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Laboratory and Animal Investigations |

Side Effects of Endotracheal Suction in Pressure- and Volume-Controlled Ventilation*

Birgitta Almgren; Carl-Johan Wickerts; Erkki Heinonen; Marieann Högman
Author and Funding Information

*From the Section of Integrative Physiology (Ms. Almgren, and Drs. Heinonen and Högman), Department of Medical Cell Biology; Uppsala University, Uppsala; and Karolinska Institute (Dr. Wickerts), Department of Anesthesia and Intensive Care, Danderyd Hospital, Stockholm, Sweden.

Correspondence to: Birgitta Almgren, RN, Section of Integrative Physiology, Department of Medical Cell Biology, Uppsala University, Box 571, SE 75123, Uppsala, Sweden; e-mail: birgitta.almgren@ane.ds.sll.se



Chest. 2004;125(3):1077-1080. doi:10.1378/chest.125.3.1077
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Study objectives: To investigate the effects of endotracheal suction in volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) with an open suction system (OSS) or a closed suction system (CSS).

Design: Randomized comparison.

Setting: Animal research laboratory.

Patients: Twelve healthy anesthetized pigs.

Interventions: The effects of endotracheal suction during VCV and PCV with tidal volume (Vt) of 14 mL/kg were compared. A 60-mm inner-diameter endotracheal tube was used. Ten-second suction was performed using OSS and CSS with 12F and 14F catheters connected to − 14 kPa vacuum.

Measurements and results: Thirty minutes after suction in PCV, Vt was still decreased by 27% (p < 0.001), compliance (Crs) by 28% (p < 0.001), and Pao2 by 26% (p < 0.001); Paco2 was increased by 42% (p < 0.0001) and venous admixture by 158% (p = 0.003). Suction in VCV affected only Crs (decreased by 23%, p < 0.001) and plateau pressure (increased by 24%, p < 0.001). The initial impairment of gas exchange following suction in VCV was no longer statistically significant after 30 min.

Conclusions: In conclusion, endotracheal suction causes lung collapse leading to impaired gas exchange, an effect that is more severe and persistent in PCV than in VCV.


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