Closed tracheal suction systems versus open tracheal suction systems for mechanically ventilated adult patients

Cochrane Database of Systematic Reviews

Volumn , Issue 4, 2007, Pages

  Subirana, M ^b   Solà, Ivan ^a   Benito, S ^b  

^a HOSPITAL DE LA SANTA CREU I SANT PAU   (Spain)

^b NONE

Author keywords

Adult; Humans; Pneumonia, ventilator associated *etiology ; Randomized controlled trials as topic; Respiration, artificial adverse effects ; Respiratory therapy methods ; Suction *adverse effects; methods

Indexed keywords

ARTIFICIAL VENTILATION; BACTERIAL COLONIZATION; CATHETERIZATION; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; ENDOTRACHEAL TUBE; HEALTH CARE COST; HEART HEMODYNAMICS; HUMAN; HYPEROXIA; INTENSIVE CARE UNIT; LENGTH OF STAY; MORTALITY; RANDOMIZED CONTROLLED TRIAL; REVIEW; SUCTION DRAINAGE; TRACHEA SURGERY; VENTILATOR ASSOCIATED PNEUMONIA;

EID: 44949151126     PISSN: 1469493X     EISSN: None     Source Type: Journal    
DOI: 10.1002/14651858.CD004581.pub2     Document Type: Review

References (76)

