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Repeated open endotracheal suctioning causes gradual desaturation but does not exacerbate lung injury compared to closed endotracheal suctioning in a rabbit model of ARDS SAKURAMOTO, Hideaki 櫻本, 秀明 サクラモト, ヒデアキ SIMOJO, Nobutake 下條, 信威 シモジョウ, ノブタケ Jesmin, Subrina 荒井, サブリナ アライ, サブリナ UNOKI, Takeshi 卯野木, 健 ウノキ, タケシ KAMIYAMA, Junko 神山, 純子 カミヤマ, ジュンコ OKI, Masami 宮, 顕 MIYA, Ken ミヤ, ケン KAWANO, Satoru 河野, 了 カワノ, サトル MIZUTANI, Taro 水谷, 太郎 ミズタニ, タロウ © 2013 Sakuramoto et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. acute respiratory distress syndrome lung injury repeated endotracheal suctioning repeated derecruitments mechanical ventilation application/pdf Background Although endotracheal suctioning induces alveolar derecruitment during mechanical ventilation, it is not clear whether repeated endotracheal suctioning exacerbates lung injuries. The present study aimed to determine whether repeated open endotracheal suctioning (OS) exacerbates lung injury compared to closed endotracheal suctioning (CS) during mechanical ventilation in an animal model of acute respiratory distress syndrome (ARDS). Methods Briefly, thirty six Japanese white rabbits were initially ventilated in pressure-controlled mode with a constant tidal volume (6 mL/kg). Then, lung injury was induced by repeated saline lavage. The rabbits were divided into four groups, namely: a) OS; b) CS; c) control with ARDS only; d) and healthy control (HC) without ARDS. Animals in all the groups were then ventilated with positive end expiratory pressure (PEEP) at 10 cm H2O. CS was performed using 6 French-closed suctioning catheters connected to endotracheal tube under the following conditions: a) a suctioning time and pressure of 10 sec and 140 mm Hg, respectively; and b) a suction depth of 2 cm (length of adapter) plus tracheal tube. OS was performed using the same conditions described for CS, except the ventilator was disconnected from the animals. Each endotracheal suctioning was performed at an interval of 30 min. Results PaO2/FIO2 (P/F) ratio for CS, control and HC groups remained at >400 for 6 hours, whereas that of the OS group progressively declined to 300 (p < 0.05), with each suctioning. However, no difference was observed either in lung injury score (histology) or in the expression pattern of inflammatory cytokines (tumor necrosis factor-α and interleukin-6) after 6 hours between the OS and CS groups in the circulatory as well as the pulmonary tissues. Conclusions Progressive arterial desaturation under conditions of repeated endotracheal suctioning is greater in OS than in CS time-dependently. However, OS does not exacerbate lung injury during mechanical ventilation when observed over a longer time span (6 hours) of repeated endotracheal suctioning, based on morphological and molecular analysis. BioMed Central 2013-12 eng journal article VoR https://jrckicn.repo.nii.ac.jp/records/840 BMC(Springer Nature) https://doi.org/10.1186/1471-2253-13-47 BMC(Springer Nature) AA12034694 1471-2253 BMC anesthesiology 13 47