Effectiveness and side effects of closed and open suctioning: An experimental evaluation

Intensive Care Medicine

Volumn 30, Issue 8, 2004, Pages 1630-1637

  Lindgren, Sophie ^a   Almgren, Birgitta ^b   Högman, Marieann ^b   Lethvall, Sven ^a   Houltz, Erik ^a   Lundin, Stefan ^a   Stenqvist, Ola ^a  

^a SAHLGRENSKA UNIVERSITY HOSPITAL   (Sweden)

^b UPPSALA UNIVERSITY   (Sweden)

Author keywords

Acute respiratory distress syndrome (ARDS); Airway pressure; Closed system suctioning; Gas exchange; Mechanical ventilation; Suctioning

Indexed keywords

ANIMAL EXPERIMENT; ARTICLE; CONTROLLED STUDY; GAS EXCHANGE; INTERMETHOD COMPARISON; LUNG ASPIRATION; LUNG HEMODYNAMICS; LUNG INJURY; LUNG LAVAGE; LUNG PRESSURE; LUNG VENTILATION; NONHUMAN; OXYGEN SATURATION; POSITIVE END EXPIRATORY PRESSURE; SUCTION; SUCTION DRAINAGE; TRACHEA PRESSURE; UNIVERSITY HOSPITAL; VENTILATOR;

EID: 4143140777     PISSN: 03424642     EISSN: None     Source Type: Journal    
DOI: 10.1007/s00134-003-2153-9     Document Type: Article

References (38)

