Artificial airway aspiration after the 2010 guideline: what has changed?

Abstract

Objective: To synthesize the existing scientific evidence on the new recommendations for the practice of aspiration of artificial airways in adult and elderly patients evidenced after the publication of the 2010 guideline. Methods: Integrative review carried out in June 2021 in the sources US National Library of Medicine National Institutes Database Search of Health, Cumulative Index to Nursing and Allied Health Literature, Latin American and Caribbean Literature in Health Sciences, Scopus, Embase and ERIC. The Rayyan program for selection and the Thematic Analysis were adopted. Results: 1519 studies were identified and six comprised the sample. Two categories were developed: new indicators for artificial airway aspiration and advances in the clinical practice of artificial airway aspiration. Final considerations: The indicators for aspiration were corroborated, consisting of the presence of crackles in the trachea, sawtooth-shaped ventilatory curve, ineffective cough, snoring and rales, drop in saturation, change in breathing pattern, sweating and cyanosis; high pressure alarms and changes in arterial gases. Two criteria were recommended for maintaining patient safety during aspiration, pre-oxygenation of the patient with oxygen at 0.20% above baseline and the use of a suction pressure of 80-120mmHg.