Is sodium bicarbonate installation (small amount and diluted) used for artificial airway (ETT and Tracheostomy) suctioning to remove thick secretions? Clinically and theoretically, Why and why not?
Intensivists, pulmonagists, Critical Care Nurses and researchers.
Thank you.
No longer an acceptable practice. The practice was discontinued as a VAP reduction measure.
http://ajcc.aacnjournals.org/content/17/5/469?cited-by=yes&legid=ajcc;17/5/469
I have never heard of the use of sodium bicarbonate.
Normal saline was used in the past, but evidenced based research indicated an increased incidence of ventilator acquired pneumonia with adding solution into the endotracheal tube before suction.
Delia Frederick, RN, MSN University of South Carolina Aiken
I agree with the las two opinions. Moreover, even normal saline is no longer recomended!
http://www.australiancriticalcare.com/article/S1036-7314(16)30136-9/fulltext
As far back as 2008 evidence identified the instillation of normal saline before endotracheal suctioning has been considered an adverse practice because of the physiological and psychological effects. More current evidence has reached similar conclusions.
This review article by Halm et al may be initially helpful: Halm et al, Instillingn normal saline with suctioning. Am J Crit Care September 2008 vol. 17 no. 5 469-472
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