Closed suction system versus open suction

Abstract

Background: Catheter suction is used to remove tracheal secretions through the endotracheal tube in mechanically ventilated patients, which may be either closed tracheal suction system (CTSS) or open one. In CTSS, the catheter is a part of ventilator circuit with no need to disconnect the ventilator. It seems that the CTSS prevent soiling and spraying of respiratory secretion into the ICU. Objective: To compare CTSS system in comparison with an open tracheal suction system in adult patients receiving mechanical ventilation for more than 24 h in terms of VAP incidence, length of stay in the intensive care unit and mortality. Methods: We prospectively recruited all mechanically ventilated patients in our general ICU, Dar El Shefa hospital between January 2012 and January 2013. Group A are those with open tracheal suction system (OTSS) and group B with closed tracheal suction system (CTSS), comparing VAP incidence, length of stay in the intensive care unit and mortality between the two groups. Results: Group A (OTSS) where the incidence of VAP was 30.13/1000 ventilator days not statistically significant in comparison with patients in group B with CTSS with VAP incidence 17.48/1000 ventilator days. Conclusion: There is no difference in the incidence of ventilator associated pneumonia and mortality rates between the two groups. The average length of stay declined in patients with OTSS group.

Keywords

• Ventilator associated pneumonia
• Endotracheal tube
• Closed suction system
• Open suction system