Open OR Closed Suctioning in Mechanically Ventilated Pediatric Patients: Which is better?

A recent study compared the efficacy of closed tracheal suction systems (CTSS) to open tracheal suction systems (OTSS) in reducing the incidence of ventilator-associated pneumonia (VAP) and evaluated their efficacy in stabilizing cardio-respiratory parameters, reducing mortality, and the duration of intubation.

The study observed-

• Enrollment of 116 pediatric ventilated patients. 
• The total incidence of VAP= 7.75%, of which 3 occurred in the open and 6 in the closed suction group. 
• A similar rate of VAP among both groups.
• A significant number of infection-related ventilator-associated conditions (IVAC) in CTSS compared to the OTSS group. 
• Better maintainance of SpO2 in the CTSS group post-suction. 
• Similar incidences of mortality and intubation days in both groups.

This study proves that both open and closed suction groups have similar incidence of VAP and hence can be chosen based on the need.

Dhal SS, Aggarwal R, Sagar H. et al. Open versus Closed Suctioning Among Mechanically Ventilated Pediatric Patients: A Randomised Control Trial. Indian J Pediatr. 2024. https://doi.org/10.1007/s12098-024-05069-2