Expiratory pause in patients undergoing mechanical ventilation

systematic review with meta-analysis

Authors

  • Luciane de Fraga Gomes Martins
  • Janine Pereira Machado
  • Andreia Barcellos Teixeira Macedo
  • Fernanda Machado Kutchak
  • Silvia Regina Rios Vieira
  • Márcio Manozzo Boniatti

Keywords:

Tracheal Suctioning, Expiratory Pause, Mechanical Ventilation, Systematic Review

Abstract

Objective: to evaluate the efficacy and safety of closed-system tracheal suctioning combined with an expiratory pause in patients undergoing invasive mechanical ventilation. Methods: a systematic review with meta-analysis. Randomized clinical trials were included, with no restrictions regarding language, publication period, or sample age group. Searches were conducted in the Medical Literature Analysis and Retrieval System Online, Cumulative Index to Nursing and Allied Health Literature, Scopus, Latin American and Caribbean Health Sciences Literature, Web of Science, Cochrane Library, Excerpta Medica dataBASE, and the Digital Library of Theses and Dissertations. Analyzed outcomes included the volume of aspirated secretions, hemodynamic stability, oxygenation parameters, and ventilatory mechanics. Risk of bias was assessed using the RoB 2 tool. Results: three studies were included, demonstrating a statistically significant increase in the volume of secretions removed using the technique combined with a pause, without compromising hemodynamic stability. Risk of bias assessment indicated "some concerns" in all studies, particularly regarding randomization and selective reporting. In the random-effects model, the technique with a pause increased the aspirated dry weight by 1.48 g (95% CI: 0.17 to 2.79; k = 3). Conclusion: closed-system tracheal suctioning combined with an expiratory pause proved more effective at removing secretions compared to the conventional technique, with an adequate safety profile.

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Published

2026-09-22

How to Cite

Martins, L. de F. G., Machado, J. P., Macedo, A. B. T., Kutchak, F. M., Vieira, S. R. R., & Boniatti, M. M. (2026). Expiratory pause in patients undergoing mechanical ventilation: systematic review with meta-analysis. Revista De Divulgação Científica Sena Aires, 15(3), 14–26. Retrieved from https://rdcsa.emnuvens.com.br/revista/article/view/1252

Issue

Vol. 15 No. 3 (2026): REVISA

Section

Literature Review

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