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Intensive Care Med. 2004 Aug;30(8):1630-7. Epub 2004 Feb 24.

Effectiveness and side effects of closed and open suctioning: an experimental evaluation.

Author information

1
Department of Anaesthesia and Intensive Care, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden. sophie.lindgren@vgregion.se

Abstract

OBJECTIVE:

To compare the effectiveness of closed system suctioning (CSS) and open system suctioning (OSS) and the side effects on gas exchange and haemodynamics, during pressure-controlled ventilation (PCV) or continuous positive airway pressure (CPAP).

DESIGN:

Bench test and porcine lung injury model.

PARTICIPANTS:

Twelve bronchoalveolar saline-lavaged pigs.

SETTING:

Research laboratory in a university hospital.

INTERVENTIONS:

In a mechanical lung, the efficacy of OSS and CSS with 12 and 14 Fr catheters were compared during volume-control ventilation, PCV, CPAP 0 or 10 cmH(2)O by weighing the suction system before and after aspirating gel in a transparent trachea. Side effects were evaluated in the animals with the same ventilator settings during suctioning of 5, 10 or 20 s duration.

MEASUREMENTS AND RESULTS:

Suctioning with 12 and 14 Fr catheters was significantly more efficient with OSS (1.9+/-0.1, 2.8+/-0.9 g) and with CSS during CPAP 0 cmH(2)O (1.8+/-0.2, 4.2+/-0.5 g) as compared to CSS during PCV (0.2+/-0.2, 0.8+/-0.3 g) or CPAP 10 cmH(2)O (0.0+/-0.1, 0.7+/-0.4 g), p<0.01 (means +/- SD). OSS and CSS at CPAP 0 cmH(2)O resulted in a marked decrease in SpO(2), mixed venous oxygen saturation and tracheal pressure, p<0.001, but the side effects were considerably fewer during CSS with PCV and CPAP 10 cmH(2)O, p<0.05.

CONCLUSIONS:

Irrespective of catheter size, OSS and CSS during CPAP 0 cmH(2)O were markedly more effective than CSS during PCV and CPAP 10 cmH(2)O but had worse side effects. However, the side effects lasted less than 5 min in this animal model. Suctioning should be performed effectively when absolutely indicated and the side effects handled adequately.

PMID:
14985963
DOI:
10.1007/s00134-003-2153-9
[Indexed for MEDLINE]
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