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in line suction


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Dear friends:

I have a problem with one pediatrician of my hospital, she is the head chief in the PICU and she want to standarized some rules that we are not agree in my NICU, so I want you opinio if I have to change it, I will.

1.- First of all, how frequent did you change your in line suction system in each ventilate patient.

2.- When you have a ventilate patient with this kind of system, always you have to increase your FiO2 (inspired oxygen) at 100% level, pre and post suction ???,

3.- What happen in those patients that we have in HFOV and in line suction system, did you change some parameters or you leave it like you have it,

4.- Do you have some protocol for in line suction in neonate that want to share with me.

I give you my e mail, in case you want to send to me by this way

Manberbenitez@yahoo.com.mx

Manuel Bernal

Thanks a lot in advance, but I have to demostrate others opinions in the world.

Edited by JACK
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1. every 24 hours

2. we don't have this strategy

3. we leave all parameters (although one may argue that CDP is abrupted during suctioning, and a new lung recruitment may be needed)

4. We have no written protocol but guidelines every need to learn: no suctioning below the tube (no rules without exceptions...), and infrequent suctioning (no strict time intervals, but we really try to be gentle with suctioning).

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Hello from Switzerland,

we are currently using the Ballard TRACH CARE System from Kimberley-Clark.

We are using them for 3 Days (72h), before we change them.

We are only using them, if it can be assumed, that our patient will be on the ventilator for more than one day... (reduces cost`s).

We do not instillate water or sterile saline routinely. The pre oxygenation is usually 5% above the patients baseline oxygen requirement, if that works. If a patient desaturates despite this action, we use oxygen pro re nata.

We use the same approach for our patients on HFOV and CMV. We do not use routine sustained inflation or recruitment maneuvers, because experience let us to the perception, that this maneuvers are not necessary in all our ventilated patients.

Recruitment maneuvers are somewhat difficult and can vary from patient to patient (depending on the patients lung pathology) as needed and the practitioners experience, so a detailed description is hard for me to give.

There exists a good presentation of how to run the HFOV and the sustained inflation method have a look at this: http://www.learnicu.org/Clinical_Practice/Fundamentals/PICU/Pages/Course_Presentations.aspx

You can find some helpful presentations here....

have fun

hope that helps

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