Endotracheal suctioning in adults with severe head injury: literature review.

Endotracheal suctioning is a routine but potentially dangerous nursing procedure. The research literature documenting approaches to minimising the complications of endotracheal suctioning in adults with severe head injuries is reviewed. Hyperoxygenation, hyperventilation, hyperinflation, normal saline instillation and the effects of endotracheal suctioning on intracranial pressure and cerebral perfusion pressure are examined. Recommendations for an evidence-based endotracheal suctioning protocol are made.