Comparison of the Pattern in Semi-Quantitative Sputum Cultures Based on Different Endotracheal Suction Techniques

Abstract

Background:The endotracheal suction was one of the critical requirements for severe neurosurgical patients in the prevention of the airway-obstruction, pneumonia, atelectasis, and so on. There were two types of suction methods, closed and open. In the literature, many reported the comparison of the two methods with variable factors, yet, it was still controversial. In this study, we compared the two types of endotracheal suction methods based on the pattern of the sputum cultivation, which was not discussed in the previous studies.Methods: In 2010, 85 patients who had intubation tube for more than 10 days were evaluated in this study. A total of 55 patients were managed with an open suction method, while the other 30 patients were managed with a closed suction method. All patients' sputum culture was reported semi-quantitatively, and had been classified into 3 different groups, according to the culture pattern. The control group was defined in which the bacterial count was not increased, whereas the non-control group was those with bacterial count increased. We investigated patients' age, gender, disease-type, suction techniques and the pattern of sputum cultivation.Results: The non-control group was 45.45% in the open suction group, while it was 16.67% in the closed suction group. On the other hand, more control group was observed in the closed suction group (36.67%), than in the open suction group (25.45%) (p < 0.05). There was no statistically significant difference in the analysis based on the pattern of sputum cultivation, age, gender, and disease-type.Conclusions: We suggest that the closed suction methods were more effective in the matiagement of endotracheal tube, according to the pattern of sputum culture.

A Closed-Suction Catheter with a Pressure Valve Can Reduce Tracheal Mucosal Injury in Intubated Patients

“…Closed suction systems may be more effective for the ICU environment where ICU bed density is too high. In fact, some Korean studies showed closed suction system outperforms open suctioning in reducing infections [9][10][11]. In this study, there were no differences between the experimental and control catheters with respect to the incidence of hypoxia, hemodynamics, infection and ICU length of stay probably because both were closed-suction catheters.…”

“…Closed suctioning, backed by continuous supply of oxygen and positive end-expiratory pressure, is said to provide physiological stability and reduce the risk of nosocomial infection by keeping ventilator circuit closed. [6][7][8][9][10][11][12] However, its efficacy in preventing infections is still debated. [13,14] Newly developed closed-suction catheter (AceTrachcare, AceMedical Co., Republic of Korea) has dial-type pressure valve, located on the suction port, enables physicians to vary the level of suction pressure depending on the amount of secretions ( Fig.…”

“…However, the total number of suctioning performed with the experimental catheter and the control catheter for 48 hours was not significantly different. We therefore postulate that suctioning efficiency of the two catheters was similar.Closed-suction catheter is widely used in the ICU due to favorable outcomes, including improved oxygenation, reduced hypoxia, positive end-expiratory pressure maintenance and subsequent decrease in atelectasis and decreased risk of nosocomial infection [6][7][8][9][10][11][12]. Closed suction systems may be more effective for the ICU environment where ICU bed density is too high.…”