Comparison of the Effects of Open and Closed Endotracheal Suction Systems on Ventilator-Associated Pneumonia and Mortality

Abstract

Aims: Nosocomial pneumonia is a prevalent complication in patients admitted to intensive care units. Endotracheal suction (ES) is used to clean the airways of secretions in patients under mechanical ventilation (MV). The objective of this study was to compare the effects of an open endotracheal suction system (OESS) versus a closed endotracheal suction system (CESS) on the incidence of ventilator-associated pneumonia (VAP). Study Design: Retrospective examination of hospital records. Place and Duration of Study: Reanimation Intensive Care Unit, Van Training and Research Hospital, Van, Turkey, between January 2018 and December 2019. Methodology: Age, gender, and length of stay in the intensive care unit and under mechanical ventilation (MV), mortality and isolated microorganism status of 73 (35.6%) patients with VAP were analyzed retrospectively. These features were compared according to the ES type applied. Sample: The study was conducted among 205 patients who were connected to a mechanical ventilator for more than 48 h in the reanimation intensive care unit (RICU) of a tertiary care hospital. Results: There was no difference between OESS and CESS groups in terms of mortality rates, length of stay in the RICU, and duration of MV. There was a significant difference in terms of incidence of VAP between the OESS group and the CESS group (41.8% and 29%, respectively; P = .045) Acinetobacter baumanii was the most frequently isolated microorganism in both groups. Conclusion: CESS treatment was associated with a lower incidence of VAP in patients of the RICU.