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Suctioning adult patients.

Latest update: June 2009. Next update: Not indicated. Patient group: Intubated and nonintubated adult patients. Intended audience: Physiotherapists, respiratory therapists, nurses, and physicians. Additional versions: This guideline is an update of a previous clinical practice guideline. Brooks D et al (2001) Can Resp J 8: 163-181. Expert working group: Six Canadian experts from a variety of professional backgrounds comprised the guideline panel. This included individuals with backgrounds in physiotherapy, nursing, and respiratory therapy. Funded by: Physiotherapy Foundation of Canada. Consultation with: Not indicated. Approved by: Not indicated. Location: Overend TJ et al (2009) Can Resp J 16: e6-17.

Description: This 12 page journal article reviews 28 randomised trials and 11 lower level studies. The guideline presents evidence for the clinical indications and precautions for suctioning adult patients. In addition it outlines the evidence for the methods and techniques that optimise benefits and reduce complications or risks when suctioning intubated, nonintubated, or tracheotomised adult patients. This includes the use of hyperoxygenation, hyperinflation, an adaptor in the ventilator circuit, open versus closed suctioning systems, subglottic suctioning, minimally invasive suctioning, saline instillation, medications administered during suctioning, infection control issues, suctioning during different ventilator modes and varied suction catheter sizes. Studies are rated using scales including the PEDro rating scale. Summary tables of all papers contributing to the review are presented. These include descriptions of groups and interventions, outcome measures and summaries of main results. Meta-analyses are undertaken to compare the effect of open vs closed suctioning on various outcome measures such as arterial oxygen saturation, end-expiratory lung volume, and the presence of ventilator associated pneumonia.

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Title Annotation:Appraisal: Clinical Practice Guidelines; brief
Publication:Australian Journal of Physiotherapy
Article Type:Report
Geographic Code:8AUST
Date:Dec 1, 2009
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