Which of the following can impair mucociliary clearance in intubated patients? 1. Use of respiratory stimulants 2. Tracheobronchial suctioning 3. Inadequate humidification 4. High inspired oxygen concentrations
a. 1 and 3 only
b. 1, 2, and 3 only
c. 3 and 4 only
d. 2, 3, and 4 only
ANS: D
Although suctioning is used to aid secretion clearance, it too can cause damage to the airway mucosa and thus impair mucociliary transport. Inadequate humidification can cause inspissation of secretions, mucus plugging, and airway obstruction. High fractional inspired oxygen concen-trations (FiO2) can impair mucociliary clearance, either directly or by causing an acute tracheo-bronchitis.
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