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(Chest. 1998;113:1335-1338.)
© 1998 American College of Chest Physicians

Effects of Tracheal Suctioning on Respiratory Resistances in Mechanically Ventilated Patients

Jean Guglielminotti MD1; Jean-Marie Desmonts MD1; and Bertrand Dureuil MD1

1 From the Département d'Anesthésie et de Réanimation Chirurgicale, Hôpital Bichat, Paris, France

Objective: To evaluate the effects of tracheal suctioning (TS) on respiratory resistances in sedated critical care patients receiving mechanical ventilation (MV).

Setting: Surgical ICU of Bichat Hospital, Paris.

Patients and participants: Thirteen sedated critical care patients receiving MV for various conditions.

Measurements and results: Airway resistances (R1), airway and pulmonary resistances (R2), and intrinsic positive end-expiratory pressure (PEEPint) were measured according to the end-inspiratory and end-expiratory occlusion methods before and after TS. R1 and R2 increased by 49.1% and 46.3%, respectively, 0.5 min after TS (p<0.01) but returned to baseline values at 1 min without any change thereafter. PEEPint decreased progressively following TS to reach a significant level (minus13.3%) at 10 min (p<0.05) and was persistently reduced at 30 min(p<0.01). Nine patients received 500 µg of inhaled albuterol before another suctioning procedure. R1 and R2 decreased by 11.5% and 9.9%, respectively, 20 min after inhalation (p<0.05), but the R1 and R2 initial increase following TS did not differ between the two suctioning procedures.

Conclusions:TS evokes only a transient bronchoconstrictor response, but thereafter, does not reduce respiratory resistances below presuctioning values. However, the decrease of PEEPint following TS suggests an increase of expiratory flow. Effective β2-adrenergic receptor blockade fails to suppress the TS-induced bronchoconstrictor response.

Key Words: β2-adrenergic agonists • mechanical ventilation • respiratory mechanics • respiratory reflexes • tracheal suctioning

Submitted on June 24, 1997
Accepted on October 31, 1997




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