Evaluation of a closed-tracheal suction system

Carlon, Graziano C.; Fox, Serena J.; Ackerman, Nancy J.

doi:10.1097/00003246-198705000-00015

Cited by 51 publications

(30 citation statements)

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“…effectiveness was an issue that was raised early, 12 but in a recent, more elaborate study in adults suctioned up to 15 times per day, DePew et al 38 concluded that closed suction was less expensive. In our institution, five open system kits cost $10 and a multi-use catheter costs $15.…”

Section: Discussionmentioning

confidence: 99%

Comparison of a Closed (Trach Care MAC) With an Open Endotracheal Suction System in Small Premature Infants

2000

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OBJECTIVE:To determine whether ventilated, low birth weight infants treated with closed versus open tracheal suction in a neonatal intensive care unit (NICU) differ as to airway bacterial colonization, nosocomial pneumonia, bloodstream infection (BSI), incidence and severity of bronchopulmonary dysplasia (BPD), neonatal mortality, frequency of suction, reintubation, and nurse preference. STUDY DESIGN:A total of 175 low birth weight infants (Յ1250 gm) consecutively born (1997 to 1999), intubated, and ventilated in the delivery room were randomized on admission to the NICU to a closed (Trach Care MAC) or open suction group. Closed multi-use catheters were changed daily; open catheters were changed after every use. Two-pass endotracheal suctioning (both groups) was performed every 8 hours or as needed. Side-port connectors were not used; thus open suction required disconnection from ventilators. Tracheal aspirate cultures were obtained on admission and weekly thereafter. Nosocomial BSI (occurring after 48 hours of life) was documented by positive blood cultures. Radiographs taken before, during, and after tracheal aspirate cultures or BSIs were graded using a semiquantitative system for pneumonia and a modified score for BPD. Nurse preference regarding suction method was recorded. RESULTS:Of the original 175 patients, 10 (5 from each group) died and 32 others (16 from each group) were extubated at or before 7 days of life. The study population comprised 67 patients in the closed group and 66 in the open group who were ventilated longer than 1 week. Groups were not statistically different in terms of demographic and clinical characteristics, such as birth weight (837 vs 876 gm), ventilation (27 vs 26 days), and length of stay (49 vs 40 days). Airway colonization with Gram-positive cocci occurred in the majority of patients by 2 weeks of life, regardless of group. A total of 39% of infants in the closed group and 44% of infants in the open group became airway colonized with Gram-negative bacilli; differences were statistically significant. No Gram-negative bacilli species was more likely to be associated with either suction. Nosocomial pneumonia was diagnosed in five patients from each group. Nosocomial BSIs occurred in six closed suction infants and five open suction infants. A comparable number of infants in each group developed severe BPD and were discharged from the hospital on oxygen. A total of 28% of closed suction patients and 27% of open suction patients died. Infants in the closed versus open group were suctioned on average 4.4 and 4.1 times per day and were reintubated 9.7 and 8.6 times per 100 ventilator days, respectively. A total of 40 of 44 NICU nurses considered closed suction to be easier to use, less time-consuming, and better tolerated by the patient. CONCLUSIONS:Closed suction obviates the physiological disadvantage of ventilator disconnection without increasing the rate of bacterial airway colonization, frequency of endotracheal suction and reintubation, duration of mechanical ventilation, length...

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Section: Discussionmentioning

confidence: 99%

Comparison of a Closed (Trach Care MAC) With an Open Endotracheal Suction System in Small Premature Infants

2000

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“…In agreement with the "open lung concept", the closed system enables suctioning to be performed without disconnection of the patient or interrupting mechanical ventilation, to prevent lung collapse. Several studies during the last 15 years support the fact that the closed system, if used correctly, minimises side-effects and environmental contamination [32,33,38,[59][60][61][62][63][64] (see Table 3). However, there is a potential to create large negative pressures if the suction flow exceeds ventilation or secretions lining the inside surface of the tube creates a too high tube resistance, preventing adequate ventilation [65].…”

Section: Losed Suction Systemsmentioning

confidence: 99%

Regional lung derecruitment after endotracheal suction during volume- or pressure-controlled ventilation: a study using electric impedance tomography

et al. 2006

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“…The closed suction system was developed in the late 1980s and employs a multiple-use suction catheter that is attached to the ventilator circuit, with no need to disconnect it from the patient to perform suction 5 . The main objective of endotracheal suctioning is to remove secretions, preventing airway obstruction, atelectasis, and pulmonary infections.…”

Section: Introductionmentioning

confidence: 99%

Análise comparativa randomizada entre dois tipos de sistema de aspiração traqueal em recém-nascidos

Paula¹,

Ceccon²

2010

Rev. Assoc. Med. Bras.

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objectIve. To quantify and compare variations in oxygen saturation throughout the suctioning procedure (before, during, and after) using two endotracheal suction systems: open suction system (OSS) vs. closed suction system (CSS). Methods. A prospective randomized controlled study was carried out with 39 newborn infants of gestational age ≥ 34 weeks using pressure-limited, time-cycled, continuous-flow mechanical ventilators. The infants were classified into two groups according to ventilatory parameters: Group I was ventilated using positive end-expiratory pressure (PEEP) ≥ 5 cm H 2 O and mean airway pressure (MAP) ≥ 8 cm H 2 O; and Group II using PEEP < 5 cm H2O and MAP < 8 cm H 2 O. results. No statistically significant differences were observed when OSS and CSS were compared in both groups. There was a statistically significant improvement in post-procedure oxygen saturation in both groups. conclusIon. Both endotracheal suction systems can be used with no drawbacks of OSS in relation to CSS, provided the sample is similar to that of the present study.

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Evaluation of a closed-tracheal suction system

Cited by 51 publications

References 0 publications

Comparison of a Closed (Trach Care MAC) With an Open Endotracheal Suction System in Small Premature Infants

Comparison of a Closed (Trach Care MAC) With an Open Endotracheal Suction System in Small Premature Infants

Regional lung derecruitment after endotracheal suction during volume- or pressure-controlled ventilation: a study using electric impedance tomography

Análise comparativa randomizada entre dois tipos de sistema de aspiração traqueal em recém-nascidos

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