An open-labelled randomized controlled trial comparing costs and clinical outcomes of open endotracheal suctioning with closed endotracheal suctioning in mechanically ventilated medical intensive care patients

Impact of closed versus open tracheal suctioning systems for mechanically ventilated adults: a systematic review and meta-analysis

“…1). After application of inclusion and exclusion criteria, 16 randomized, controlled trials that compared CTSS and OTSS were identified [14,[30][31][32][33][34][35][36][37][38][39][40][41][42][43][44]. Two major CTSS sales companies were contacted, but no new information was obtained.…”

“…The follow-up periods were reported in six trials, and ranged from 7 to 31 days [30,33,34,37,41,44]. Four trials were conducted in medical ICUs [32,35,36,40], four in surgical ICUs [14,30,31,38], and six in mixed (medico-surgical) ICUs [33,34,37,39,43,44]; the remainder was unclear. Six trials used Trach Care, two Steri Cath, two Hi Care, and one Ty Care as the CTSS; the CTSS brand was unclear in five trials.…”

“…Six trials used Trach Care, two Steri Cath, two Hi Care, and one Ty Care as the CTSS; the CTSS brand was unclear in five trials. The cycle of CTSS exchange varied considerably; nine trials exchanged CTSS every 24 h [14,30,31,34,35,38,40,42,44], one every 72 h [37], one every 168 h [32], and one trial included groups that exchanged CTSS every 24 and 48 h [43], respectively. All trials except two excluded patients with pneumonia at the onset of the studies [32,41].…”

“…The cycle of CTSS exchange varied considerably; nine trials exchanged CTSS every 24 h [14,30,31,34,35,38,40,42,44], one every 72 h [37], one every 168 h [32], and one trial included groups that exchanged CTSS every 24 and 48 h [43], respectively. All trials except two excluded patients with pneumonia at the onset of the studies [32,41]. Fourteen trials set VAP as the primary outcome [14,[31][32][33][34][35][36][37][38][39][40][42][43][44], four of which a priori calculated the sample size [32][33][34]37].…”

“…All trials except two excluded patients with pneumonia at the onset of the studies [32,41]. Fourteen trials set VAP as the primary outcome [14,[31][32][33][34][35][36][37][38][39][40][42][43][44], four of which a priori calculated the sample size [32][33][34]37]. Twelve trials were reported in English, two in Chinese [43,44], one in Korean [37], and one in Arabic [42].…”