n Southern African Journal of Critical Care - To instill or not to instill - is it still a question? : editorial




All intubated adults and children managed in an intensive care unit (ICU) require endotracheal suctioning in order to maintain a patent airway. Patients cannot eliminate secretions themselves, partly because the presence of the endotracheal tube (ETT) compromises glottic closure, thereby limiting the pressures and velocity of airflow that can be generated for an effective cough. In addition, normal mucociliary function may be impaired by inadequately humidified inspired gas. The ETT itself may cause irritation of the airways and increased secretion production, and in the presence of respiratory infection the increased amount and viscosity of pulmonary secretions further impede clearance.


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