Does open or closed endotracheal suction affect the incidence of ventilator associated pneumonia in the intensive care unit? A systematic review

Objective: To compare closed and open endotracheal suction system in relation to ventilator-associated pneumonia in adult intensive care unit patients Method: Systematic review. Results: Of the 18 eligible studies identified through the search strategy, only 5 studies were included in the review. The two endotracheal suction systems show no differences in the incidence of ventilator-associated pneumonia (5 trials: odds ratio [OR], 0.92; Mantel-Haenszel [M-H], fixed; 95% confidence interval [95%CI], 0.72-1.18) or mortality rates (3 trials: OR, 0.89; M-H, fixed; 95%CI, 0.62-1.28). Conclusions: Results from 5 studies showed that suctioning with either closed or open endotra-cheal suction did not have an effect on the incidence of ventilator-associated-pneumonia or mortality rates. Therefore, more rigorous and large-scale research is needed for further evaluation.