Effect of incomplete withdrawal of a closed-suction catheter on airway resistance

Ruan, Sheng‐Yuan; Lin, Feng-Ching; Huang, Chun-Ta; Ku, Shih-Chi; Wu, Huey-Dong

doi:10.1007/s00134-015-3886-y

Cited by 3 publications

(5 citation statements)

References 3 publications

(3 reference statements)

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“…Despite the benefits, there are some inevitable problems with the closed sputum suction system widely used now. For the closed suction tube with an external sheath, after a number of suctioning procedures, the soft catheter sheath may twist, leading to the shortening of its length, making the sputum aspiration tube unable to withdraw in time and thus increasing airway resistance [ 9 ]. Similarly, Bhattacharjee's study found that during sputum aspiration care for COVID-19 patients, incompletely withdrawn of the closed suction catheter and the rotating access knob not be closed may occurred.…”

Section: Discussionmentioning

confidence: 99%

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Application of a New Type of Protective Sputum Suction Device in Clinic against Cross-Infection between Medical Staff and Patients

Lu,

Wu,

Jin

et al. 2023

Critical Care Research and Practice

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Objective. To explore the clinical application of a new type of protective sputum suction device (PSSD) in patients with tracheotomy or tracheal intubation and to evaluate the protective effect of PSSD against cross-infection between medical staffs and patients. Methods. A novel PSSD was designed which can assist closed sputum suction operation without disconnecting the ventilator. 32 patients with tracheotomy were included to study the protective effect and safety of this device. Patients’ vital signs including heart rate, respiratory rate, mean arterial pressure, and blood oxygen saturation were recorded to compare the influence of open suction and closed suction (performed with this novel device). To verify the antisplash effect of this device on airway secretions, bacterial samples were collected from the hands of the suction operators and the environment near the endotracheal tube orifice before and after the two suction processes. In addition, the satisfaction of the two suction methods was compared through the questionnaire of suction staff. Finally, with the assistance of this device, an attempt was made to complete the bronchoscopy without weaning of ventilator. Results. Compared with open sputum suction, closed sputum suction has a smaller decrease in patients’ blood oxygen saturation (P<0.05), and no significant differences in other vital signs. Compared with open sputum suction, bacteria from the hands of suction staffs and the surrounding environment of the endotracheal tube were barely detected in closed suction. A questionnaire survey of sputum suction nurses suggested that the satisfaction with use and protective effect of the closed suction were better than open suction. In addition, bronchoscopy can be successfully completed with the assistance of this device, which is not possible for other breathing tubes. Conclusion. This closed sputum suction device has little effect on the oxygen saturation of patients but has excellent protective effects for medical staff against cross-infection. It has a unique advantage that can assist in completing the fiberoptic bronchoscopy with continuous ventilator-assisted breathing.

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Section: Discussionmentioning

confidence: 99%

“…However, some completely closed suction tubes have some unavoidable problems, such as incomplete withdrawal of the suction catheter due to catheter sheath twisting [ 9 ]. In addition, for patients with endotracheal intubation or tracheotomy, fibroptic bronchoscopy is sometimes inevitable.…”

Section: Introductionmentioning

confidence: 99%

Application of a New Type of Protective Sputum Suction Device in Clinic against Cross-Infection between Medical Staff and Patients

Lu,

Wu,

Jin

et al. 2023

Critical Care Research and Practice

View full text Add to dashboard Cite

show abstract

“…In addition, after many times of sputum suction by the closed sputum suction device, the soft catheter sheath will be twisted, which will shorten its length. The shortened catheter sheath prevents the catheter from completely withdrawing from the trachea, thus increasing the airway resistance and leading to some ventilator-related complications 10 . Moreover, although the closed sputum suction device tends to reduce the occurrence of VAP, the cost is high, which greatly increases the economic burden of patients 11 .…”

Section: Discussionmentioning

confidence: 99%

“…The adapter includes three nozzles: upper nozzle, lower nozzle and side nozzle. The lower ori ce (1) of the adapter is connected with the tracheal intubation of the patient, and the side ori ce (10) is connected with the arti cial nose and the ventilator. An isolation sleeve (3) is inserted into the upper nozzle, and the bottom of the isolation sleeve is provided with cross-cross grooves (11) capable of penetrating sputum suction tubes, the grooves and grooves are respectively located on the edges (6), and the con uence of adjacent edges protrudes upward along the midline of the edges to form two pressure-bearing inclined planes (5) (Fig.…”

