Comparison of the Effect of Open and Closed Endotracheal Suction Systems on the Results of the Smear and Bacterial Culture in Patients under Mechanical Ventilation in Intensive Care Unit

Document Type : Original Article (s)

Authors

1 Instructor, Department of Nursing, School of Nursing, Gonabad University of Medical Sciences, Gonabad, Iran

2 MSc Student, Department of Nursing, School of Nursing, Gonabad University of Medical Sciences, Gonabad, Iran

3 Professor, Department of Medical-Surgical Nursing, School of Nursing AND Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran

4 Associate Professor, Department of Medical-Surgical Nursing, School of Nursing AND Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran

Abstract

Background: Choosing the right method of suction can be effective in reducing its complications. Therefore, this study was performed to compare the effect of open and closed endotracheal suction systems on the results of the smear and bacterial culture in patients under mechanical ventilation in intensive care unit.Methods: The present study was performed on 52 patients admitted to the intensive care unit. Patients were selected by convenience sampling method, and randomly divided into open and closed suction groups. Samples of patients' tracheal secretions were collected before the intervention and 72 hours later by minibal method under completely sterile conditions. Samples sent to the laboratory were incubated in a special culture medium at 37 °C for 24 hours; then the plates were examined in two groups and the results were compared.Findings: There was no statistically significant difference between the two groups of open and closed suction in terms of the results of microbial culture of tracheal secretions. In the open suction group, 96.3% and in the closed suction group, 92% had positive culture results. In addition, the microbial strain of Acinetobacter had the highest prevalence in both open and closed suction groups, with 40.7% and 40.0%, respectively. There was no statistically significant difference between the two groups in terms of Gram-positive and Gram-negative masses in respiratory secretions.Conclusion: There is no significant difference between open and closed endotracheal suctioning for endotracheal culture results, Gram positive and negative masses and bacterial types, and one system could not be preferred over the other.

