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Open versus Closed Suctioning Among Mechanically Ventilated Pediatric Patients: A Randomised Control Trial

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Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objectives

To compare the difference in efficacy of closed tracheal suction system (CTSS) to open tracheal suction system (OTSS) in reducing incidence of ventilator associated pneumonia (VAP). Also to evaluate their efficacy in stabilizing cardio-respiratory parameters, reducing mortality and duration of intubation.

Methods

This study was a single centre, parallel group, open label, randomized controlled study with an equal allocation (1:1) in pediatric patients requiring mechanical ventilation. A specific suction system of CTSS or OTSS was assigned to the two groups based on randomization. All the demographic, clinical, laboratory parameters and treatment outcomes were noted in the preformed sheet.

Results

Total 116 eligible pediatric ventilated patients were studied. Total incidence of VAP was 9 (7.75%) of which 3 occurred in open and 6 in closed suction group. Rate of VAP was similar among both the groups with RR 2.11 (95% CI 0.50–8.9). However, significant number of infection-related ventilator associated condition (IVAC) were found in CTSS (17) compared to OTSS (6) group with RR 3.5 (95% CI 1.3–9.9). SpO2 was better maintained in the CTSS group post-suction (p = 0.001). Incidence of mortality and intubation days were similar between both groups.

Conclusions

Incidence of VAP was similar between open and closed suction groups.

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Acknowledgements

The authors are grateful for the cooperation of parents and the Narayana Hrudayalaya Multispeciality Hospital, Bangalore for providing the infrastructure. They are obliged to Prof. Devi Shetty for constant motivation to carry out this work. They offer sincere thanks to Seniors, Colleagues for their insightful discussion to complete this work.

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Authors and Affiliations

  1. Department of Pediatrics, Narayana Hrudayalaya Institute of Medical Sciences, Bangalore, Karnataka, India

    Subhranshu Sekhar Dhal, Rajiv Aggarwal, Hiremath Sagar & Anilkumar Sapare

  2. Department of Pediatrics, Kalinga Institute of Medical Sciences, KIIT Deemed University, Bhubaneswar, Odisha, India

    Subhranshu Sekhar Dhal & Nirmal Kumar Mohakud

  3. School of Biotechnology, Kalinga Institute of Industrial Technology, KIIT Deemed University, Bhubaneswar, Odisha, India

    Nirmal Kumar Mohakud

  4. Department of Research and Development, Kalinga Institute of Medical Sciences, KIIT Deemed University, Bhubaneswar, Odisha, India

    Sourav Padhee

  5. Department of Neonatology, Kalinga Institute of Medical Sciences, KIIT Deemed University, Bhubaneswar, 751024, Odisha, India

    Manaswinee Sahoo

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  1. Subhranshu Sekhar Dhal
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  2. Rajiv Aggarwal
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  4. Nirmal Kumar Mohakud
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  5. Anilkumar Sapare
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  7. Manaswinee Sahoo
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Contributions

SSD, RA, HS, NKM: conceptualization; SSD, MS, AS, SP: data acquisition, data analysis, literature review and manuscript writing; HS, AS, MS: critical review of the manuscript. All the authors approved the final manuscript. SSD will act as guarantor of the study.

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Correspondence to Manaswinee Sahoo.

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Dhal, S.S., Aggarwal, R., Sagar, H. et al. Open versus Closed Suctioning Among Mechanically Ventilated Pediatric Patients: A Randomised Control Trial. Indian J Pediatr (2024). https://doi.org/10.1007/s12098-024-05069-2

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