Effects of open or closed suctioning on lung dynamics and hypoxemia in mechanically ventilated Patients

Purpose: This study was conducted to compare effects of open and closed suctioning methods on lung dynamics (dynamic compliance, tidal volume, and airway resistance) and hypoxemia (oxygen saturation and heart rate) in mechanically ventilated patients. Methods: This study was a cross-over repeated design. Participants were 21 adult patients being treated with endotracheal intubation using a pressurecontrolled ventilator below Fraction of Inspired Oxygen (FiO₂) 60% and PEEP 8 cmH₂O. Data were collected at baseline and 1, 2, 3, 4, 5, and 10 minutes after suctioning. Data were analyzed using two-factor ANOVA with repeated measures on time and suctioning type. Results: Effects of the interaction between suction type and time were significant for oxygen saturation and heart rate but not significant for dynamic compliance, tidal volume, or airway resistance. Prior to performance of suctioning, tidal volume and oxygen saturation were significantly lower, but airway pressure and heart rate were significantly higher using the closed suctioning method as compared with the open suctioning method. Conclusion: For patients on ventilator therapy below FiO2 60% and PEEP 8cmH₂O, open suctioning performed after delivery of 100% FiO₂ using a mechanical ventilator may not have as much negative impact on lung dynamics and hypoxemia as closed suctioning.