Suctioning
Endotracheal suctioning of patients on a ventilator is an important aspect of pulmonary care. There is debate whether open suctioning (disconnecting the ventilator from the ETT) or closed suctioning (using a system that is integrated into the circuit) leads to better outcomes. Find a comparison below:
- No need to disconnect patient from ventilator --> less derecruitment
- Less staff needed to perform suction
- Less cardiovascular side effects in children with unstable circulation
- Less glove contamination of staff and therefore less risk of transmission of microorganisms
- No difference to open suction with regards to VAP or mortality
Closed Suctioning
Open Suctioning
- Need for 2 staff to do procedure
- Risk of derecruitment due to need for disconnection
- No difference in VAP-rate or mortality
- More cardiovascular side effects in children with unstable circulation
- Option to use T-piece / bag --> Recruitment manoeuvre
- More cardiovascular side effects (hypertension, tachycardia, bradycardia, desaturation)
- Option to instill saline (in case of tough secretions or bleeding)
Intensive Care NSW has the following comparison table available:
