The Science Journal of the American Association for Respiratory Care

2011 OPEN FORUM Abstracts

EVALUATING THE PROPER SUCTION CATHETER SIZE FOR AN ARTIFICIAL AIRWAY.

Chris Russian, Joshua F. Gonzales, Kevin Collins, Amanda Martinez; Respiratory Care, Texas State University-San Marcos, San Marcos, TX

Background: Current clinical practice guidelines (CPGs) recommend a suction catheter to endotracheal tube (SC:ETT) ratio of 50% or less to minimize the adverse effects of suctioning. This ratio is based on a comparison of external diameter of the SC to the internal diameter of the ETT. We theorized that a more accurate assessment of SC:ETT ratio would involve measuring the ETT total internal volume with and without the insertion of a SC. Current clinical practice and some respiratory care texts recommend a SC:ETT ratio that exceeds the CPG standard. Research Question: Does measuring endotracheal tube total volume with and without the insertion of a suction catheter provide a more consistent assessment of SC:ETT ratio based on current clinical practice? Methods: The current research project was granted IRB exemption (EXP2011P480) status by the institutional review board at Texas State University-San Marcos. ETT sizes of 10.0mm to 6.0mm will be examined with suction catheter sizes ranging from 6 to 16 Fr. Total ETT volume was established by filling each tube with fluid to the entire length of the tube. Next, researchers inserted a variety of suction catheters into each ETT and refilled the tube with fluid. Volume measurements were made with each suction catheter insertion. Only one catheter was inserted at a time. A comparison was made between the total volume held by each ETT and the volume held by each tube with a SC inserted. A SC:ETT ratio of less than 50%, based on volume measurements, was recorded at the conclusion of all measurements. Results: Total internal volume measurements were collected for each ETT size prior to SC insertion. After examining the SC:ETT ratio measurements, we determined that larger SC sizes could be used with some ETT compared to current CPG recommendations. Table 1. outlines our recommendations versus current CPG guidelines. Conclusion: We examined suction catheter size and volume displacement in relation to endotracheal tube total internal volume. Our results indicate the ability to use a larger suction catheter for elected ETTs while still maintaining a SC:ETT ratio of 50% or less based on volume measurements. We compared our findings with current respiratory CPG recommendations for SC:ETT ratio based on internal diameter measurement. Anecdotally, we believe our recommendations for suction catheter size based on ETT size is more consistent with current clinical practice.
Sponsored Research - None
All suction catheter and ETT length 305mm unless indicated otherwise.
* Suction catheter and ETT lengths changed to 290mm
t Suction catheter and ETT lengths changed to 270mm

± Volume of a 16Fr suction catheter with length of 305mm equals 6.81mL