Chest
Clinical Investigations in Critical CareSelective Left Endobronchial Suctioning in the Intubated Patient
Section snippets
METHODS
Special curved tip (Bronchitrac-L) catheters were provided by the manufacturer.8 A flexible, radiopaque, vascular catheter had been aseptically inserted into each suction catheter to facilitate x-ray visualization (Fig 1). A prospective study, utilizing 81 attempts at left endobronchial placement, was made on 74 consecutive stable adult ICU patients requiring suctioning. Catheter placement was performed immediately prior to daily chest roentgenogram usually through an adaptor. Following chest
RESULTS
Suction catheters were adequately visualized by x-ray film in each case (Fig 2). Six of 81 attempts (7 percent) resulted in failure to pass the catheter beyond the tip of the oral endotracheal tube. The inserted radiopaque markers were not found to greatly affect the configuration or compliance characteristics of the suction catheters. In vitro trials in lung models performed by the manufacturer demonstrated a continued left sided placement with this particular radiopaque marker in place. Table
DISCUSSION
The current study demonstrates that the curved tip suction catheter is successful in allowing catheter entry into the left bronchus. The specific end-curve and catheter bend allow a high rate of left bronchus entry particularly in patients with tracheostomy tubes. In patients with oral endotracheal tubes with tips greater than 2 cm above the carina, the rates of left bronchial entry are better than those found in similar studies using both straight or curved/angled tip suction catheters.
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Cited by (5)
Understanding anesthesia equipment: Fifth edition
2012, Understanding Anesthesia Equipment: Fifth EditionSecretion management in the mechanically ventilated patient
2007, Respiratory CareManaging the artificial airway
1999, Respiratory CareThe closed tracheal suction system: Implications for critical care nursing
1994, Dimensions of Critical Care Nursing
Manuscript received May 31: revision accepted August 29