Retained secretions in mechanically ventilated patients can interfere with ventilation and cause potentially serious complications. Endotracheal suctioning is an essential part of care for these patients, and respiratory therapists and nurses must be knowledgeable and skilled in its use. This program lists indications for endotracheal tube suctioning and describes the equipment needed and techniques used for both open and closed suctioning. Recent literature reviews comparing the advantages and disadvantages of open and closed suctioning are also summarized, including cost considerations.