ABSTRACT
Endotracheal suction is essential to keep the respiratory capacity of the bronchial tree. The aim of this study was to establish the principles reducing potential side-effects, like hypoxia, bradycardia, hypotension, arrhythmia, nosocomial infections. Analysing the literature we have selected the following major beneficial factors: 1:2 to 2:3 cathether - tracheal tube diameter ratio, individual adjustment of the suctioning frequency, maximal duration of the procedure capped at 10-15 sec., minimal effective suctioning pressure of 80-100 mmHg. We have also determined that the following procedures should be also taken into consideration: preoxygenation (only for unstable patients), sedation and analgesia. We have concluded with the comparison of the two suction systems, pointing out that, especially for unstable patients, closed-suction system proves more suitable.
Subject(s)
Intubation, Intratracheal/methods , Suction/methods , Arrhythmias, Cardiac/etiology , Arrhythmias, Cardiac/prevention & control , Bradycardia/etiology , Bradycardia/prevention & control , Child , Child, Preschool , Cross Infection/etiology , Cross Infection/prevention & control , Humans , Hypotension/etiology , Hypotension/prevention & control , Hypoxia/etiology , Hypoxia/prevention & control , Infant , Infant, Newborn , Preoperative Care/methods , Suction/adverse effectsABSTRACT
Preoxygenation is a standard technique in general anaesthesia, but is frequently neglected. It has been proven that calm breathing of 100% oxygen allows for removal of 95% of the nitrogen from the body, replacing it with oxygen. This technique allows for safe intubation, even in difficult settings. The most efficient methods of preoxygenation are: 1. Calm breathing over 3 min via a tight face mask, of 100% oxygen delivered from the circle system, with a fresh gas flow of more than 8 L min-1; 2. Four vital capacity breaths of 100% oxygen over 30 s; and 3. Four deep breaths of 100% oxygen with subsequent insufflation of 100% oxygen via a nasal catheter. Preoxygenation should be always performed before induction of general anaesthesia, especially in children and high-risk patients. Unfortunately, many anaesthesiologists do not use this simple technique, usually because they regard it as unpleasant for patients.
