Effect of closed endotracheal suction on incidence of ventilator-associated pneumonia

Ventilator-associated pneumonia (VAP) is one of the common nosocominal infections in intensive care units (ICU) which leads to high mortality rates. Endotracheal suctioning is routinely performed in mechanically ventilated patients to clear secretions. The aim of this study was to compare the effect of closed versus open endotracheal suction methods on development of ventilator-associated pneumonia. This randomized control trial included 156 hospitalized patients in intensive care units of the hospitals of Arak University of Medical Sciences. Patients who had required mechanical ventilation and been transferred to ICU in less than 24 hours after their admission and had endotracheal tubes for less than six hours were assigned randomly into two groups. Routine open suction and closed suction methods were used for control (n=74) and intervention (n=82) groups respectively. After 72 hours the patients were examined for signs and symptoms of pneumonia based on clinical pulmonary infection score (CPIS). The results of this study showed the incidence of pneumonia in the intervention and control groups were 28% and 48.6% respectively. Considering the incidence of pneumonia, there was a significant difference between the two groups (P=0.01). Patients with history of cigarette smoking had increased incidence of pneumonia but no difference was detected in the incidence of pneumonia between males and females. Considering the decreased risk of transfer of contamination via medical devices and personnel's hands, use of closed suction method can lead to a decrease in the incidence of ventilator associated pneumonia.