open suction, our nurse suctioned secretions using sterile gloves and catheter changed after each suction. First, tracheal tube was disconnected from the ventilator and discharges suctioned by inserting a catheter into tracheal tube. After suction, patient was reconnected to ventilator and ventilated during 2 minutes by 3 to 5 inhalations with oxygen 100% using ventilator.