To systematically evaluate the effect of deep and shallow sputum aspiration on sputum aspiration in adult patients with artificial airway.

Cochrane was searched by computer Randomized controlled studies of the effect of deep and shallow sputum aspiration on sputum aspiration in patients with artificial airway in Library, PubMed, MEDLINE, EM-Base, CINAHL, China Biomedical Literature Database, China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP Database and Chinese Medical Journal Full-text Database At the same time, the included literature was screened for references. Two researchers extracted the literature data, and evaluated the quality of the literature with the Cochrane evaluator manual. Meta-analysis was performed with Rev Man5.3 software for the randomized controlled trials that met the quality standards.

A total of 22 randomized controlled trials involving 1 514 patients were conducted. In terms of effectiveness, deep sputum aspiration was more effective, with fewer suctions per day [WMD=-2.09, 95%CI: -2.61 to -1.58, P<0.01], blood oxygen saturation increased more [WMD=-1.22, 95%CI(-1.51, -0.94), P<0.001], but there was no significant difference in sputum sound improvement score. In terms of complications of sputum aspiration, shallow sputum aspiration had more advantages, with fewer cases of heart rate (HR) change [WMD=3.73, 95%CI: 2.41 to 5.77, P<0.001] and small increase in respiration (RR) [WMD=0.89, 95%CI: 0.64 to 1.15, P<0.001], lower fluctuation of blood pressure (SBP) [WMD=3, 95%CI (1.78, 4.22), P<0.001], airway mucosal injury[OR=8.54, 95%CI(6.20, 11.76), P<0.001] and irritating cough [OR=5.01, 95%CI(3.68, 6.81), P<0.001].

Depth of sputum suction in the sputum suction effectiveness is more effective, the depth of the sputum suction can decrease The Times of 24 h draw blood oxygen saturation rise is bigger, but in the sputum suction security, sputum suction depth than shallow sputum suction may cause greater fluctuations in heart rate, respiration, blood pressure, and high incidence of airway injury, choking cough, sputum suction can be personalized according to patients condition in clinical choice depth.