الفهرس 
AbstractOnly 14 pages are availabe for public view
 |  | from | 168 |  |  |
| | | from | 168 | | |
Abstract
Suctioning airway refers to the collective measures that are used for clearing the airway of mechanically ventilated patients. Suctioning can maintain and establish gas exchange, adequate oxygenation, and alveolar ventilation. There are two types of endotracheal tube suctioning: Deep endotracheal tube suctioning which means insertion of the catheter until resistance or cough then withdraws it slowly 1-2 cm before the application of suction. Also, shallow ETT suctioning means inserting the catheter until the point emerging from the lumen of the tracheal tube during which stimulation of the carina should be avoided. Endotracheal suctioning technique has a considerable impact on the physiological indices of critically ill ventilated patients. Tracheal suctioning causes emotional stress and pain which stimulate the sympathetic nervous system, that increases peripheral vascular resistance, potentially blood pressure, and heart rate. Moreover, hypoxemia, bleeding, infection, atelectasis, cardiovascular instability, elevated intracranial pressure, and tracheal mucosa lesions are among adverse events of endotracheal suctioning. Therefore, since airway suctioning is associated with many unwanted effects, it should be performed only when indicated rather than predetermined schedule. Additionally, Tracheal cuff pressure management is an important part of artificial airway management. Cuffed endotracheal tubes are used to ensure ventilator compliance and prevent pulmonary aspiration. The optimal endotracheal tube cuff pressure, places within the range of 20–30 cmH2O. However, maintaining it in this range is challenging. There are many studies that reported changes in tube cuff pressure outside the normal range after initial adjustment. Among these factors, tracheal suctioning, which is one of the most common interventions in mechanically ventilated patients that may affect the tube cuff pressure.