Closed Suction in Respiratory Care

Closed Suction in Ventil∆ted P∆tients

As described in the American Association for Respiratory Care’s Clinical Guidelines, endotracheal suctioning is a common procedure performed in mechanically ventilated patients in order to clear airways of pulmonary secretions and improve respiratory function (1). The suction may be performed in one of two ways: open or closed (1). In open suctioning, the patient is disconnected from the ventilator and a single-use suction catheter is inserted into the endotracheal tube (1).

Closed suctioning allows a suction catheter to be inserted into the endotracheal tube through a one-way valve, with no need to disconnect the patient from the ventilator (1).

While suctioning is a necessary procedure, it involves risks for both patients and caregivers. Suction lumens often become clogged with difficult-to-eliminate secretions, which prevents effective suctioning, thereby increasing the risk of potentially infectious secretions entering the lungs and causing ventilator-associated event (VAE). Opening the suction circuit can also expose the patient to more risk of cross-contamination, and the caregiver to potentially contaminated fluids that leak out of the suction line.

Closed suctioning offers benefits not found in the open procedure and can minimize the overall risks and complications associated with endotracheal suctioning. Closed suctioning is in keeping with current patient safety measures designed to lower the risk for both patients and healthcare workers of being exposed to potentially harmful bacteria. A closed suctioning device with integrated rinse port also allows healthcare workers to perform both suctioning and rinsing without opening the suction circuit, again reducing the possibility of cross-contamination for patients and caregivers alike.

The reduced likelihood of exposure to potential infectious illnesses such as Ventilator Associated Pneumonia (VAP) may also help lower hospital time and expense associated with caring for VAP patients. (2)

References

  1. American Association for Respiratory Care (AARC) Clinical Practice Guidelines: Endotracheal Suctioning. Respiratory Care, June 2010. Volume 55, No. 6.
  2. Kimberly-Clark Health Care: Ventilator-Associated Pneumonia (VAP) Best Practice Strategies for Caregivers.