title: Closed suctioning system reduces cross-contamination between bronchial system and gastric juices.
abstract: In this prospective, randomized study, we evaluated whether a closed suctioning (CS) system (TrachCare) influences crossover contamination between bronchial system and gastric juices when compared with an open suctioning system (OS). The secondary aims were an analysis of the frequency of ventilator-associated pneumonia (VAP) and an analysis of alteration in gas exchange. Antibiograms were performed from tracheal secretions and gastric juice aspirates on Days 1 and 3 of intubation in 24 patients in a medical intensive care unit. Five cross-contaminations were observed in the OS group on Day 3 versus Day 1; the 5 strains shared common genotypes as determined by random amplification of polymorphic DNA. No cross-contaminations were seen in the CS group (P = 0.037). VAP occurred in 5 patients of the OS group but in none of the CS group patients (P = 0.037). Spao(2) decreased significantly in the OS group compared with presuctioning values--the opposite of the CS group. Whereas presuctioning values were comparable between groups, postsuctioning Spao(2) was significantly higher in the CS group. CS significantly reduced cross-contamination between bronchial system and gastric juices and reduced the incidence of VAP when compared with OS. Hypoxic phases can be reduced by the help of CS.
authors.affiliation: Intensive Care Unit, Department of Internal Medicine I, University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
authors.forename: Werner
authors.initials: W
authors.lastname: Rabitsch
authors.forename: Wolfgang J
authors.initials: WJ
authors.lastname: Köstler
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Fiebiger
authors.forename: Christoph
authors.initials: C
authors.lastname: Dielacher
authors.forename: Heidrun
authors.initials: H
authors.lastname: Losert
authors.forename: Camillo
authors.initials: C
authors.lastname: Sherif
authors.forename: Thomas
authors.initials: T
authors.lastname: Staudinger
authors.forename: Edith
authors.initials: E
authors.lastname: Seper
authors.forename: Walter
authors.initials: W
authors.lastname: Koller
authors.forename: Florian
authors.initials: F
authors.lastname: Daxböck
authors.forename: Ernst
authors.initials: E
authors.lastname: Schuster
authors.forename: Paul
authors.initials: P
authors.lastname: Knöbl
authors.forename: Heinz
authors.initials: H
authors.lastname: Burgmann
authors.forename: Michael
authors.initials: M
authors.lastname: Frass
mesh_terms: D000368:Aged; D001980:Bronchi / Q000382:microbiology*; D004866:Equipment Contamination / Q000517:prevention & control*; D005260:Female; D005750:Gastric Juice / Q000382:microbiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000209:etiology; D011446:Prospective Studies; D013396:Suction / Q000295:instrumentation*; D012122:Ventilators, Mechanical / Q000382:microbiology*