From the Guidelines
The recommended length of a suction catheter for suctioning in Endotracheal Tubes (ETT) or Tracheostomy Tubes (TT) should be the length of the artificial airway plus 1-2 cm, extending just beyond the tip without going too far into the trachea. When considering the size of the suction catheter, it's crucial to balance the need for effective secretion removal with the risk of causing trauma to the tracheal mucosa or inducing atelectasis. The literature suggests that the suction catheter size should be one-half the internal diameter of the tracheostomy tube 1, allowing for airflow around the catheter and minimizing the risk of atelectasis during suctioning. In practice, selecting a suction catheter that is approximately twice the length of the artificial airway can help ensure that the catheter extends just beyond the tip of the ETT or TT without causing undue trauma. Key considerations for suction catheter selection include:
- The catheter should not exceed half the internal diameter of the artificial airway to maintain adequate ventilation during the procedure.
- The catheter should be inserted until resistance is met or the patient coughs, then pulled back 1-2 cm before applying suction.
- Using the appropriate catheter length and diameter helps prevent complications such as tracheal trauma, hypoxemia, and bronchospasm while ensuring effective clearance of secretions.
From the Research
Suction Catheter Length for ETT or TT Suctioning
- The recommended length of a suction catheter for suctioning in Endotracheal Tubes (ETT) or Tracheostomy Tubes (TT) is not explicitly stated in terms of a specific length in the provided studies.
- However, study 2 recommends inserting the catheter no further than the carina, which implies that the length of the suction catheter should be sufficient to reach the carina without causing damage to the tracheal mucosa.
- Study 3 mentions that 71% of nurses suctioned no further than 0.5 cm past the end of the endotracheal tube (ETT), which may indicate a general guideline for the depth of suction catheter insertion.
- It is essential to note that the length of the suction catheter may depend on various factors, including the size of the ETT or TT, the patient's anatomy, and the specific suctioning procedure being performed.
Key Considerations for Suction Catheter Selection
- Study 4 discusses the importance of selecting a suction catheter with an appropriate size relative to the ETT or TT, recommending a suction catheter to endotracheal tube ratio (SC/ETT) of less than 50% based on the external diameter of the SC and the internal diameter of the ETT.
- Study 5 examines the effect of airway diameter, suction catheters, and the bronchofiberscope on airflow in endotracheal and tracheostomy tubes, highlighting the need to consider the internal diameter of the ETT or TT when selecting a suction catheter.