Comparison of the effect of closed versus open suction methods on outcomes in mechanically ventilated intensive care patients

Abstract

Background and objective: Different techniques of implementing therapeutic interventions could lead to distinct results in terms of length of hospitalization, recovery and side effects, and less invasive techniques could be employed. Nowadays, endotracheal suction is performed using two methods, closed and open suction systems. Various studies have been conducted regarding the advantages and disadvantages of these two methods, and sometimes conflicting results have been reported. The aim of the present study was to compare the effects of closed and open suction methods on outcomes in mechanically ventilated patients. Methods and materials: This quasi-experimental study was carried out through winter and spring 2016 on 64 patients hospitalized in Intensive Care Unit (ICU) of Amin Hospital, Isfahan, Iran. Demographic and clinical data were collected. After cost estimation, outcomes associated with closed versus open suction systems including changes in SPO2, length of stay in ICU, ventilator-associated pneumonia (VAP) incidence and the costs were measured. Finally, conclusions regarding each method were made using statistical analyses. Results: post-suctioning, mean spo2 was significantly lower in open suction group compared to the baseline and a significant increase was observed in closed suction group (p<0.05). Although, no significant differences in terms of changes in mean spo2 were observed between two groups (p=0.12). Incidence of VAP in open and closed suction groups was 6.2 and 18.8, respectively, with no statistically significant difference observed (p=0.25). The cost of catheters and the total cost of commodities were significantly higher in the closed suction group compared to the open suction group (p=0.00). Length of ICU stay showed no different between two groups (p=0.60). Conclusion: While the present study showed lower incidence of VAP in open suction group compared to the closed suction but enough evidence to prefer one method more than the other is still lacking. Therefore, more clinical trials are warranted. © 2018 Medknow. All rights reserved.