IMPORTANCE Hospitalizations of infants for bronchiolitis are common and costly. Despite the high incidence and resource burden of bronchiolitis, the mainstay of treatment remains supportive care, which frequently includes nasal suctioning. OBJECTIVE To examine the association between suctioning device type and suctioning lapses greater than 4 hours within the first 24 hours after hospital adm...

Mechanical ventilation is indispensable for the survival of patients with acute lung injury and acute respiratory distress syndrome. However, excessive tidal volumes and inadequate lung recruitment may contribute to mortality by causing ventilator-induced lung injury. This bench-to-bedside review presents the scientific rationale for using adjuncts to mechanical ventilation aimed at optimizing ...

BACKGROUND Conventional sputum suctioning is a routine clinical practice, but complications may arise from the blind manipulation of the catheter. Recently, a visual sputum suctioning system (VSSS) was developed, and we tested this new system in a laboratory setting. METHODS We used coagulant concentrations of 1.5% and 3.0% to simulate mucus and sputum. Conventional single-lumen and triple-lu...

Endotracheal suctioning is performed regularly in mechanically-ventilated infants and children in the paediatric intensive care unit, by both physiotherapists and nursing staff. The primary purpose of endotracheal suctioning is to remove secretions and prevent airway obstruction, thereby aiming to prevent atelectasis whilst optimising oxygenation and ventilation and decreasing the work of breat...

We have assessed the evidence that closed tracheal suction systems (TSS) prevent ventilator-associated pneumonia (VAP), using a meta-analysis of randomized controlled trials (RCTs). We searched PubMed and Cochrane databases to identify RCTs that compared closed with open TSS for the management of mechanically ventilated (MV) patients. Nine RCTs were included in the meta-analysis. There was no d...

BACKGROUND Trainees rarely have the opportunity to practice suctioning copious or bloody secretions from the airways of patients in respiratory distress. The act of suctioning is frequently overlooked during the training of personnel in airway management and, thus, there is a dearth of simulated suction devices that can reproduce the fidelity of this process. OBJECTIVE The authors describe th...

Landiolol is an ultra-short-acting β1-selective antagonist developed in Japan that was recently approved for the treatment of tachycardia in intensive care units (ICUs). This study investigated the protective effects of landiolol against the cardiovascular responses during bronchoscopic endotracheal suctioning. This study enrolled 15 patients requiring orotracheal intubation in an ICU. All of t...

BACKGROUND Self-report is the best indicator of pain; however, pain is more difficult to assess in noncommunicative patients who may be receiving mechanical ventilation or sedated and unable to report pain. OBJECTIVES To evaluate the validity and sensitivity of 6 pain scales (Adult Nonverbal Pain Scale; Behavior Pain Scale [BPS]; Comfort Scale; FACES; Face, Legs, Activity, Cry, and Consolabil...