However, if the suction did not provide the clearance of the double cannula, the inner cannula was removed, cleaned thoroughly, and re-inserted.
We found that the rate of application of suction did not detectably affect calculated mechanical properties (Fig. 1G I, Table 1), including the power-law exponent and the creep compliances at specific times (J 60 s) and J 300 s)).
Analysis of subgroups of the events, namely sedation bolus, opiate bolus and endotracheal suction, did not reveal any groups in which the processed EEG performed better (see Additional data file 1).
Finally, cough strength induced by airway suctioning does not depend on patient effort and is thus feasible for most mechanically ventilated patients, including those who are uncooperative because of dementia, delirium, or altered mental status.
However, subglottic suctioning does not alter oropharyngeal or tracheal bacterial loads [ 71], nor does it significantly reduce the duration of mechanical ventilation, length of ICU stay, or mortality [ 70, 72- 75].
As tidal volume remained constant throughout the experiment, we think that not performing endotracheal suctioning did not influence our results.
Subglottic suctioning did affect the volume of contaminated secretions that could leak but the model was too simplified to quantify the effect of reduced volume on microaspiration.
We hypothesized that there are thresholds beyond which drugs and intratracheal suctioning do not result in significant changes in the respective processed EEG parameters, and that the thresholds for reactions to intratracheal suctioning are modified by prior drug application.