1. Adams 1997 {published data only} *Adams DH, Hughes M, Elliott TS. Microbial colonization of closed-system suction catheters used in liver transplant patients. Intensive & Critical Care Nursing : the official journal of the British Association of Critical Care Nurses 1997;13(2):72-6. [MEDLINE: 9180492].
2. Cereda 2001 {published data only} *Cereda M, Villa F, Colombo E, Greco G, Nacoti M, Pesenti A. Closed system endotracheal suctioning maintains lung volume during volume-controlled mechanical ventilation. Intensive Care Medicine 2001;27(4):648-54. [MEDLINE: 11398690].
3. Combes 2000 {published data only} *Combes P, Fauvage B, Oleyer C. Nosocomial pneumonia in mechanically ventilated patients, a prospective randomised evaluation of the Stericath closed suctioning system. Intensive Care Medicine 2000;26(7):878-82. [MEDLINE: 10990101].
4. Conrad 1989 {published data only} *Conrad SA, George RB, Romero MD, Owens MW. Comparison of nosocomial pneumonia rates in closed and open tracheal suction systems [abstract]. Chest 1989;96:Suppl:184.
5. Deppe 1990 {published data only} *Deppe SA, Kelly JW, Thoi LL, Chudy JH, Longfield RN, Ducey JP, et al.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. Critical Care Medicine 1990;18(12):1389-93. [MEDLINE: 2245613].
6. Gallagher 1994 {published data only} *Gallagher J, Campbell D, Morris A, McArthur C, Judson J. A closed multi-use suction system does not protect individual patients against cross-colonization with endemic Acinetobacter calcoaceticus in an Intensive Care Unit. A prospective randomised study. Department of Critical Care Medicine, Auckland Hospital, Auckland New Zealand 1994.
7. Gallagher J, Campbell D, Morris A, McArthur C, Judson J. A closed multi-use suction system does not protect intubated patients from cross-colonization with endemic Acinetobacter calcoaceticus in the ICU [abstract]. Anaesthesia and Intensive Care 1996;24(2):274.
8. Johnson 1994 {published data only} *Johnson KL, Kearney PA, Johnson SB, Niblett JB, MacMillan NL, McClain RE. Closed versus open endotracheal suctioning: costs and physiologic consequences. Critical Care Medicine 1994;22(4):658-66. [MEDLINE: 8143475].
9. Lee 2001 {published data only} *Lee CK, Ng KS, Tan SG, Ang R. Effect of different endotracheal suctioning systems on cardiorespiratory parameters of ventilated patients. Annals of the Academy of Medicine, Singapore 2001;30(3):239-44. [MEDLINE: 11455735].
10. Lorente 2005 {published data only} *Lorente L, Lecuona M, Martin MM, Garcia C, Mora ML, Sierra A. Ventilator-associated pneumonia using a closed versus an open tracheal suction system. Critical Care Medicine 2005;33(1):115-9. [MEDLINE: 15644657].
11. Lorente 2006 {published data only} *Lorente L, Lecuona M, Jimenez A, Mora ML, Sierra A. Tracheal suction by closed system without daily change versus open system. Intensive Care Medicine 2006;32(4):538-44. [MEDLINE: 16511633].
12. Rabitsch 2004 {published data only} *Rabitsch W, Kostler WJ, Fiebiger W, Dielacher C, Losert H, Sherif C, et al.Closed suctioning system reduces cross-contamination between bronchial system and gastric juices. Anesthesia and Analgesia 2004;99(3):886-92. [MEDLINE: 15333426].
13. Topeli 2004 {published data only} *Topeli A, Harmanci A, Cetinkaya Y, Akdeniz S, Unal S. Comparison of the effect of closed versus open endotracheal suction systems on the development of ventilator-associated pneumonia. Journal of Hospital Infection 2004;58(1):14-9. [MEDLINE: 15350708].
14. Welte 1997 {published data only} *Welte T, Ziesing S, Schulte S, Wagner TOF. Incidence of ventilator associated pneumonia inmechanically ventilated patients: a comparison of closed versus open endotrachela suctioning [abstract]. European Respiratory Journal 1997;10 Suppl:(25):319.
15. Witmer 1991 {published data only} Witmer MT, Hess D, Simmons M. An evaluation of the effectiveness of secretion removal with a closed-circuit suction catheter [abstract]. Respiratory Care 1990;35(11):1117-8.
16. *Witmer MT, Hess D, Simmons M. An evaluation of the effectiveness of secretion removal with the ballard closed-circuit suction catheter. Respiratory Care 1991;36:844-8.
