{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T08:11:02Z","timestamp":1788768662350,"version":"build-2803163510"},"reference-count":22,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T00:00:00Z","timestamp":1777680000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respiratory Care"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Endotracheal suctioning is a routine procedure in the pediatric ICU (PICU) and can be performed via open or closed systems. Closed-system suctioning has benefits for pressure maintenance in the ventilatory system and oxygen supply during the technique but is less effective. The association of an expiratory pause in closed-system suctioning is an alternative technique. We sought to\u00a0evaluate the volume of suctioned secretions, respiratory mechanics, and hemodynamic parameters during closed endotracheal suctioning with expiratory pause, compared with conventional closed suctioning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A randomized crossover pilot trial with infants receiving\u00a0invasive mechanical ventilation &gt;24 h, with neuromuscular blocker, without cough reflex, randomized to define the order of suctioning techniques (T1\u2014technique 1 conventional suctioning without expiratory pause; T2\u2014technique 2: with expiratory pause), performed with a 2-h interval. Evaluated hemodynamic parameters (heart rate, blood pressure, and peripheral arterial oxygen saturation), respiratory mechanics (static and dynamic compliance, inspiratory and expiratory resistance, driving pressure), and suctioning secretion were weighed on a precision balance. Shapiro\u2013Wilk test for normally distributed variables analysis and generalized estimating equation for effect analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Ten infants were included with a median age of 2 months (1.0\u20133.7). The amount of secretions\u00a0from the\u00a0technique with expiratory pause was significantly higher compared with conventional suctioning (mean 1.4\u2009g vs 1.1\u2009g;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). Treatment effect was observed in the analysis of driving pressure (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) and inspiratory resistance (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .02), with an increase in these variables after suctioning with expiratory pause. There were no significant differences in hemodynamic variables.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The closed-system suctioning with expiratory pause was more effective in secretion removal compared with conventional closed suctioning. However, driving pressure and inspiratory resistance increased after suctioning with an expiratory pause.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19433654261427697","type":"journal-article","created":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T09:42:43Z","timestamp":1777714963000},"page":"998-1004","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of Endotracheal Suctioning With Expiratory Pause in Infants"],"prefix":"10.1177","volume":"71","author":[{"given":"Ana Paula","family":"Dattein Peiter","sequence":"first","affiliation":[{"name":"Ms. Dattein Peiter is affiliated with Department of Physical Therapy, Hospital da Crian\u00e7a Concei\u00e7\u00e3o, Porto Alegre, Brazil."},{"name":"Ms. Dattein Peiter and Ziegler are affiliated with Postgraduate Program in Pneumology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taila Cristina","family":"Piva","sequence":"additional","affiliation":[{"name":"Ms. Piva, Piccoli, Dr. Schaan, and Ms. Ziegler are affilaited with Department of Physical Therapy, Hospital de Cl\u00ednicas de Porto Alegre, Porto Alegre, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taciana Fassbinder","family":"Piccoli","sequence":"additional","affiliation":[{"name":"Ms. Piva, Piccoli, Dr. Schaan, and Ms. Ziegler are affilaited with Department of Physical Therapy, Hospital de Cl\u00ednicas de Porto Alegre, Porto Alegre, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Bruno","sequence":"additional","affiliation":[{"name":"Drs. Bruno and Andreolio are affilaited with Department of Pediatric Intensive Care, Hospital de Cl\u00ednicas de Porto Alegre, Porto Alegre, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinara","family":"Andreolio","sequence":"additional","affiliation":[{"name":"Drs. Bruno and Andreolio are affilaited with Department of Pediatric Intensive Care, Hospital de Cl\u00ednicas de Porto Alegre, Porto Alegre, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camila Wohlgemuth","family":"Schaan","sequence":"additional","affiliation":[{"name":"Ms. Piva, Piccoli, Dr. Schaan, and Ms. Ziegler are affilaited with Department of Physical Therapy, Hospital de Cl\u00ednicas de Porto Alegre, Porto Alegre, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruna","family":"Ziegler","sequence":"additional","affiliation":[{"name":"Ms. Dattein Peiter and Ziegler are affiliated with Postgraduate Program in Pneumology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil."},{"name":"Ms. Piva, Piccoli, Dr. Schaan, and Ms. Ziegler are affilaited with Department of Physical Therapy, Hospital de Cl\u00ednicas de Porto Alegre, Porto Alegre, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,2]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.42579"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.4037\/ajcc2017844"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.08511"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1721725"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.09548"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.5005\/jp-journals-10071-24252"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200601000-00008"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-003-2153-9"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.1590\/1984-0462\/2022\/40\/2020290"},{"issue":"3","key":"e_1_3_3_11_1","first-page":"114","article-title":"Expiratory pause repercussions with closed aspiraton system in the volume of secretion, ventilation and hemodynamics of patients in mechanical ventlation","volume":"7","author":"Pinheiro DRdR","year":"2022","unstructured":"10.Pinheiro DRdR, , Kutchak FM, , Bombarda-M\u00fcller A. Expiratory pause repercussions with closed aspiraton system in the volume of secretion, ventilation and hemodynamics of patients in mechanical ventlation. Scientia: Revista Cient\u00edfica Multidisciplinar 2022;7(3):114\u2013131.","journal-title":"Scientia: Revista Cient\u00edfica Multidisciplinar"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.01229"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.5005\/jp-journals-10071-23263"},{"key":"e_1_3_3_14_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-1732448"},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.physio.2022.11.004"},{"key":"e_1_3_3_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-017-0475-6"},{"key":"e_1_3_3_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000003333"},{"key":"e_1_3_3_18_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.08024"},{"key":"e_1_3_3_19_1","doi-asserted-by":"publisher","DOI":"10.32641\/andespediatr.v94i3.4616"},{"key":"e_1_3_3_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000022101"},{"key":"e_1_3_3_21_1","doi-asserted-by":"publisher","DOI":"10.5005\/jp-journals-10071-23594"},{"key":"e_1_3_3_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/0023677217725365"},{"key":"e_1_3_3_23_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1330-8538"}],"container-title":["Respiratory Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19433654261427697","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/19433654261427697","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19433654261427697","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T08:00:34Z","timestamp":1788768034000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/19433654261427697"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,2]]},"references-count":22,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1177\/19433654261427697"],"URL":"https:\/\/doi.org\/10.1177\/19433654261427697","relation":{},"ISSN":["1943-3654","1943-3654"],"issn-type":[{"value":"1943-3654","type":"print"},{"value":"1943-3654","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,2]]}}}