Comparison of a Closed with an Open Endotracheal Suction: Costs and the Incidence of Ventilator-associated Pneumonia.

Jung, Jae Woo; Choi, Eun Hee; Kim, Jin Hee; Seo, Hyo Kyung; Choi, Ji Yeon; Choi, Jae Cheol; Shin, Jong Wook; Park, In Won; Choi, Byoung Whui; Kim, Jae Yeol

doi:2008.65.3.198

Tuberc Respir Dis > Volume 65(3); 2008 > Article

Original Article

Tuberculosis and Respiratory Diseases 2008;65(3):198-206.
DOI: https://doi.org/10.4046/trd.2008.65.3.198 Published online September 1, 2008.

Comparison of a Closed with an Open Endotracheal Suction: Costs and the Incidence of Ventilator-associated Pneumonia.

Jae Woo Jung, Eun Hee Choi, Jin Hee Kim, Hyo Kyung Seo, Ji Yeon Choi, Jae Cheol Choi, Jong Wook Shin, In Won Park, Byoung Whui Choi, Jae Yeol Kim

¹Department of Internal Medicine, ChungAng University College of Medicine, Seoul, Korea. jykimmd@cau.ac.kr
²Department of Medical Intensive Care Unit, ChungAng University Hospital, Seoul, Korea.

Abstract

BACKGROUND
Tracheobronchial suctioning using the closed suctioning system has physiological benefits for critically ill patients. Despite these benefits, there are concerns about increased colonization of tracheobronchial tree by pathogenic organisms. The cost is another hinder to the introduction of closed suction system. The aim of this study was to evaluate the incidence of colonization and ventilator associated pneumonia and the cost-effectiveness of closed suction compared with open suction. METHODS: During separated one month period, patients admitted MICU were cared by multiple-use, open suction, single-use, open suction and multiple-use, closed suction method, consecutively. Costs, colonization of tracheobronchial tree by MRSA and the incidence of ventilator-associated pneumonia (VAP) were analyzed. RESULTS: One-hundred and six patients were enrolled. Twenty patients were treated with multiple-use, open suction, while 42 and 44 patients were cared with single-use, open catheter and multiple-use, closed catheter, respectively. Colonization by MRSA and the incidence of VAP were not different among three ways of suctioning. The overall costs per patient per day for suctioning were 10.58 dollars for multiple-use, open suction, 28.27 dollars for single-use, open suction and 23.76 dollars for multiple-use, closed suction. CONCLUSION: Multiple-use, closed suctioning, when suction catheters were changed every 48 hrs, has the similar incidence of colonization of MRSA and occurrence of VAP and is a cost-efficient way of endotracheal suction.

Key Words: Closed suction, Cost, MRSA, Open suction, Ventilator-associated pneumonia