1. Ritz R, Scott LR, Coyle MB, Pierson DJ (1986) Contamination of a multiple-use suction catheter in a closed-circuit system compared to contamination of a disposable, single-use suction catheter. Respir Care 31:1086-1091
2. Deppe SA, Kelly JW, Thoi LL, Chudy JH, Longfield RN, Ducey JP, Truwit CL, Antopol MR (1990) Incidence of colonization, nosocomial pneumonia and mortality in critically ill patients using a Trach Care closed-suction system versus an open-suction system: prospective, randomized study. Crit Care Med 18:1389-1393
3. Cobley M, Atkins M, Jones PL (1991) Environmental contamination during tracheal suction. A comparison of disposable conventional catheters with a multiple-use closed system device. Anaesthesia 46:957-961
4. Brown SE, Stansbury DW, Merrill EJ, Linden GS, Light RW (1983) Prevention of suctioning-related arterial oxygen desaturation. Comparison of off-ventilator and on-ventilator suctioning. Chest 83:621-627
5. Craig CK, Benson MS, Pierson DJ (1984) Prevention of arterial oxygen desaturation during closed-airway endotracheal suction: effect of ventilator mode. Respir Care 29:1013-1018
6. Carlon GC, Fox SJ, Ackerman NJ (1987) Evaluation of a closed-tracheal suction system. Crit Care Med 15:522-525
7. Clark AP, Winslow EH, Tyler DO, White KM (1990) Effects of endotracheal suctioning on mixed venous oxygen saturation and HR in critically ill adults. Heart Lung 19:552-557
8. Harshbarger SA, Hoffman LA, Zullo TG, Pinsky MR (1992) Effects of a closed tracheal suction system on ventilatory and cardiovascular parameters. Am J Crit Care 1:57-61
9. Johnson KL, Kearney PA, Johnson SB, Niblett JB, MacMillan NL, McClain RE (1994) Closed versus open endotracheal suctioning: costs and physiologic consequences. Crit Care Med 22:658-666
10. Weitl J, Bettstetter H (1994) Indication for use of the closed suction system in respiratory therapy with high levels of positive end-expiratory pressure. Anaesthesist 43:359-363
11. Lachmann B (1992) Open up the lung and keep the lung open. Intensive Care Med 18:319-321
12. Bernard GR, Artigas A, Brigham KL, Carlet J, Falke K, Hudson L, Lamy M, LeGall JR, Morris A, Spragg R (1994) Report of the American-European consensus conference on ARDS: definitions, mechanisms, relevant outcomes and clinical trial coordination. The Consensus Committee. Intensive Care Med 20:225-232
13. Cereda M, Villa F, Colombo E, Greco G, Nacoti M, Pesenti A (2001) Closed system endotracheal suctioning maintains lung volume during volume-controlled mechanical ventilation. Intensive Care Med 27:648-654
14. Lee CK, Ng KS, Tan SG, Ang R (2001) Effect of different endotracheal suctioning systems on cardiorespiratory parameters of ventilated patients. Ann Acad Med Singapore 30:239-244
15. Baun MM, Stone KS, Rogge JA (2002) Endotracheal suctioning: open versus closed with and without positive end-expiratory pressure. Crit Care Nurs Q 25:13-26
16. Maggiore SM, Lellouche F, Pigeot J, Taille S, Deye N, Durrmeyer X, Richard JC, Mancebo J, Lemaire F, Brochard L (2003) Prevention of endotracheal suctioning-induced alveolar derecruitment in acute lung injury. Am J Respir Crit Care Med 167:1215-1224
17. Noll ML, Hix CD, Scott G (1990) Closed tracheal suction systems: effectiveness and nursing implications. AACN Clin Issues Crit Care Nurs 1:318-328
18. Witmer M, Hess D, Simmons M (1991) An evaluation of the effectiveness of secretion removal with the Ballard closed-circuit suction catheter. Respir Care 36:844-848
19. Combes P, Fauvage B, Oleyer C (2000) Nosocomial pneumonia in mechanically ventilated patients, a prospective randomised evaluation of the Stericath closed suctioning system. Intensive Care Med 26:878-882
20. Taggart JA, Dorinsky NL, Sheahan JS (1988) Airway pressures during closed system suctioning. Heart Lung 17:536-542
21. Stenqvist O, Lindgren S, Karason S, Sondergaard S, Lundin S (2001) Warning! Suctioning. A lung model evaluation of closed suctioning systems. Acta Anaesthesiol Scand 45:167-172
22. Brooks D, Solway S, Graham I, Downes L, Carter M (1999) A survey of suctioning practices among physical therapists, respiratory therapists and nurses. Can Respir J 6:513-520
23. American Association for Respiratory Care (1993) AARC clinical practice guideline. Endotracheal suctioning of mechanically ventilated adults and children with artificial airways. Respir Care 38:500-504
24. Burton GG, Hodgkin JE, Ward JJ (1997) Respiratory care modalities and equipment. In: Hess DR (ed) Respiratory care: a guide to clinical practice, Lippincott, Philadelphia, pp 600-609
25. Pilbeam SP (1998) Airways, circuit changes, medications, positioning and other patient issues. In: Pilbeam SP (ed) Mechanical ventilation: physiological and clinical applications. Mosby, St Louis pp 292-293
26. Brooks D, Anderson CM, Carter MA, Downes LA, Keenan SP, Kelsey CJ, Lacy JB (2001) Clinical practice guidelines for suctioning the airway of the intubated and nonintubated patient. Can Respir J 8:163-181
27. National Research Council (U.S.), Commission on Life Sciences. Institute of Laboratory Animal Resources (1996) Guide for the care and use of laboratory animals. National Academy Press. ISBN 0309053773
28. Nunes S, Takala J (2000) Evaluation of a new module in the continuous monitoring of respiratory mechanics. Intensive Care Med 26:670-678
29. Karason S, Sondergaard S, Lundin S, Wiklund J, Stenqvist O (2001) Direct tracheal airway pressure measurements are essential for safe and accurate dynamic monitoring of respiratory mechanics. A laboratory study. Acta Anaesthesiol Scand 45:173-179
30. Sondergaard S, Karason S, Wiklund J, Lundin S, Stenqvist O (2003) Alveolar pressure monitoring: an evaluation in a lung model and in patients with acute lung injury. Intensive Care Med 29:955-962
31. Lumb A (2000) Oxygen. In: Lumb A (ed), Nunn's applied respiratory physiology. Butterworth-Heinemann, Reed Educational and Professional Publishing, Oxford, pp 265-266, 294-297
32. Lachmann B, Robertson B, Vogel J (1980) In vivo lung lavage as an experimental model of the respiratory distress syndrome. Acta Anaesthesiol Scand 24:231-236
33. Tabachnick BG, Fidell LS (1989) Profile analysis of repeated measures. In: Tabachnick BG (ed), Using multivariate statistics. Harper Collins, New York, pp 437-505
34. Steuer JD, Stone KS, Nickel J, Steinfeld Y (2000) Methodologic issues associated with secretion weight as a dependent variable in research using closed-system suction catheters. Nurs Res 49:295-299
35. Brochard L, Mion G, Isabey D, Bertrand C, Messadi AA, Mancebo J, Boussignac G, Vasile N, Lemaire F, Harf A (1991) Constant-flow insufflation prevents arterial oxygen desaturation during endotracheal suctioning. Am Rev Respir Dis 144:395-400
36. Dyhr T, Bonde J, Larsson A (2003) Lung recruitment manoeuvres are effective in regaining lung volume and oxygenation after open endotracheal suctioning in acute respiratory distress syndrome. Crit Care 7:55-62
37. Cook D, De Jonghe B, Brochard L, Brun-Buisson C (1998) Influence of airway management on ventilator-associated pneumonia: evidence from randomized trials. JAMA 279:781-787
38. Maggiore SM, Iacobone E, Zito G, Conti C, Antonelli M, Proietti R (2002) Closed versus open suctioning techniques. Minerva Anestesiol 68:360-364