Evidence map›Paper›PMID 41535785›Full record

ReviewBMC anesthesiology2026

Pharmacologic and non-pharmacologic strategies to prevent intracranial pressure surges during endotracheal suctioning in acute brain injury: a narrative review.

Sagar Jolly, Shashank Paliwal, Rashida Lokhandwala, Aditya Gadepalli, Kiran Jangra, Navneh Samagh, Abhijit Vijay Lele, Rafi Avitsian

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in BMC anesthesiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Sagar JollyDepartment of Anesthesiology, New York Medical College, Metropolitan Hospital Center, 1901 1 st Ave, New York, NY, 10029, USA. medsagar10@gmail.com.
Shashank PaliwalDepartment of Anaesthesiology, Critical Care and Pain Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, India.
Rashida LokhandwalaDepartment of Anaesthetics, University Hospitals Coventry and Warwickshire, Coventry, UK.
Aditya GadepalliAnaesthetics and Intensive Care, Royal Free London NHS Foundation Trust, London, UK.
Kiran JangraDepartment of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Navneh SamaghDepartment of Anaesthesiology, Critical Care and Pain Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, India.
Abhijit Vijay LeleDepartments of Anesthesiology and Pain Medicine. Neurology and Neurological Surgery, Harborview Medical Center, University of Washington, Seattle, USA.
Rafi AvitsianDepartment of Anesthesiology, Cleveland Clinic, Cleveland, OH, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Endotracheal suctioning remains a critical intervention in the respiratory management of mechanically ventilated patients with brain injury. However, it carries the risk of triggering abrupt intracranial pressure elevations, potentially exacerbating secondary brain injury. This narrative review combines current evidence on pharmacologic and non-pharmacologic strategies to mitigate ICP fluctuations during ETS in neurosurgical patients. The findings support the need for an integrated approach involving analgo-sedation, controlled ventilation, and targeted drug selection to minimize ICP surges and improve outcomes. While each strategy offers distinct benefits, its application must be adapted to the patient's physiological profile and clinical context, and regional resources. The review also highlights the need for continued research into effective dosing, administration techniques, and the integration of real-time monitoring technologies to enhance procedural safety in this high-risk population.

Indexed as

Brain InjuriesIntracranial HypertensionIntracranial PressureIntubation, IntratrachealHumansRespiration, ArtificialSuctionCerebral blood flowCerebral perfusion pressureEndotracheal suctioningIntracranial pressureMechanical ventilationSecondary brain injuryTraumatic brain injury

Identifiers

PMID41535785
PMCPMC12888679

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.