PMID- 24400607
OWN - NLM
STAT- MEDLINE
DCOM- 20150421
LR  - 20220309
IS  - 1478-5153 (Electronic)
IS  - 1362-1017 (Linking)
VI  - 19
IP  - 1
DP  - 2014 Jan
TI  - Clinical experience and incidence of ventilator-associated pneumonia using closed 
      versus open suction-system.
PG  - 34-41
LID - 10.1111/nicc.12010 [doi]
AB  - 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.
CI  - (c) 2013 The Authors. Nursing in Critical Care (c) 2013 British Association of 
      Critical Care Nurses.
FAU - Akerman, Eva
AU  - Akerman E
AD  - E. Akerman, RNIC, PhD, MScN, Clinic of Intensive Care and Perioperative Medicine, 
      Skane University Hospital, 205 02, Malmo, Sweden.
FAU - Larsson, Catharina
AU  - Larsson C
FAU - Ersson, Anders
AU  - Ersson A
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Observational Study
DEP - 20130130
PL  - England
TA  - Nurs Crit Care
JT  - Nursing in critical care
JID - 9808649
MH  - Aged
MH  - Cohort Studies
MH  - Cross Infection/prevention & control
MH  - Equipment Contamination/prevention & control
MH  - Female
MH  - Hand Hygiene
MH  - Humans
MH  - Incidence
MH  - Intensive Care Units
MH  - Intubation, Intratracheal/adverse effects
MH  - Male
MH  - Middle Aged
MH  - Pneumonia, Ventilator-Associated/*epidemiology/prevention & control
MH  - Practice Guidelines as Topic
MH  - Respiration, Artificial/*methods
MH  - Suction/*adverse effects/methods/statistics & numerical data
MH  - Sweden/epidemiology
OTO - NOTNLM
OT  - Suction systems
OT  - Ventilator-associated pneumonia
EDAT- 2014/01/10 06:00
MHDA- 2015/04/22 06:00
CRDT- 2014/01/10 06:00
PHST- 2012/08/07 00:00 [received]
PHST- 2012/10/08 00:00 [revised]
PHST- 2012/11/27 00:00 [accepted]
PHST- 2014/01/10 06:00 [entrez]
PHST- 2014/01/10 06:00 [pubmed]
PHST- 2015/04/22 06:00 [medline]
AID - 10.1111/nicc.12010 [doi]
PST - ppublish
SO  - Nurs Crit Care. 2014 Jan;19(1):34-41. doi: 10.1111/nicc.12010. Epub 2013 Jan 30.