Suctioning children with an artificial airway in a healthcare setting - a systematic review

Review Objective The objective of this quantitative review is to identity the most effective practices associated with suctioning children who have an artificial airway to minimise suction associated complications. More specifically, the objectives are to identify: •Which method promotes the removal of respiratory secretions? •Which method of suctioning reduces mucosal trauma? •Which methods or techniques reduce the occurrence of suctioning induced hypoxaemia, during or following the suctioning procedure? •Which method prevents hospital acquired infections associated with suctioning? Types of participants This review will consider studies that include neonates, infants and children (aged 0 -12 years) who have an artificial airway and who are located in a healthcare setting. This excludes studies that include children being nursed at home, adolescents and adults. Types of interventions/Phenomena of Interest The review will consider studies that include the following interventions: •Instillation of normal saline •Hyperoxygenation •Hyperinflation •Size of catheter •Frequency of suctioning •Suction pressure •Depth of suctioning •Techniques for preventing infections •Techniques for minimizing trauma Types of outcome measures/anticipated outcomes This review will consider studies that include the following outcome measures: •Changes to PaO2, PaCO2, SpO2 levels •Mucosal trauma or mucosal dysfunction •Volume of secretion removal •Frequency of suctioning •Prevalence of Pneumonia •Tube obstruction •Haemorrhage •Prevalence of atelactasis & tracheitis •Mortality