EXPIRATORY PAUSE REPERCUSSIONS WITH CLOSED ASPIRATION SYSTEM IN THE VOLUME OF SECRETION, VENTILATION AND HEMODYNAMICS OF PATIENTS IN MECHANICAL VENTILATION

Abstract

Background: The technique of aspiration in closed system with expiratory pause in the mechanical ventilator is a common practice in ICU. It is believed that an expiratory flow with a longer duration and without the inspiratory counterflow allows to maintain the airway open, facilitating the displacement of the secretions to the proximal airways, thus facilitating their removal. Objective: To compare the effects of the use of expiratory pause in the closed suction system, quantifying the volume of bronchial secretions aspirated, hemodynamic and ventilatory responses in mechanically ventilated patients in the ICU. Method: A randomized crossover clinical trial with 24 patients mechanically ventilated for more than 48 hours in the reference ICU in the south of the country. They measured the amount of secretion, hemodynamic and respiratory variables, plus the system pressure before and after the suction in a closed system with and without expiratory pause. Results: The volume of secretion was 6.28±3.10g with expiratory pause and 2.58±1.18g without expiratory pause (p<0.001). There was an increase in TAV (p=0.005) and decreased HR after aspiration with expiratory pause. The MBP significantly increased in both protocols. There were no significant changes in ventilation parameters. Conclusion: The aspiration technique with expiratory pause was effective and safe in removing bronchial secretions being higher aspiration technique in a closed system, it removed a greater volume of secretion, increased the TAV 30 minutes after the procedure and it was able to decrease HR.