PURPOSE: The purpose of this study was to compare the difference of change in oxygen saturation, vital signs and suction time taken for the suctioning during endotracheal suctioning performed with closed suction system and with opened suction system. METHODS: Data were collected from 31 adult patients with ventilator treatment who were admitted to a university hospital in Seoul and the collection period was from July 1 to November 15, 2005. Oxygen saturation, heart rate, respiration rate and mean arterial pressure were collected immediately prior to the suctioning intervention, during and 1 and 5 minutes after the suctioning from opened suction system and closed suction system. RESULTS: 1) The difference in oxygen saturation was statistically significant in recovery time for oxygen saturation to return to baseline values after suctioning was significantly rapid on closed suction system (p < .05). 2) The difference in heart rate, respiration rate and mean arterial pressure was statistically insignificant. 3) The suction time was shorter in closed suction system. CONCLUSION: Closed suction system is more efficient, as compared with the open suction system in the ventilator treatment.