BACKGROUND. Normal saline instillation prior to endotracheal suctioning is a critical care ritual that persists despite a lack of demonstrated benefit. Saline instillation may dislodge viable bacteria from a colonized endotracheal tube into the lower airway, overwhelming the defense mechanism of immunocompromised patients. OBJECTIVE. To determine the extent to which normal saline irrigation and suction catheter insertion dislodge viable bacteria from endotracheal tubes. METHODS. Endotracheal tubes from 10 critical care patients intubated for at least 48 hours were obtained immediately after extubation. Each tube was used in random order for both saline instillation and suction catheter insertion. Dislodged material was cultured for quantitative analysis. RESULTS. Suction catheter insertion dislodged up to 60,000 viable bacterial colonies. A 5-mL saline instillation dislodged up to 310,000 viable bacterial colonies. CONCLUSIONS. The potential for infection caused by dislodging bacteria into the lower airway is additional evidence that routine use of saline during suctioning procedures should be abandoned.
Skip Nav Destination
Article navigation
1 November 1994
Articles|
November 01 1994
Endotracheal saline and suction catheters: sources of lower airway contamination
Am J Crit Care (1994) 3 (6): 444–447.
Citation
DA Hagler, GA Traver; Endotracheal saline and suction catheters: sources of lower airway contamination. Am J Crit Care 1 November 1994; 3 (6): 444–447. doi: https://doi.org/10.4037/ajcc1994.3.6.444
Download citation file:
Sign in
Don't already have an account? Register
AACN Account
Sign InSign in via your Institution
Sign in via your InstitutionShort-term Access
Purchase short-term access on a pay-per-article or pay-per-issue basis.
$15 72 - hour single article access $30 7 - day full issue access