Endotracheal tube suctioning is an essential and frequency nursing intervention in intensive care units. This includes the removal of secretions from the respiratory tract in patient which has an artificial airway is special. Providing appropriate methods to facilitate the clearance of airway secretions, lung volumes for synthetic and save provide measures to minimize complications, the most important part of the nursing care is patients with tracheal tube in intensive care units. The major complication of suction is a Hypoxemic hypoxia. Due to oxygen is off during the procedure and also increases the amount of oxygen consumed, this result to decrease in tissue oxygenation. hyperoxygenation and hyperinflationand combining these two methods are prevention of suctioning-related arterial oxygen depletion. Therefore, the decrease in arterial blood oxygen during suctioning and the detailed information about the quality and effectiveness of each of these methods are not available, in the previous studies, different and contradictory results can be seen and their impact on arterial blood gas and physiologic parameters are not proven. We accomplish these methods to helping nurses with better suction and less complication. This study is a clinical trial (Cross over); 36 patients admitted to the ICU that have the inclusion criteria will be randomly divided into two groups. In hyperoxygenation, patients receive concentration of 100% before and after suctioning procedure for 2 minutes by using keys O2 flush on mechanical ventilation. In combination therapy hyperoxygenation and hyperinflation, before and after suctioning, simultaneously for 2 min, tidal volume mechanical ventilation increased to 150% base rate and respiratory rate cut to 8 breaths per minute and 100% oxygen to the patient. Then researcher take arterial blood sample before, after and during suctioning and checks the impact of these methods on physiological parameters ( HR, MAP, BP) and some indicators of arterial blood gas (PH, Pao2, O2Sat, PaCo2 and HCO3-) on 36 patients admitted to the intensive care unit. Instrument for data collection is check list which includes 2 tables to record the results of the demographic characteristics and arterial blood sampling and continuous monitoring of the parameters of the patient.