DEEP SUCTION PERFORM MORE EFFECTIVE THAN SHALLOW SUCTION IN TRACHEA INTU- BATION PATIENTS: A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

YAO LIAO¹, QIAOMIAO ZENG², YU XU³, QIAN YANG¹, JUNRONG YE⁴, XI YIN¹

¹Department of Cardiothoracic Surgery, Jingzhou Central Hospital, Jingzhou 434000, People’s Republic of China - ²Department of Oncological Radiotherapy, XiangYa Hospital Central South University, Changsha 410000, People’s Republic of China - ³Intensive Care Unit, West China Hospital Sichuang University, Chengdu 610000, People’s Republic of China - ⁴Department of Nursing administration, Huiai Hospital, Guangzhou 510000, People’s Republic of China

Background: Suction is a routine practice in trachea intubation patients in Intensive Care Units to avoid a store of secretions and blockage of the airway. Effectiveness and complication of suction varied according to the depth of catheter. Many guidelines supported care providers in determining the most appropriate method but the most appropriate depth of suctioning is still unclear.

Objective: To identify evidence about the benefits and risks of deep and shallow suction.

Date Source Ten electronic databases were comprehensive searched (Cochrane Library, PubMed, Medline, EMBASE, CINAHL, Academic Search Complete, Science Direct, Chinese and Technology Periodicals database (VIP), Wangfang database, and Chinese National Knowledge Infrastructure (CNKI) database) until September 30, 2017 with no restriction for language.

Method: Two reviewers independently evaluated selected randomized controlled trials (RCTs) according to Cochrane Handbook 5.3.

Results: Totally 11 RCTs and 617 patients were involved. Deep suction performed more effective with fewer suction times daily (WMD=1.32, 95% CI: 1.11 to 1.53, P<0.01), longer suction interval (WMD=-0.48, 95% CI: -0.61 to -0.36, P<0.01) and better arterial blood oxygen saturation (SPO2) improvement (WMD=-0.58, 95% CI: -0.77 to -0.39, P<0.01). Deep suction will cause bigger fluctua- tion in heart rate (HR) (WMD=-3.32, 95% CI: -3.50 to -3.15, P<0.01). Unexpected, no significant difference of tracheal or bronchial damage rate (OR=0.45, 95% CI: 0.11 to 1.90, P>0.01)and Systolic blood pressure (SBP) change level (WMD=0.16, 95% CI: -0.02 to 0.33, P>0.01)were found between the two different suction depth.

Conclusions: This meta-analysis provides evidence for benefits and risks of different suction depth. It is clear that deep suction performed more effective in airway clean. A clear risk of deep suction has not been established.