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Published in: Intensive Care Medicine 8/2004

01-08-2004 | Original

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

Authors: Sophie Lindgren, Birgitta Almgren, Marieann Högman, Sven Lethvall, Erik Houltz, Stefan Lundin, Ola Stenqvist

Published in: Intensive Care Medicine | Issue 8/2004

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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.
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Metadata
Title
Effectiveness and side effects of closed and open suctioning: an experimental evaluation
Authors
Sophie Lindgren
Birgitta Almgren
Marieann Högman
Sven Lethvall
Erik Houltz
Stefan Lundin
Ola Stenqvist
Publication date
01-08-2004
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 8/2004
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-003-2153-9

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