EMCON 2008: 10th Annual National Conference of the Society for Emergency Medicine in India

Background: In the context of today’s critical care, many patients require prolonged intubation and tracheostomy care. Though these are life-saving procedures, they are not totally devoid of complications. Suctioning of secretions via the ET tube/tracheostomy tube with a suction catheter is associated with trauma to the passages owing to the structure and material of catheters. To avoid the traumatic complications associated with the suction catheter, we wanted to use Foley’s catheter instead of suction catheter (since the former is softer and structurally advantageous than the latter). Aim: The aim of the study was to compare the advantages of using Foley’s catheter vs. suction catheter for suctioning through the endotracheal tube/tracheostomy tube. Methods: This was a prospective study done over a period of one and half years from Feb 2007 to Aug 2008. All the patients who underwent tracheostomy were included in the study. Patients with bleeding disorders, coagulation profile abnormalities, and ICU stay less than a week were excluded from the study. Every alternate patient was suctioned using Foley’s catheter. All the patients were followed till the time of discharge for any complications developed during the study. Data were collected from 363 patients of whom 181 were randomized to Foley’s catheter group and 182 to the suction catheter group. Results: The data obtained from the trial have shown that only 2% of the patients developed bleeding when Foley’s catheter was used as compared to 23% when the suction catheter was used. Adequate suctioning was obtained in both groups and there was no other significant complication related to the suctioning noted in both methods. Conclusion: Foley’s catheter is superior to conventional suction catheter in preventing tracheal bleed during endotracheal suctioning.