• Jozef Kesecioglu, Maurine A Leverstein-van Hall, Irene P Jongerden, Ben Speelberg, and Anton G Buiting.
• Department of Intensive Care Medicine, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands. i.p.jongerden@umcutrecht.nl
• J Crit Care. 2012 Dec 1;27(6):647-54.

PurposeIt is widely assumed that closed suction systems (CSSs), as compared with open suction systems (OSSs), better guarantee optimal oxygenation with less disturbance of physiologic parameters in mechanically ventilated intensive care patients. We, therefore, quantified changes in heart rate (HR), mean arterial pressure (MAP), and peripheral oxygen saturation (Spo(2)) in patients undergoing endotracheal suctioning (ES) with CSS and OSS.Materials And MethodsWe performed a prospective observational study nested within a crossover trial in 4 intensive care units between January 2007 and February 2008. Per unit, 50 ES procedures were selected at random, and HR, MAP, and Spo(2) were measured before and after ES.ResultsIn total, 197 complete ES procedures (103 OSS and 94 CSS) were monitored. Mean HR, MAP, and Spo(2) changed directly after ES and returned to baseline after 5 minutes. Changes in HR and MAP were comparable after using CSS and OSS, whereas in Spo(2), slightly better values were monitored 3 and 5 minutes after OSS, these differences being rather small (0.3%-0.7%) and clinically not relevant.ConclusionsChanges in HR, MAP, and Spo(2) were comparable and mild during and after CSS and OSS. Both systems can be considered equally safe.Copyright © 2012 Elsevier Inc. All rights reserved.

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