Endotracheal Tube Suctioning in the Newborn: A Review of the Literature

Maintaining the patency of the endotracheal tube (ETT) is crucial to effective ventilation and oxygenation of the patient receiving assisted ventilation. Performed frequently in the NICU, ETT suctioning has not received extensive study in this population. However, the deleterious effects of this procedure in the newborn are well documented. Methods to reduce these effects include suctioning only as needed instead of using a routine schedule, shallow (or measured) suctioning to avoid trauma to the carina, and closed systems for suctioning in which ventilator pressure is mostly maintained throughout the procedure. Overall, there is limited scientific evidence to guide practice related to ETT suctioning in the newborn, and unit protocols and clinician practices vary. This article will review the current literature regarding ETT suctioning in the newborn and summarize recommendations for best practice.