Effect of open and closed endotracheal suctioning on cross-transmission with Gram-negative bacteria: A prospective crossover study*

Abstract

Closed suction systems failed to reduce cross-transmission and acquisition rates of the most relevant Gram-negative bacteria in intensive care unit patients.

Changes in heart rate, mean arterial pressure, and oxygen saturation after open and closed endotracheal suctioning: A prospective observational study

“…Although OSS and CSS were dictated during 6-month study periods, nonadherence to the prescribed system occurred in 7% of the MV days, most often because of prone positioning (reason for using CSS during OSS) and of weaning (reason for using OSS during CSS) [13]. As a result, 3 CSS procedures were observed during OSS period, and 8 OSS procedures, during CSS, counting up to a total of 95 bedside observations during CSS and 105 during OSS procedures.…”

“…The latter was more effective in removing secretions than CSS in animal models and in vitro [29,30]. If true in vivo, we would have expected more procedures of ES with CSS, which was not observed (both mean and median, 6 times per day) [13].…”

“…The study was nested in a larger crossover trial in which, during periods of 6 months, either CSS or OSS was used for all mechanically ventilated patients to determine occurrence of cross-transmission with Gram-negative bacteria in both systems (described elsewhere) [13]. Four ICUs participated in the trial: 2 ICUs from a university hospital with 10 beds (4 single rooms and 6 on the ward) and 8 beds (1 single room and 7 on the ward) and two 8-bed units from a teaching hospital (all single rooms).…”

Strategies to Prevent Ventilator-Associated Pneumonia in Acute Care Hospitals: 2014 Update

“…ICUs found no difference between open versus closed systems in patient-to-patient transmissions of gramnegative pathogens 143. Different trials have reached different conclusions regarding cost 141. '…”

Protection From Ventilator-Associated Infections

“…Meta-analizlerde, VİP oranları, mekanik ventilasyon ve yoğun bakımda yatış süreleri ile mortalite oranları açısından açık veya kapalı endotrakeal aspirasyon sistemleri arasında fark olmadığı belirtilmiştir (57,58) . Benzer şekilde dört yoğun bakımdan hastaların alındığı bir çalışmada gram negatif patojenlerin hastadan hastaya bulaşmasında bu iki aspirasyon sistemi arasında fark olmadığı bulunmuştur (59) . Kapalı endotrakeal aspirasyon sistemi stratejisinin getirdiği ek maliyet konusunda farklı çalışmalarda farklı sonuçlar rapor edilmektedir (57,60) .…”