Endotracheal intubation and mechanical ventilation are life-saving procedures for patients with respiratory failure. But it can profoundly impair the defense mechanisms that maintain sterility of the lower respiratory tract, increasing the risk of bacterial colonization and ventilator-associated pneumonia. Although endotracheal suctioning is a standard of care in all mechanically ventilated patients, clear guidelines regarding suctioning technique and timing are lacking. Applicable American Association for Respiratory Care (AARC) guidelines suggest that endotracheal suctioning should be performed with minimal frequency or when clinically indicated. Since endotracheal suctioning can cause hypoxemia, mechanical trauma, bronchospasm, and hemodynamic instability, accurate assessment of the need for suctioning could decrease the frequency of suctioning complications. TBA Care is a new device designed to generate a signal when secretions are present in the airway of an intubated patient, indicating the need for endotracheal suctioning. This is the first prospective randomized trial comparing different indications for endotracheal suctioning. This study compared the effectiveness of TBA Care in detecting the presence of secretions in the respiratory tract to standard indications, and also tested the hypothesis that different suction indications could impact the incidence of pneumonia associated with the ventilator and the extubation rate (Lucchini et al., 2011). This is a quantitative research study with a prospective randomized trial involving 72 general intensive care unit patients randomized upon intubation into 2 groups, differing only in suction indications. The study was carried out over a period of 9 months and on 72 adult patients...... middle of paper ...... and there is no clear guidance on when to carry it out. TBA Care appears to provide a reliable indication of the need for aspiration. So this would be useful in intensive care units. Although the study did not find a significant difference in the frequency of ventilator-associated pneumonia, further studies with a larger sample size may be helpful. Although the nurses who performed the suction were trained to categorize the amount of secretion collected, future studies should provide a more accurate method for measuring the amount of secretion.ReferencesLucchini, A., Zanella, A. , Bellani, G., Gariboldi, R., Foti, G. and Pesanti, A. et al. (2011). Management of tracheal secretions in mechanically ventilated patients: comparison of standard assessment and an acoustic secretion detector. Respiratory Care, 56(5), 596-603. doi:10.4187/respcare.00909.