Background The increase in admissions to intensive care units (ICUs) in 2020 and the morbidity and mortality associated with SARS-CoV-2 infection pose a challenge to the analysis of evidence of health interventions carried out in ICUs. One of the most common interventions in patients infected with the virus and admitted to ICUs is endotracheal aspiration. Endotracheal suctioning has also been considered one of the most contaminating interventions. Objective This review aims to analyze the benefits and risks of endotracheal suctioning using closed suction systems (CSS) in COVID-19 patients. Methods A rapid review was carried out using the following databases: PubMed, MEDLINE, CINAHL, LILACS, the Cochrane Library, and IBECS. The data search included articles in English and Spanish, published between 2010 and 2020, concerning adult patients, and using the key words “endotracheal,” “suction,” and “closed system.” Results A total of 15 articles were included. The benefits and risks were divided into 3 categories: patient, care, and organization. Relating to the patient, we found differences in cardiorespiratory variables and changes in the ventilator, for example, improvement in patients with elevated positive and end-expiratory pressure due to maladaptation and alveolar collapse. Relating to care, we found a shorter suctioning time, by up to 1 minute. Relating to organization, we found fewer microorganisms on staff gloves. Other conflicting results between studies were related to ventilator-associated pneumonia, bacterial colonization, or mortality. Conclusions Aside from the need for quality research comparing open suction systems and CSS as used to treat COVID-19 patients, closed endotracheal suctioning has benefits in terms of shorter stay in the ICU and reduced environmental contamination, preventing ventilator disconnection from the patient, reducing the suctioning time—though it does produce the greatest number of mucosal occlusions—and preventing interpatient and patient-staff environmental contamination. New evidence in the context of the SARS-CoV-2 virus is required in order to compare results and establish new guidelines.
BACKGROUND In 2020, the increase in admissions to intensive care units (ICUs) and the morbidity and mortality of the disease pose a challenge to the analysis of evidence of health interventions carried out in ICUs. One of the most common interventions in patients admitted to ICUs for covid19 is endotracheal aspiration. Endotracheal suctioning has also been considered one of the most contaminating interventions. OBJECTIVE To analyse the benefits and risk of endotracheal suctioning using closed suction systems (CSS), with application to the COVID- 19 patients. METHODS A Rapid Review was carried out using the following databases: Pubmed, MEDLINE, CINAHL, LILACS, Cochrane Library and IBECS. It included articles in English and Spanish, published between 2010 and 2020, concerning adult patients and using the key words “endotracheal”, “suction” and “closed system”. RESULTS A total of 15 articles are included. The benefits and risks have been divided into three categories: relating to the patient, care and organisation. The most noteworthy benefits of CSSs are: preventing the ventilator from disconnecting from the patient, reducing the time taken to use the suctioning technique albeit that it produces the greatest number of mucosal occlusions, and avoiding inter-patient and patient-staff environmental contamination. CONCLUSIONS Aside from the need for quality research comparing open suction systems (OSS) and CSSs, in the case of COVID-19 patients, closed endotracheal suctioning has benefits related to ICU stay times and, above all, the reduction of environmental contamination. New evidence in the COVID-19 context should be generated to compare results and establish new indicators for guidelines. CLINICALTRIAL None
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.