilator and on-ventilator suctioning. Chest 1983;83:621–627.

Riegel B , Forshee T. A review and critique of the literature on preoxygenation for endotracheal suctioning. Heart & Lung 1985;14:507–518.

Campbell RS , Branson RD . How ventilators provide temporary O2 enrichment: what happens when you press the 100% suction button? Respir Care 1992; 37:933.

Baker PO , Baker JP , Koen PA . Endotracheal suctioning techniques in hypoxemic patients. Respir Care 1983;28:1563–1568.

Barnes TA , McGarry WP . Evaluation of ten disposable manual resuscitators. Respir Care 1990;35:960–968.

Smith RM , Benson MS , Schoene RB . The efficacy of oxygen insufflation in preventing arterial oxygen desaturation during endotracheal suctioning of mechanically ventilated patients. Respir Care 1987;32:865–869.

Langrehr EA , Washburn SC , Guthrie MP . Oxygen insufflation during endotracheal suctioning. Heart Lung 1981;10:1028–1036.

Kelly RE , Yao FF , Artusio JS Jr. Prevention of suction-induced hypoxemia by simultaneous oxygen insufflation. Crit Care Med 1987;15:874–875.

Hess D , Spahr C. An evaluation of volumes delivered by selected adult disposable resuscitators: the effects of hand size, number of hands used, and use of disposable medical gloves. Respir Care 1990;35:800–805.

Branson RD , Campbell RS . Sighs: wasted breath or breath of fresh air? Respir Care 1992;37:462–468.

Bostick J , Wendelgass ST . Normal saline instillation as part of the suctioning procedure: effects on PaO2 and amount of secretions. Heart Lung 1987;16:532–537.

Gray JE , MacIntyre NR , Kronenberger WG . The effects of bolus normal-saline instillation in conjunction with endotracheal suctioning. Respir Care 1990;35:785–790.

Rindfleisch SH , Tyler ML . Duration of suctioning: an important variable (point of view). Respir Care 1983;28:457–459.

Plevak DJ , Ward JJ . Airway management. In: Burton GG , Hodgkin JE , Ward JJ , eds. Respiratory care—a guide to clinical practice, 3rd ed. Philadelphia: JB Lippincott, 1991:501.

Eubanks DH , Bone RC . Comprehensive respiratory care—a learning system. St Louis: CV Mosby 1985:517.

Boba A , Cincotti JJ , Peazza TE , . The effects of apnea, endotracheal suction, and oxygen insufflation, alone and in combination, upon arterial oxygen saturation in anesthetized patients. J Lab Clin Med 1959;53:680–685.

Boutros AR . Arterial blood oxygenation during and after endotracheal suctioning in the apneic patient. Anesthesiology 1970:32:114–118.

Craig KC , Benson MS , Pierson DJ . Prevention of arterial oxygen desaturation during closed-airway endotracheal suction: effect of ventilator mode. Respir Care 1984;29:1013–1018.

Demers RR . Complications of endotracheal suctioning procedures. Respir Care 1982;27:453–457.

Kergin FG , Bean DM , Paul W. Anoxia during intrathoracic operations. J Thorac Surg 1948;17:709–711.

Rosen M , Hillard EK . The effects of negative pressure during tracheal suction. Anesth Analg 1962;41:50–57.

Shim C , Fine N , Fernandez R , Williams MH Jr. Cardiac arrhythmias resulting from tracheal suctioning. Ann Intern Med 1969;71:1149–1153.

Walsh JM , Vanderwarf C , Hoscheit D , Fahey PJ . Unsuspected hemodynamic alterations during endotracheal suctioning. Chest 1989;95:162–165.

Sackner MA , Landa JF , Greeneltch, Robinson MJ . Pathogenesis and prevention of tracheobronchial damage with suction procedures. Chest 1973;64:284–290.

Shumacker HB , Hampton LJ . Sudden death occurring immediately after operation in patients with cardiac disease, with particular reference to the role of aspiration through the endotracheal tube and extubation. J Thorac Surg 1950;18:48–56.

Storm W. Transient bacteremia following endotracheal suctioning in ventilated newborns. Pediatrics 1980;65:487–490.

Catanzaro A. Nosocomial tuberculosis. Am Rev Respir Dis 1982;125(5):559–562.

Fisher DM , Frewen T , Swedlow DB . Increase in intracranial pressure during suctioning: infant stimulation vs rise in PaCO2. Anesthesiology 1982:57:416–417.

Perlman JM , Volpe JJ . Suctioning in the preterm: effects on cerebral blood flow velocity, intracranial pressure, and arterial blood pressure. Pediatrics 1983;72:329–334.

Rudy EB , Turner BS , Baun M , Stone KS , Brucia J. Endotracheal suctioning in adults with head injury. Heart Lung 1991;20:667–674.

Stone KS , Vorst EC , Lanham B , Zahn S. Effects of lung hyperinflation on mean arterial pressure and post-suctioning hypoxemia. Heart Lung 1989;18:377–385.

Tiffin NH , Keim MR , Frewen TC . The effects of variations in flow through an insufflating catheter and endotracheal-tube and suction-catheter size on test-lung pressures. Respir Care 1990;35:889–897.

Centers for Disease Control. Update: Universal Precautions for prevention of transmission of human immunodeficiency virus, hepatitis B virus, and other bloodborne pathogens in health care settings. MMWR 1988:37:377–399.