RECOMMENDATIONS Based on the analyzed studies, the recommendation of this integrative review is to only perform endotracheal suctioning in intubated newborns when there are clinical signs of tracheal secretions, which are primarily evaluated by the presence of snoring or decreased breathing sounds on auscultation. This procedure should not be routinely performed to prevent airway obstruction. The suction time should not exceed 15 seconds, and the negative pressure must not exceed 100mmHg. Hyperoxygenation should not be used routinely and is only indicated when the baby has a clinically significant reduction in peripheral oxygen saturation during suctioning. When required to reduce hypoxemia, pre-oxygenation is recommended 30 to 60 seconds before, during and 1 minute after endotracheal suctioning by applying an inspired oxygen fraction that is 10 to 20% higher than what was used in the previous procedure. Saline instillation should not be routinely performed. Moreover, the Center for Disease Control and Prevention standards for invasive procedures must be respected during the procedure, the procedure must be conducted by at least two professionals, a maximum of three probe insertions should be performed, with a return to the ventilator between suctionings.