Comparison of the effect of suction catheter and nelaton catheter in airway suctioning on hemodynamic status of patients in intensive care units

Endotracheal suctioning is an essential procedure in mechanically ventilated patients to maintain airway patency and ensure adequate ventilation. Despite its regular use in intensive care units (ICUs), there is limited consensus on the ideal approach or preferred device. This study aimed to compare the effects of the Nelaton catheter and standard suction catheter on hemodynamic parameters during endotracheal suctioning. This repeated-measures crossover clinical trial was performed in the ICU of Besat Specialized Teaching Hospital, Hamedan, Iran, from November 2022 to March 2023. A total of 40 intubated patients were randomized into two catheter-sequence groups. Hemodynamic parameters such as heart rate (HR), respiratory rate (RR), oxygen saturation (SpO₂), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were documented 1 min pre-procedure and at 30 s, 3 min, and 5 min after suctioning. A formal crossover analysis demonstrated no statistically significant treatment, period, carryover, or sequence effect on any hemodynamic parameter (all P > 0.05). Both devices produced transient increases in HR, RR, SBP, DBP, and MAP, peaking at 30 s post-suction and returning to baseline by 5 min. SpO₂ declined transiently during suctioning and recovered within 3–5 min. No adverse events (arrhythmias, bleeding, or ST-segment changes) were observed. No statistically significant differences in hemodynamic responses were detected between the Nelaton catheter and standard suction catheter in mechanically ventilated ICU patients. Given the moderate sample size ( n = 40) and associated risk of type II error, these findings should be regarded as hypothesis-generating rather than confirmatory of equivalence. Adequately powered, prospectively registered trials are needed. IRCT20230902059327N1 (retrospectively registered 11 September 2023).