Airway suction
 

Definitions

Airway suctioning is performed by inserting a catheter or device via the nasopharynx or oropharynx, or through a nasopharyngeal or an oropharyngeal airway, or an endotracheal or tracheostomy tube.

Why it's needed1

The aim of airway suction is to clear secretions, thereby maintaining a patent airway and improving ventilation and oxygenation.
The procedure of airway suctioning is a common practice in the treatment of patients with a variety of pathologies. Most frequently undertaken to remove excessive or retained secretions from a patient’s respiratory tract, it may also be necessary to obtain specimens for laboratory examination. It may be performed as a single procedure by nursing and medical staff (or occasionally by parents), or it may be incorporated into a chest physiotherapy regime.

Indications1

People may be unable to clear their own trachebronchial secretions for several reasons, including:

  • Respiratory pathology causing an alteration in type or quantity of secretions, or disruption of the normal mucociliary clearance process

  • Neurological disorders which inhibit / depress the normal cough reflex, or

  • Presence of an artificial airway

 

Medela products

We recommend the Vario 18 suction pumps. It is capable of reaching the precise vacuum levels [mmHg] according to the publications referenced later. This is only a recommendation, the individual setting is the responsibility of the medical practitioner.
 

Benefits

Benefits of Vario 18 for airway suctioning:
Simple to use
  • Stressful situations require a fast setup and handling - both needs are met with the Vario 18 pump.
  • The distinct connection ports facilitate attachment of canister and accessories.
  • The vacuum tubing is attached to the canister and can stay put when liners are inserted or replaced.

Quiet running low vibration

  • The Vario 18 operates quietly, making airway suctioning discreet - even on the ward.

Robust and safe

  • The vacuum strength can be set to the precise recommended level using the push-down vacuum regulator.
  • Sturdy housing and components make the pump ideal for use on crash carts.
  • The Vario 18 can be used where ever it's needed due to the battery powered version, optional car connection cable and its small size.
  • The push-down vacuum regulator prevents accidental adjustment.
 

Suction levels

Negative pressure of 80–100mmHg in neonates and less than 150mmHg in adults have been recommended1.
 
Limiting pressures to between 80 and 150mmHg is recommended2
 
The suction pressure recommendations are:
• 60-80 mmHg (8-10 kPa) for neonates
• Up to 120 mmHg (<16 kPa) for older children3
 

References

1. AARC Clinical Practice Guideline: Endotracheal suctioning of mechanically ventilated adults and children with artificial airways, Respir Care 2010 http://www.rcjournal.com/cpgs/pdf/06.10.0758.pdf   
2. Suctioning: a review of current research recommendations, Tina Day et al, Intensive and Critical Care Nursing (2002)
3. Clinical guideline Airway Suction, Great Ormond Street Hospital for children, Date approved: 26 October 2011