Consensus was observed in half of the analyzed studies that the Center for Disease Control and Prevention (CDC) guidelines for standard precautions in invasive procedures must be respected to reduce instances of pneumonia associated with the procedure.(6,10) The remaining analyzed studies did not address this issue. In addition, certain studies argued that endotracheal suction is a procedure that should be performed by two people, thereby increasing safety of the procedure.(6,8,10) On the National Health Surveillance Agency’s (Agência Nacional de Vigilância Sanitária - ANVISA) website, references were not found regarding the biosafety standards for endotracheal suctioning or for invasive procedures. Therefore, with regard to the bio-security standards for the performance of endotracheal suctioning in intubated newborns, the recommendation of this review is to follow the CDC guidelines, which advocate protecting the professional’s eyes, nose and mouth using a face mask and goggles, wearing an apron and sterile gloves, and performing hand hygiene before and after the procedure.(29) An eye protector may also be placed on the newborn to prevent mucosa contamination. A further recommendation is for the procedure to be performed by at least two people.(