Endotracheal suctioning is one of the common procedures performed on patients with an artificial airway. It helps to remove secretions to prevent obstruction. Suctioning is also important in intubated patients in order to prevent the accumulation of secretions, which would then lead to colonization of the respiratory tract by pathogenic bacteria leading to the development of ventilator-associated pneumonia. Endotracheal suctioning can immediately reduce the dynamic compliance and expired tidal volume in patients (G Briassoulis, 2009).
A study by Choi et al in 2005 indicated that manual hyperinflation followed by suctioning induces beneficial changes in respiratory mechanics in mechanically ventilated patients on endotracheal intubation. Several techniques of suctioning have various advantages. Preoxygenation improves arterial oxygen saturation; hyperoxygenation maintains oxygen levels while a combination of hyperinflation and hyperoxygenation is also beneficial to the patient (Anderson CM & Carter MA, (2001).
PEG is known as percutaneous endoscopic gastrostomy feeding. It is effective in providing enteral feeding to patients who possess a functional gastrointestinal tract but for one reason or the other, are not able to meet the nutritional needs of the body. This method id the preferred method of feeding patients who are not likely to be able to feed themselves for up to six weeks. In order to stop weight loss in such individuals, this method is utilized in feeding them. It ensures better nutritional outcomes and improved mortality and morbidity outcomes in patients in whom it is utilized (Kuiren, 2010).
These feeding tubes are being increasingly popular in patients who are on long-term enteral nutrition. This method is a useful way of maintaining the nutrition of the individual in this state. It has been said that one should avoid the use of percutaneous endoscopic gastrostomy in some category of patients (Kuiren, 2010). They include patients who are acutely ill, patients who have a short life expectancy because it would not be beneficial in any way. In addition, in patients who have a cough, it is also better to avoid its use because such patients can easily aspirate their gastric contents into the airways and this would be another problem to solve entirely.
References
Choi JS & Jones AY (2005). Effects of manual hyperinflation and suctioning in respiratory mechanics in mechanically ventilated patients with ventilator-associated pneumonia. .Aust J Physiother. 2005;51(1):25-30. Accessed on 18th May 2012 and retrieved from
George Briassoulis et al (2009). The Effects of Endotracheal Suctioning on the Accuracy of Oxygen Consumption and Carbon Dioxide Production Measurements and Pulmonary Mechanics Calculated by a Compact Metabolic Monitor. doi: 10.1213/ane.0b013e3181b018ee. Accessed on 18th May 2012. Vol. 109 no. 3 873-879. http://www.anesthesia-analgesia.org/content/109/3/873.full
Cicutto et al (2012). Updating the evidence base for suctioning adult patients: A systematic review. Accessed on 18th May 2012 and retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2706678/.
Matthew, Kurien (2010). Percutaneous endoscopic gastrostomy (PEG) feeding. BMJ 2010; 340 doi: 10.1136/bmj.c2414 (Published 7 May 2010)