Keywords

References

  1. Fallahinia G, Gharabaghi A, Azizi A, Moghimbeigi A. The effect of standard suction training by group method education on nurses' performance in critical care unit. Sci J Hamadan Nurs Midwifery Fac 2018; 26 (3): 145-4. [In Persian].
  2. Memarian R, Misaghi A, Brujerdi MH, Nazem ekbatani N. Effect of planned passive respiratory exercise on prevention of pneumonia among coma patients undergoing mechanical ventilation. Hayat 2010; 16(2): 29-37. [In Persian].
  3. Mazhari S, Pishgou’ei A, Zareian A, Habibi H. Effect of open and closed endotracheal suction systems on heart rhythm and artery blood oxygen level in intensive care patients. Critical Care Nursing 2010; 2(4): 1-2. [In Persian].
  4. Salimi T, Ghaderian R, Jarahzadeh MH, Vaezi AA. Side effects of suction catheter and nelaton catheter in patients with brain trauma. J Shahid Sadoughi Univ Med Sci 2015; 22(6): 1691-701. [In Persian].
  5. Ramazani J, Hosseini M. The assessment of apache ii scoring system in predicting the result of weaning from ventilator. Knowledge Health 2014; 8(4): 187-92. [In Persian].
  6. Mohammadpour A, Amini S, Shakeri MT, Mirzaei S. Comparing the effect of open and closed endotracheal suctioning on pain and oxygenation in post CABG patients under mechanical ventilation. Iran J Nurs Midwifery Res 2015; 20(2): 195-9.
  7. Mohammadi N, Parviz S, Peyravi H, Hosseini AF. Effect of endotracheal suctioning education for nurses on patients' hemodynamic parameters. Hayat 2012; 18(2): 38-46. [In Persian].
  8. Esmaeili M. Comparing the effect of using normal saline and distilled water for tracheal suctioning on the incidence of ventilator-associated pneumonia and hemodynamic indexes in ventilator-dependent patients. Journal of Clinical Nursing and Midwifery 2020; 9(2): 689-98. [In Persian].
  9. Jongerden IP, Rovers MM, Grypdonck MH, Bonten MJ. Open and closed endotracheal suction systems in mechanically ventilated intensive care patients: a meta-analysis. Crit Care Med 2007; 35(1): 260-70.
  10. Zolfaghari M, Nikbakht Nasrabadi A, Karimi Rozveh A, Haghani H. Effect of open and closed system endotracheal suctioning on vital signs of ICU patients. Hayat 2008; 14(1): 13-20. [In Persian].
  11. alipour n, Toulabi T, Manouchehrian N, Anbari K, Rahimi Bashar F. A comparison of the effect of open and closed endotracheal suctioning on hemodynamic status of patients in the ICU. Evid Basic Care 2014; 3(4): 65-74. [In Persian].
  12. Dadkhah B, Amri P, Mohammadi MA, Shabani A. Comparative study of vital signs during open and closed suctioning in patients with head trauma hospitalized in ICU. Health and Care 2017; 19(2): 169-76. [In Persian].
  13. Combes P, Fauvage B, Oleyer C. Nosocomial pneumonia in mechanically ventilated patients, a prospective randomised evaluation of the Stericath closed suctioning system. Intensive Care Med 2000; 26(7): 878-82.
  14. Babaii A, Abbasinia M, Bahrami N. The effect of artificial airway standardization cares on the ventilator-associated pneumonia. Nurs Midwifery J 2016; 13(11): 987-94. [In Persian].
  15. Lorente L, Lecuona M, Martin MM, Garcia C, Mora ML, Sierra A. Ventilator-associated pneumonia using a closed versus an open tracheal suction system. Crit Care Med 2005; 33(1): 115-9.
  16. Ebrahimi Fakhar HR, Rezaei K, Kohestani HR. effect of closed endotracheal suction on incidence of ventilator-associated pneumonia. Sci J Kurdistan Univ Med Sci 2010; 15(2): 79-87. [In Persian].
  17. Elmansoury A, Said H. Closed suction system versus open suction. Egypt J Chest Dis Tuberc 2017; 66(3): 509-15.
  18. Gallagher JA. Implementation of ventilator-associated pneumonia clinical guideline (Bundle). J Nurse Pract 2012; 8(5): 377-82.
  19. Michel F, Franceschini B, Berger P, Arnal JM, Gainnier M, Sainty JM, et al. Early antibiotic treatment for BAL-confirmed ventilator-associated pneumonia: a role for routine endotracheal aspirate cultures. Chest 2005; 127(2): 589-97.
  20. AARC Clinical Practice Guidelines. Endotracheal suctioning of mechanically ventilated patients with artificial airways 2010. Respir Care 2010; 55(6): 758-64.
  21. Hlinkova E, Nemcova J, Bielena K. Closed versus open suction system of the airways in the prevention of infection in ventilated patients. Cent Eur J Nurs Midwifery 2014; 5(2): 63-71.
  22. Cordero L, Sananes M, Ayers LW. Comparison of a closed (Trach Care MAC) with an open endotracheal suction system in small premature infants. J Perinatol 2000; 20(3): 151-6.
  23. Jongerden IP, Buiting AG, Leverstein-van Hall MA, Speelberg B, Zeidler S, Kesecioglu J, et al. Effect of open and closed endotracheal suctioning on cross-transmission with Gram-negative bacteria: a prospective crossover study. Crit Care Med 2011; 39(6): 1313-21.
  24. Topeli A, Harmanci A, Cetinkaya Y, Akdeniz S, Unal S. Comparison of the effect of closed versus open endotracheal suction systems on the development of ventilator-associated pneumonia. J Hosp Infect 2004; 58(1): 14-9.
  25. Pagotto IM, Oliveira LR, Araujo FC, Carvalho NA, Chiavone P. Comparison between open and closed suction systems: a systematic review. Rev Bras Ter Intensiva 2008; 20(4): 331-8.
  26. Aminzadeh Z, Hajiekhani B. Bacterial endotracheal tube colonization in intubated patients in poisoning ICU ward of Loghman Hakim hospital of Tehran in 2005. Horizon Med Sci 2007; 13(2): 12-8. [In Persian].

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History

  • Receive Date: 26 May 2021
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

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