17. Zeitoun 2003 {published data only} *Zeitoun SS, de Barros AL, Diccini S. A prospective, randomized study of ventilator-associated pneumonia in patients using a closed vs open suction system. Journal of Clinical Nursing 2003;12(4):484-9. [MEDLINE: 12790861].
18. Zeitoun SS, de Barros AL, Diccini S, Juliano Y. [Incidence of ventilator-associated pneumonia in patients using open-suction systems and closed-suction systems: a prospective study - preliminary data]. Revista Latino-Americana de Enfermagem 2001;9(1):46-52. [MEDLINE: 12041052].
19. Zielmann 1992 {published data only} *Zielmann S, Grote R, Sydow M, Radke J, Burchardi H. [Endotracheal suctioning using a 24-hour continuous system. Can costs and waste products be reduced?]. Anaesthesist 1992;41(8):494-8. [MEDLINE: 1524162].
20. Almgren 2004 Almgren B, Wickerts CJ, Heinonen E, Hogman M. Side effects of endotracheal suction in pressure- and volume-controlled ventilation. Chest 2004;125(3):1077-80. [MEDLINE: 15006972].
21. Baker 1989 Baker T, Taylor M, Wilson M, Rish J, Brazeal S. Evaluation of a closed system endotracheal suction catheter [abstract]. American Journal of Infection Control 1989;17:97.
22. Baun 2002 Baun MM, Stone KS, Rogge JA. Endotracheal suctioning: open versus closed with and without positive end-expiratory pressure. Critical Care Nursing Quarterly 2002;25(2):13-26. [MEDLINE: 12211333].
23. Brown 1983 Brown SE, Stansbury DW, Merrill EJ, Linden GS, Light RW. Prevention of suctioning-related arterial oxygen desaturation. Comparison of off-ventilator and on-ventilator suctioning. Chest 1983;83(4): 621-7. [MEDLINE: 6831950].
24. Carlon 1987 Carlon GC, Fox SJ, Ackerman NJ. Evaluation of a closed-tracheal suction system. Critical Care Medicine 1987;15(5):522-5. [MEDLINE: 3552445].
25. Clark 1990 Clark AP, Winslow EH, Tyler DO, White KM. Effects of endotracheal suctioning on mixed venous oxygen saturation and heart rate in critically ill adults. Heart Lung 1990;19(5 Pt2):552-7. [MEDLINE: 2211166].
26. Cobley 1991 Cobley M, Atkins M, Jones PL. Environmental contamination during tracheal suction. A comparison of disposable conventional catheters with a multiple-use closed system device. Anaesthesia 1991;46(11):957-61. [MEDLINE: 1750600].
27. Craig 1984 Craig KC, Benson MS, Pierson DJ. Prevention of arterial oxygen desaturation during closed-airway endotracheal suction: effect of ventilator mode. Respiratory Care 1984;29:1013-8.
28. DePew 1994 DePew CL, Moseley MJ, Clark EG, Morales CC. Open vs closed-system endotracheal suctioning: a cost comparison. Critical Care Nurse 1994;14(1):94-100. [MEDLINE: 8194331].
29. Eckert 1998 Eckert P, Blanc D, Francioli P, Schaller MD, Feihl F. Microbiological and physiological evaluation of two closed tracheal suction systems [abstract]. American Journal of Respiratory and Critical Care Medicine 1998;157(3):Suppl: A687.
30. Fernández 2004 Fernandez MD, Piacentini E, Blanch L, Fernandez R. Changes in lung volume with three systems of endotracheal suctioning with and without pre-oxygenation in patients withmild-to-moderate lung failure. Intensive Care Medicine 2004;30(12):2210-5. [MEDLINE: 15480564].
31. Freytag 2003 Freytag CC, Thies FL, Konig W, Welte T. Prolonged application of closed in-line suction catheters increases microbial colonization of the lower respiratory tract and bacterial growth on catheter surface. Infection 2003;31(1):31-7. [MEDLINE: 12590330].
32. Gertsmann 1995 Gertsmann G, Cooper L, Haskill R, Lassen G. Open disconnect versus closed in-line suctioning during HFOV [abstract]. Respiratory Care 1995;40(11):1201.
33. Gu 2005 Gu Q, Ge M, Dong DJ. [Effects of lung recruitment maneuver on oxygenation and hemodynamics after open endotracheal suctioning in acute respiratory distress syndrome]. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue 2005;17(8):484-6. [MEDLINE: 16105428].
34. Hardie 1989 Hardie DK, Kirchoff KT. A comparison of the open versus closed system suctioning [abstract]. Heart Lung 1989;18:305.
35. Harshbarger 1992 Harshbarger SA, Hoffman LA, Zullo TG, Pinsky MR. Effects of a closed tracheal suction system on ventilatory and cardiovascular parameters. American Journal of Critical Care 1992;1(3):57-61. [MEDLINE: 1307908].
