Cent Eur J Nurs Midw 2014, 5(2):63-71

Closed versus open suction system of the airways in the prevention of infection in ventilated patients

Edita Hlinková1,*, Jana Nemcová1, Katarína Bielená2
1 Department of Nursing, Jessenius Medical Faculty in Martin, Comenius University in Bratislava, Slovakia
2 Clinic of Anaesthesiology and Intensive Medicine, University Hospital in Martin, Slovakia

Aim: The aim of our study was to show the influence of the type of suction system (Closed versus Open Suction System) on the minimisation of the risk of respiratory infections in ventilated patients (Ventilator Associated Pneumonia - VAP).

Methods: A retrospective study was conducted. The sampling was intentional. Inclusion criteria for the patients were: at least three days' stay in hospital and endotracheal or tracheostomy intubation. Patients with acute or chronic respiratory disease and sepsis were excluded. Of the total (n = 100) sample 49 patients had closed and 51 had open suction systems. To collect empirical data, we used content analysis of the findings in the medical records. A research protocol included VAP diagnostic signs: changes in body temperature (BT > 38°C; BT < 36°C), leukocytosis, leukopenia, PaO2 below 10kPa, a positive finding on a chest X-ray, the nature of removed secretions, microbial colonization, uncontrollable VAP risk factors (age, gender, primary disease, the mortality rate in ventilated patients at the Clinic of Anaesthesiology and Intensive Medicine - CAIM).

Results: We did not observe differences in the incidence of changes in BT in terms of physiological values, leukocytes values, or PaO2 in patients with artificial lung ventilation in relation to the type of suction system. Similarly, other diagnostic signs of infection were not statistically significant. We found significant results in the relationship between microbial colonization (Acinetobacter spp, Proteus mirabilis) and the type of suction system (Pearson's Chi-square = 4.060; p = 0.044 and Pearson's Chi-square = 4.273; p = 0.039). Closed suction systems led to faster colonization by multi-resistant microorganisms.

Conclusion: The type of suction system does not affect the incidence of nosocomial respiratory tract infections in ventilated patients. It is crucial to respect general precautions in sanitary - epidemiological regime and barrier nursing techniques.

Keywords: artificial lung ventilation, closed and open suction system, Ventilator Associated Pneumonia

Received: September 24, 2013; Accepted: December 9, 2013; Published: September 30, 2014  Show citation

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Hlinková E, Nemcová J, Bielená K. Closed versus open suction system of the airways in the prevention of infection in ventilated patients. Central European Journal of Nursing and Midwifery. 2014;5(2):63-71.
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