Section: The Structure Of Medical Protective Sputum Suction Respiratory Circuitmentioning

confidence: 99%

Development and Application of a New Type of Medical Protective Sputum Suction Respiratory Circuit

Wu¹,

Lu²,

Jin³

et al. 2022

Preprint

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Background: At present, there are few breathing circuits that can protect health care workers. Here, we have developed a new disposable medical protective sputum suction breathing circuit.Methods：The main components of the structure of the novel medical protective breathing circuit are adapter, isolation sleeve, stop sleeve, sealing cover and sealing ring. An isolation sleeve is inserted into the conversion joint. The isolation sleeve inner sleeve has a stop sleeve with an inverted round table structure. The upper nozzle of the adapter is provided with a sealing ring tightly combined with the lower outer edge of the isolation sleeve, and a sealing cover is provided on the sealing ring.Results: The device is easy to operate and can prevent the pollution caused by sputum splashing when sucking sputum.Conclusion: The medical protective sputum suction and breathing circuit is simple in structure, easy to use, and can effectively protect medical staff.

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“…CSS have been shown to increase airway resistance (R) in cases of incomplete catheter withdrawal, a complication specific to CSS that often evades detection. 31 Therefore, to resolve whether OSS and CSS differentially affect cardiopulmonary physiology differentially affect, this study used a crossover design with 66 subjects to test the hypothesis that CSS presents better pulmonary and cardiovascular parameters after suction than OSS. To compare how these techniques affect pulmonary mechanics and hemodynamics, we assessed cardiopulmonary physiology before and after endotracheal suction in mechanically ventilated subjects in an ICU.…”

Section: Introductionmentioning

confidence: 99%

Open and Closed Endotracheal Suction Systems Divergently Affect Pulmonary Function in Mechanically Ventilated Subjects

et al. 2021

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BACKGROUND: In mechanically ventilated subjects, intra-tracheal secretions can be aspirated with either open suction systems (OSS) or closed suction systems (CSS). In contrast to CSS, conventional OSS require temporarily disconnecting the patient from the ventilator, which briefly diminishes PEEP and oxygen supply. On the other hand, CSS are more expensive and less effective at aspirating secretions. Thus, it was hypothesized that the 2 procedures differentially affect pulmonary and cardiovascular parameters after suction. METHODS: Subjects in the ICU (N 5 66) were quasi-randomized for initial treatment with OSS or CSS in a crossover design. To compare the potential for these suction systems to compromise cardiorespiratory stability, changes in cardiopulmonary physiology were assessed from before to just after use of each suction system (three 10-s aspirations). RESULTS: For most pulmonary and cardiovascular parameters (ie, peak inspiratory pressure, airway resistance, pressure plateau, heart rate, and arterial pressures), the effects of aspiration inversely correlated with baseline values for that parameter, with a similar regression slope between suction systems. However, when controlling for baseline values, OSS caused significantly greater increases in airway resistance and peak inspiratory pressure (P < .001 and < .01 vs CSS, respectively). CONCLUSIONS: Elevated airway resistance prior to endotracheal suction may justify use of a CSS and contraindicate a conventional OSS in mechanically ventilated subjects. Adoption of this approach into clinical guidelines may prevent suction-induced pulmonary injury in subjects, especially for those with underlying diseases involving increased airway resistance or increased alveolar pressure. (ClinicalTrials.gov registration: NCT03256214.

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Effect of incomplete withdrawal of a closed-suction catheter on airway resistance

Cited by 3 publications

References 3 publications

Application of a New Type of Protective Sputum Suction Device in Clinic against Cross-Infection between Medical Staff and Patients

Application of a New Type of Protective Sputum Suction Device in Clinic against Cross-Infection between Medical Staff and Patients

Development and Application of a New Type of Medical Protective Sputum Suction Respiratory Circuit

Open and Closed Endotracheal Suction Systems Divergently Affect Pulmonary Function in Mechanically Ventilated Subjects

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