Background: Studies have shown a decreasing ventilator-associated pneumonia (VAP) incidence after prophylactic interventions bundles. The use of closed suction systems (CSS) has been suggested beneficial as a prophylactic measure.
Aim: To investigate the effects of a CSS on VAP incidence, suction circuit contamination and adverse events (AEs) compared to an open suction system (OSS) approach in a general mixed intensive care unit (ICU).
Methods: Adult patients on mechanical ventilation were consecutively included. Data were collected during four 1-month periods where CSS and OSS were used on an alternating basis. Airway cultures were obtained at intubation, after 72 h and every Monday. After changing CSS and at extubation, the catheter tip was cultured. AEs and desaturation events during suction were monitored.
Analyse: Descriptive analysis and differences between the groups were analysed using comparative methods.
Results: No differences in airway colonization at admission between the groups were detected (Table 2). The CSS group had a higher Simplified Acute Physiology Score (SAPS) III and also a non-significant increase in VAP incidence. Positive cultures were obtained in 50% of all the retrieved CSS catheters. There was no inter-patient contamination in either group. Six AEs versus one (CSS/OSS) related to tube-occlusion and secretion clogging was seen. Desaturations at suctioning were rare in both groups.
Conclusion: No beneficial effects were seen on VAP incidence or inter-patient contamination compared to OSS. A high frequency of circuit contamination in the CSS group paralleled with experienced secretions clearance problems seem unfavourable and in concordance with previous studies.
Keywords: Suction systems; Ventilator-associated pneumonia.
© 2013 The Authors. Nursing in Critical Care © 2013 British Association of Critical Care Nurses.