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

Jung, Jae Woo (Department of Internal Medicine, ChungAng University College of Medicine)
Choi, Eun Hee (Department of Medical Intensive Care Unit, ChungAng University Hospital)
Kim, Jin Hee (Department of Medical Intensive Care Unit, ChungAng University Hospital)
Seo, Hyo Kyung (Department of Medical Intensive Care Unit, ChungAng University Hospital)
Choi, Ji Yeon (Department of Medical Intensive Care Unit, ChungAng University Hospital)
Choi, Jae Cheol (Department of Internal Medicine, ChungAng University College of Medicine)
Shin, Jong Wook (Department of Internal Medicine, ChungAng University College of Medicine)
Park, In Won (Department of Internal Medicine, ChungAng University College of Medicine)
Choi, Byoung Whui (Department of Internal Medicine, ChungAng University College of Medicine)
Kim, Jae Yeol (Department of Internal Medicine, ChungAng University College of Medicine)
Publication Information
Tuberculosis and Respiratory Diseases / v.65, no.3, 2008 , pp. 198-206 More about this Journal
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 for multiple-use, open suction, $28.27 for single-use, open suction and $23.76 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.
Keywords
Closed suction; Cost; MRSA; Open suction; Ventilator-associated pneumonia;
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