Question

A 90-kg male is receiving mechanical ventilation through a 7.5 ET tube. Bronchial hygiene has been difficult due to thick secretions. The patient is being suctioned with a 10 Fr. catheter at a pressure of 110 mmHg. Which of the following can be done to increase the effectiveness of suctioning:

A. administer sodium bicarbonate
B. change to a 12 Fr. catheter
C. change to an 8.5 ET tube and 12 Fr. catheter
D. increase suction pressure to 130 mmHg

Answer 1

Option C). To increase the effectiveness of suctioning in a mechanically ventilated patient, changing to a larger catheter such as a 12 French can be more effective for thick secretions, as opposed to increasing suction pressure which can be harmful.

Step-by-step explanation:

Selecting a catheter size that corresponds with the endotracheal tube being used can improve the efficiency of suctioning thick secretions from a patient undergoing mechanical ventilation. The patient in this case is being suctioned at 110 mmHg using a 10 French catheter. Given the thickness of the secretions, suctioning may be more effective if sodium bicarbonate is added, a larger catheter is used, or the ET tube and catheter's diameters are increased. A larger catheter—like a 12 French—would fit the 7.5 ET tube better and enable more efficient secretion removal. Therefore, switching to a 12 Fr. catheter would be the wise decision. On the other hand, increasing the suction pressure to 130 mmHg could be hazardous and could potentially damage the tracheal mucosa.