36. Hopkins 1990 Hopkins M, Mahlmeister M, Koo P, Cohen N. The effect of closed vs open endotracheal suctioning on PaO2 in ventilated patients [abstract]. Heart Lung 1990;19:308.
37. Kollef 1997 Kollef MH, Prentice D, Shapiro SD, Fraser VJ, Silver P, Trovillion E, et al.Mechanical ventilation with or without daily changes of in-line suction catheters. American Journal of Respiratory and Critical Care Medicine 1997;156(2 Pt 1):466-72. [MEDLINE: 9279225].
38. Lindgren 2004 Lindgren S, Almgren B, Hogman M, Lethvall S, Houltz E, Lundin S, et al.Effectiveness and side effects of closed and open suctioning: an experimental evaluation. Intensive Care Medicine 2004;30(8): 1630-7. [MEDLINE: 14985963].
39. Maggiore 2002 Maggiore SM, Iacobone E, Zito G, Conti C, Antonelli M, Proietti R. Closed versus open suctioning techniques. Minerva Anestesiologica 2002;68(5):360-4. [MEDLINE: 12029246].
40. Mattar 1992 Mattar JA, Sproesser AM, Gomes MA. A comparative study of oxygen transport between open and closed methods of tracheal suctioning. Intensive and Critical Care Digest 1992;11(3):57-88.
41. O'Dell-Batalla 2000 O'Dell-Batalla IR, Blanco Limpin ME, De Guia T. A randomised crossover trial between cath-guide closed system suctioning and conventional open system in the respiratory airway care of postoperative patients in the recovery room of the Philippine Heart Center [abstract]. The European Respiratory Journal 2000;16. Suppl(31):427.
42. Prentice 1994 Prentice D, Weilitz PB, Fraser VJ. A prospective randomized trial comparing outcomes of a closed versus open suctioning system [abstract]. Critical Care Medicine 1994;22(1):A92.
43. Ritz 1986 Ritz R, Scott LR, Coyle MB, Pierson DJ. Contamination of a multiple-use suction catheter in a closed-circuit system compared to contamination of a disposable, single-use suction catheter. Respiratory Care 1986;31(11):1086-91. [MEDLINE: 10315714].
44. Schön 2002 Schön R. [Closed versus open endobronchial suctioning in mechanically ventilated intensive care patients]. Journal für Anasthesie und Intensivbehandlung 2002;9(2):139-42.
45. Stenqvist 2001 Stenqvist O, Lindgren S, Karason S, Sondergaard S, Lundin S. Warning! Suctioning. A lung model evaluation of closed suctioning systems. Acta Anaesthesiologica Scandinavica 2001;45(2):161-72. [MEDLINE: 11167161].
46. Valderas 2004 Valderas Castilla D, Bravo Páramo C, Torres González JI, Corniero Pico A, Ambit Lemus R, López Almorox E, et al.Repercussion on respiratory and hemodynamic parameters with a closed system of aspiration of secretion [Repercusión sobre parámetros respiratorios y hemodinámicos con un sistema cerrado de aspiración de secreciones]. Enfermería Intensiva 2004;15(1):3-10. [MEDLINE: 14998444].
47. Vonberg 2006 Vonberg RP, Eckmanns T, Welte T, Gastmeier P. Impact of the suctioning system (open vs. closed) on the incidence of ventilation-associated pneumonia: meta-analysis of randomized controlled trials. Intensive Care Medicine 2006;32(9):1329-35. [MEDLINE: 16788806].
48. Weitl 1994 Weitl J, Bettstetter H. [Indications for the use of closed endotracheal suction. Artificial respiration with high positive end-expiratory pressure]. Anaesthesist 1994;43(6):359-63. [MEDLINE: 8048770].
49. Wu 1993 *Wu RS, Tao CW, Wong SY, Tan PP. Use of a closed-airway suctioning system during anesthesia. Ma Zui Xue Za Zhi (Anaesthesiologica Sinica) 1993;31(1):9-14.
50. Çelik 2000 Çelik SS, Elbas NO. The standard of suction for patients undergoing endotracheal intubation. Intensive and Critical Care Nursing 2000;16(3):191-8. [MEDLINE: 10859628].
51. Bourgault 2006 Bourgault AM, Brown CA, Hains SM, Parlow JL. Effects of endotracheal tube suctioning on arterial oxygen tension and heart rate variability. Biological Research for Nursing 2006;7(4):268- 78. [MEDLINE: 16581897].
52. Lasocki 2006 Lasocki S, Lu Q, Sartorius A, Fouillat D, Remerand F, Rouby JJ. Open and closed-circuit endotracheal suctioning in acute lung injury: efficiency and effects on gas exchange. Anesthesiology 2006;104(1):39-47. [MEDLINE: 16394688].
53. Lee 2004 Lee ES, Kim SH, Kim JS. Effects of a closed endotracheal suction system on oxygen saturation, ventilator-associated pneumonia, and nursing efficacy. Taehan Kanho Hakhoe Chi 2004;34(7):1315-25. [MEDLINE: 15687772].
