Effect of Endotracheal Suctioning During Disconnection of Ventilator on Pleural Space Violation in Median Sternotomy

Median sternotomy is the most common surgical approach used in cardiac surgery. During sternotomy there is a risk of accidental pleural space violation which may lead to postoperative pulmonary complications such as pneumothorax pleural effusion and prolonged chest drainage. Ventilator disconnection before sternotomy is commonly practiced to reduce lung volume and minimize pleural injury. Some anesthesiologists additionally perform endotracheal suctioning during this period to facilitate further lung deflation. However the effectiveness of this technique in reducing pleural space violation has not been adequately studied.

This prospective study aims to evaluate the effect of endotracheal suctioning during ventilator disconnection on the incidence of pleural space violation in patients undergoing elective cardiac surgery through median sternotomy. Patients aged 18 to 65 years undergoing elective cardiac surgery will be included in the study. Participants will be divided into two groups based on whether endotracheal suctioning is performed during ventilator disconnection before sternotomy. The incidence of pleural space violation will be recorded intraoperatively and compared between the two groups. Secondary outcomes such as hemodynamic parameters oxygen saturation intraoperative blood loss postoperative pulmonary complications and duration of ICU stay will also be evaluated.

The results of this study may help determine whether endotracheal suctioning during ventilator disconnection provides any additional benefit in reducing pleural injury during cardiac surgery.