Ventilator-associated pneumonia with a closed versus an open endotracheal suction system

Objective

To analyze the incidence of ventilator-associated pneumonia with a closed endotracheal suction system (CESS) versus an open system (OESS).

Methods

It is a prospective study during 3 months. Included were all patients who required mechanical ventilation for 12 hours or more. At admission to the ICU patients were randomized in two groups: one group was suctioned with CESS, and another group with OESS. Infections were diagnosed according to CDC criteria. The statistical analysis was realized by chi-square test and Student t test, and we took values P < 0.05 to consider a significant difference.

Results

Included were 121 patients (64% male). Mean age was 57.68 ± 16.90 years, APACHE II was 14.40 ± 6.25. Mortality was 14.85%. Patient distribution was: 50% cardiac surgery, 9% cardi-ologic, 7% respiratory, 4% digestive, 10% neurologic, 11% traumathology, 3% intoxication, 6% abdominal sepsis. Both groups of patients (58 with CESS and 63 with OESS) were similar in age, sex, diagnosis groups, mortality and APACHE II. No significant differences were found in the percentage of patients who developed ventilator-associated pneumonia (13.79% vs 14.28%), nor in the number of ventilator-associated pneumonia per 1000 mechanical ventilation-days (15.85 vs 16.12).

Conclusions

In our series, a closed endotracheal suction system did not reduce significantly the ventilator-associated pneumonia incidence.