To the Editor:--We report a case of respiratory distress during patient transport that was treated by a simple, easily assembled suction device for endotracheal tubes. The patient was a 2-yr-old girl with a history of respiratory failure secondary to interstitial pulmonary infiltrates. The patient required tracheal intubation and mechanical ventilatory support in the intensive care unit. The patient was being transported to the operating room for open lung biopsy. In the elevator, the lungs became difficult to ventilate by self-inflating resuscitator, breath sounds were distant, and oxygen saturation, as monitored by pulse oximetry, began to decrease. A large mucous plug was removed with the aid of a portable suction device we created at our institution (Figure 1). The device consists of a suction catheter (Baxter, Valencia, CA) connected to a luer lok syringe (Becton Dickinson, Franklin Lakes, NJ). The suction catheter is screwed directly onto the syringe, and suction is created by pulling a syringe plunger. Any size catheter can be used in combination with any size luer lok syringe, in a one-size-fits-all fashion.
We tested the negative pressure that could be generated with our device. Using a digital pressure meter (Dynatech Nevada), we generated 600 mmHg pressure without collapsing the catheters (8, 10, and 14 French). Wall suction available in the operating rooms also was tested and noted to be 560 mmHg. The negative pressure generated with the device, unlike that of wall suction, cannot be increased, which limits its use. This easy-to-assemble and simple-to-use portable suction device provides an alternative to cumbersome, battery-powered or pneumatically powered suction devices. Our suction device provides a cost-effective and efficient way to alleviate a common cause of inability to ventilate the lungs in intubated pediatric patients during intrahospital transport.
John W. Daniel, M.D.; Resident in Anesthesiology
Mark L. Pinosky, M.D.; Assistant Professor; Department of Anesthesia and Perioperative Medicine; Medical University of South Carolina; Charleston, South Carolina 29425-2207
(Accepted for publication April 1, 1996.)