Does open or closed endotracheal suction affect the incidence of ventilator associated pneumonia in the intensive care unit? A systematic review

Aryani, Denissa Faradita; Tanner, Judith

doi:10.1016/s1130-8621(18)30179-7

Cited by 11 publications

(7 citation statements)

References 49 publications

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“…For example, Jongerden et al [ 9 ] and Subirana et al [ 10 ] found no statistically significant differences between CSS and OSS (OR=1.02, 95% CI 0.84-1.25 and RR=1.02, 95% CI 0.84-1.23, respectively) [ 10 , 11 , 24 ]. The systematic review by Faradita Aryani and Tanner [ 15 ] included 435 prospective studies, concluding that none of the studies found differences regarding increased VAP or resultant mortality.…”

Section: Resultsmentioning

confidence: 99%

Closed Endotracheal Suction Systems for COVID-19: Rapid Review

Ramírez-Torres¹,

Rivera-Sanz²,

Sufrate-Sorzano³

et al. 2023

Interact J Med Res

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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.

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Section: Resultsmentioning

confidence: 99%

Closed Endotracheal Suction Systems for COVID-19: Rapid Review

Ramírez-Torres¹,

Rivera-Sanz²,

Sufrate-Sorzano³

et al. 2023

Interact J Med Res

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“…By close suction, suctioning performed didn't change every day and it is optimal for patients to need suction for a longer period because the close suction is safe to use until 5 days and has the advantage to reduce VAP. They performed the same with open suction needed to provide hyperoxygenation to reduce (20).…”

Section: Discussionmentioning

confidence: 99%

The Effect of Close Suction to Prevent Ventilator-Associated Pneumonia Based on the Sequence Organ Failure Assessment Score (Sofa) and Clinical Pulmonary Infection Score

Utami

Amir

et al. 2023

Kme

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The purpose of the study is to compare SOFA Score and CPIS by using close suction to prevent VAP. This is a quasi-experiment study without a control group. Close suction is used as an intervention. SOFA score and CIPS were used to evaluate VAP. The SOFA score assesses respiratory, platelet, liver, neurology, cardiovascular, and renal function. SOFA scores range from 0 to 24 and if the mean score ≥ 6 indicates the functioning organ is worse. CPIS evaluates body temperature, leucosis, sputum secretion, thorax photo, culture endotracheal secretion, and oxygen saturation. The CPIS score ranges from 0-12, more than 6 indicates the patient has VAP. This study included 20 ICU patients on ventilators. The collected data were analyzed using percentages, mean, and paired t-tests. The mean SOFA score before and after was 4.75 to 4.1 and CPIS 2.9 to 2.65 before and after providing close suction. The close suction is significant to prevent VAP (p-value < 0.00). Close suction is effective to prevent VAP in patients with ventilator mechanics, and VAP can be measured using the SOFA score and CPIS. Keywords: close suction, CPIS, mechanic ventilator, ventilator-associated pneumonia, SOFA

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“…Jongerden et al 63 , en un metaanálisis de ocho estudios aleatorizados publicados en 2007, no encontraron diferencias en la incidencia de NAVM utilizando un sistema cerrado o uno abierto (RR [IC 95%]: 0,96 [0,76-1,21]), al igual que Aryani 64 , en una revisión de 2018, o Ardehali et al 65 , en un ECA de 2020.…”

Section: Medidas Mecánicas ( Tabla 3 )unclassified