Suction Catheter Online
In 1960 Rosen and Hillard published an extensive paper on the use of suctioning during clinical practice, and then a follow-up study in 1962 that focused specifically on negative pressure during tracheal suctioning. They introduced a formula to determine the negative pressure generated within the lungs during suctioning. Based on their calculations they recommended that the suction catheter (SC) should be no more than half the diameter of the endotracheal tube (ETT). Those were the seminal publications on SC/ETT ratios. Regardless of widespread acceptance of an SC/ETT ratio based on tube diameter, there is evidence that clinicians and researchers use larger ratios than recommended
BACKGROUND: Current American Association for Respiratory Care (AARC) clinical practice guidelines recommend a suction catheter to endotracheal tube ratio (SC/ETT) based on the external diameter of the SC and the internal diameter of the ETT. An SC/ETT ratio of < 50% is consistent with the current recommendation. We theorized that a more satisfactory assessment of SC/ETT ratio could be accomplished using volume or area formulas and expansion of diameter recommendations. Some respiratory care texts recommend an SC/ETT ratio that exceeds the clinical practice guideline standard.
METHODS: We calculated the internal volume and cross-sectional area of various ETT sizes, the external volume and cross-sectional area of various SC sizes, and the SC/ETT ratios. We also measured negative pressures created by suction in a lung model, during multiple suction maneuvers.
RESULTS: Volume and area calculations provide an alternative method for determining the SC/ETT ratio. A volume or area ratio of 50% corresponds to a diameter ratio of 70%. Negative pressures during suctioning remain low at the new ratios, so a larger SC than current clinical practice guidelines still allows adequate air passage between the SC and ETT.
CONCLUSIONS: Our results support an alternative SC/ETT ratio when pairing SCs and ETTs.
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