54. Chan 2005 Chan AW, Altman DG. Epidemiology and reporting of randomised trials published in PubMed journals. Lancet 2005;365:1159-62. [MEDLINE: 15794971].
55. Chester 2002 Chester J, Fagon JY. Ventilator-associated pneumonia. American Journal of Respiratory and Critical Care Medicine 2002;165:867-903.
56. Collard 2003 Collard HR, Saint S, Matthay MA. Prevention of ventilator-associated pneumonia: an evidence-based systematic review. Annals of Internal Medicine 2003;138(6):494-501. [MEDLINE: 12639084].
57. Cracknell 2006 Cracknell J, Møller A, Pedersen T. Cochrane Anaesthesia Review Group. In: The Cochrane Library, Issue 2, 2006.
58. Downs 1998 Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. Journal of Epidemiology and Community Health 1998;56:377-84. [MEDLINE: 9764259].
59. Grap 1996 Grap MJ, Glass C, Corley M, Parks T. Endotracheal suctioning: ventilator vs manual delivery of hyperoxygenation breaths. American Journal of Critical Care 1996;5(3):192-7. [MEDLINE: 8722922].
60. Higgins 2003 Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency inmeta-analyses. BMJ 2003;327(7414):557- 60. [MEDLINE: 12958120].
61. Higgins 2005 Higgins JPT, Green S, editors.Cochrane Handbook for Systematic Reviews of Interventions 4.2.5 [updated May 2005]. In: The Cochrane Library, Issue 3, 2005. Chichester, UK: John Wiley & Sons, Ltd.
62. Hixson 1998 Hixson S, Sole ML, King T. Nursing strategies to prevent ventilator-associated pneumonia. AACN Clinical Issues 1998;9(1):76-90. [MEDLINE: 9505574].
63. Jüni 2001 Jüni P, Altman DG, Egger M. Assessing the quality of controlled clinical trials. BMJ 2001;323:42-6. [MEDLINE: 11440947].
64. Kollef 1999 Kollef MH. The prevention of ventilator-associated pneumonia. New England Journal of Medicine 1999;340(8):627-34. [MEDLINE: 10029648].
65. McKelvie 1998 McKelvie S. Endotracheal suctioning. Nursing in Critical Care 1998;3(5):244-8. [MEDLINE: 9887773].
66. McQuillan 1992 McQuillan, P. Introduction of a closed circuit suction system with a multi-use suction catheter. Stobhill General Hospital (Glasgow) 1992.
67. Moher 2001 Moher D, Schulz KF, Altman D. The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomised trials. Lancet 2001;357:1191-4. [MEDLINE: 11323066].
68. Naigow 1977 Naigow D, Powaser MM. The effect of different endotracheal suction procedures on arterial blood gases in a controlled experimental model. Heart & Lung: the journal of critical care 1977;6(5):808-16. [MEDLINE: 19373].
69. NNIS 2000 No authors listed. National Nosocomial Infections Surveillance (NNIS) system report, data summary from January 1992-April 2000, issued June 2000. American Journal of Infection Control 2000;28(6):429-48. [MEDLINE: 11114613].
70. Noll 1990 Noll ML, Hix CD, Scott G. Closed tracheal suction systems: effectiveness and nursing implications. AACN Clinical Issues in Critical Care Nursing 1990;1(2):318-28. [MEDLINE: 2206731].
71. Paul-Allen 2000 Paul-Allen J, Ostrow CL. Survey of nursing practices with closed system suctioning. American Journal of Critical Care 2000;9(1):9-17. [MEDLINE: 10631386].
72. RevMan 4.2 Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan) [Computer program]. Version 4.2 for Windows. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2003.
73. Robinson 2002 Robinson KA, Dickersin K. Development of a highly sensitive search strategy for the retrieval of reports of controlled trials using PubMed. International Journal of Epidemiology 2002;31(1): 150-3. [MEDLINE: 11914311].
74. Thompson 2000 Thompson L. Suctioning adults with an artificial airway. Joanna Briggs Institute for Evidence Based Nursing and Midwifery Systematic Reviews. Vol. 9, Adelaide, Australia: Joanna Briggs Institute for Evidence Based Nursing and Midwifery, 2000:1-95.
75. Wood 1998 Wood CJ. Endotracheal suctioning: a literature review. Intensive and Critical Care Nursing 1998;14(3):124-36. [MEDLINE: 9824217].
76. Woodgate 2001 Woodgate PG, Flenady V. Tracheal suctioning without disconnection in intubated ventilated neonates. Cochrane Database of Systematic Reviews 2001, Issue 2.Art. No.: CD003065.. DOI:10.1002/14651858. CD003065..