Intensive Care Medicine

, Volume 30, Issue 8, pp 1630–1637 | Cite as

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

  • Sophie Lindgren
  • Birgitta Almgren
  • Marieann Högman
  • Sven Lethvall
  • Erik Houltz
  • Stefan Lundin
  • Ola Stenqvist
Original

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 cmH2O 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 cmH2O (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 cmH2O (0.0±0.1, 0.7±0.4 g), p<0.01 (means ± SD). OSS and CSS at CPAP 0 cmH2O resulted in a marked decrease in SpO2, mixed venous oxygen saturation and tracheal pressure, p<0.001, but the side effects were considerably fewer during CSS with PCV and CPAP 10 cmH2O, p<0.05.

Conclusions

Irrespective of catheter size, OSS and CSS during CPAP 0 cmH2O were markedly more effective than CSS during PCV and CPAP 10 cmH2O 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.

Keywords

Suctioning Closed system suctioning Airway pressure Gas exchange Acute respiratory distress syndrome (ARDS) Mechanical ventilation 

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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Sophie Lindgren
    • 1
  • Birgitta Almgren
    • 2
  • Marieann Högman
    • 2
  • Sven Lethvall
    • 1
  • Erik Houltz
    • 1
  • Stefan Lundin
    • 1
  • Ola Stenqvist
    • 1
  1. 1.Department of Anaesthesia and Intensive CareSahlgrenska University HospitalGothenburgSweden
  2. 2.Department of Medical Cell Biology; Section of Integrative PhysiologyUppsala UniversityUppsalaSweden

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