A patient with tracheobronchial mucosal injury secondary to tracheal suctioning, and safe suctioning protocols for ICUs have been discussed.
A 70-year old patient with chronic obstructive pulmonary disease was on mechanical ventilation due to pulmonary insufficiency after coronary artery bypass grafting. On the 15th day of intubation, percutaneous tracheostomy was performed, and tracheobronchial tree was evaluated with flexible bronchoscope. Diffuse bleeding areas on tracheal mucosa extending to carina and mucosal injury located in the carina, seems to be related to tracheal suctioning catheter were observed. One week after modification of the aspiration protocol, mucosal injury reevaluated with bronchoscope, and significant recovery was observed.
In conclusion, endotracheal suctioning is necessary to prevent air way obstruction, but it is not a totally innocent procedure. It is decided that, specialists should be informed about suctioning related tracheal mucosal injury, and clinics should formulate endotracheal suctioning protocols.
Keywords: Endotracheal suctioning, tracheal injury, mechanical ventilation