J Korean Acad Nurs.  2011 Apr;41(2):175-181. 10.4040/jkan.2011.41.2.175.

Endotracheal Colonization and Ventilator-associated Pneumonia in Mechanically Ventilated Patients according to Type of Endotracheal Suction System

• Cha KS
• Park HR

• KMID: 1754158
• DOI: http://doi.org/10.4040/jkan.2011.41.2.175

Abstract

PURPOSE
This study was conducted to identify endotracheal colonization and the incidence of ventilator-associated pneumonia related to the type of endotracheal suction system.
METHODS
The participants in this study were ICU patients hospitalized between October 2009 to March 2010 who used ventilators for over 48 hr with closed (CSS, n=30) or open (OSS, n=32) suction systems. To standardize the pre-intervention suction system, a suctioning protocol was taught to the ICU nurses. Collected data were analyzed using chi2-test, Fisher's exact test, Wilcoxon rank sums test, Wilcoxon test, Log-rank test and Poisson regression.
RESULTS
Endotracheal colonization was higher in OSS than CSS from day 1 to day 8 while using a ventilator and there was a significant difference between the two groups. The CSS reached 50% of endotracheal colonization by the 4th day, whereas for the OSS, it was the 2nd day (p=.04). The incidence of ventilator-associated pneumonia showed no significant difference.
CONCLUSION
For patients with a high risk of pneumonia, CSS must be used to lower endotracheal colonization.

Keyword

Suction; Colonization; Ventilator-associated Pneumonia

MeSH Terms

Adult
Aged
Aged, 80 and over
Female
Gram-Negative Bacteria/isolation & purification
Gram-Positive Bacteria/isolation & purification
Humans
Incidence
Intensive Care Units
Intubation, Intratracheal/instrumentation/*methods
Male
Middle Aged
Pneumonia, Ventilator-Associated/*epidemiology
Risk
Severity of Illness Index
Time Factors
Ventilators, Mechanical/*microbiology

Figure

• 

  Figure 1 A comparison of same organisms (≥3) repeatedly isolated from the sputum of patients in study groups. CSS=closed suction system; OSS=open suction system.

• 

  Figure 2 A comparison of endotracheal colonization rates in study groups. CSS=closed suction system; OSS=open suction system.

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