Efficacy of closed and open endotracheal suction on prevention of ventilator-associated pneumonia on patients admitted to critical care unit at tertiary care hospital

Abstract

Background: Endotracheal suctioning is a method commonly used to clean airway secretions in patients under mechanical ventilation. This study aimed to compare the effects of open and closed suction methods on the occurrence of ventilator-associated pneumonia (VAP). In the open endotracheal suction, the approach necessitates the participation of two nurses and may result in a momentary interruption of ventilation and oxygen supply due to the patient's disconnection from the ventilation device during suctioning. In the closed endotracheal suction, the approach can be performed through connections in a closed suction set while the patient is ventilated without separating the patient from the ventilator. Objective: (1). To compare the close endotracheal suction with open endotracheal suction for the prevention of VAP. (2) To assess the incidence of VAP among intubated patients. Materials and Methods: The study was conducted among 60 patients who are on mechanical ventilator in the critical care unit in tertiary care hospital. For the study, simple random sampling technique is used for the selection of sample. Using a lottery method of sampling, one in the experimental group and one in the control group on the basis of inclusion criteria. Results: The study was done on patients who are on mechanical ventilators in the critical care unit in tertiary care hospitals. The data analysis was done using descriptive and inferential statistics. The study finding revealed that in VAP scoring of the patient's 1st and 2nd day in open endotracheal suction, there are no significant changes in open endotracheal suction then null hypothesis was accepted (t = 0.9, P = 0.37). VAP scoring of the patient's 2nd and 3rd day and 3rd and 1st day in open endotracheal suction, there are significant changes in open endotracheal suction method in null hypothesis was rejected (P < 0.05). VAP scoring of the patient's 1st and 2nd day and 2nd and 3rd day and 3rd and 1st day in closed endotracheal suction, there are significant changes in closed endotracheal suction then null hypothesis was rejected (P < 0.05). Conclusion: The study assessed the efficacy of open endotracheal suction versus closed endotracheal suction on age, sex, duration of hospital stays, return of mechanical ventilation, and mode of ventilation are not significant but the duration of mechanical ventilation is significant. The nurses play a vital role in assessing the cardiac monitor while doing suctioning to prevent cardiorespiratory complications.