Endotracheal Colonization and Ventilator-associated Pneumonia in Mechanically Ventilated Patients according to Type of Endotracheal Suction System

ABSTRACT

PURPOSE: This study was conducted to identify endotracheal colonization and the incidence of ventilator-associated pneumonia related to the type of endotracheal suction system. METHODS: The participants in this study were ICU patients hospitalized between October 2009 to March 2010 who used ventilators for over 48 hr with closed (CSS, n=30) or open (OSS, n=32) suction systems. To standardize the pre-intervention suction system, a suctioning protocol was taught to the ICU nurses. Collected data were analyzed using chi2-test, Fisher's exact test, Wilcoxon rank sums test, Wilcoxon test, Log-rank test and Poisson regression. RESULTS: Endotracheal colonization was higher in OSS than CSS from day 1 to day 8 while using a ventilator and there was a significant difference between the two groups. The CSS reached 50% of endotracheal colonization by the 4th day, whereas for the OSS, it was the 2nd day (p=.04). The incidence of ventilator-associated pneumonia showed no significant difference. CONCLUSION: For patients with a high risk of pneumonia, CSS must be used to lower endotracheal colonization.