title: Changes in heart rate, mean arterial pressure, and oxygen saturation after open and closed endotracheal suctioning: a prospective observational study.
abstract: OBJECTIVE
  It 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.
  
  
  METHODS
  We 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.
  
  
  RESULTS
  In 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.
  
  
  CONCLUSIONS
  Changes in HR, MAP, and Spo(2) were comparable and mild during and after CSS and OSS. Both systems can be considered equally safe.
authors.affiliation: Department of Intensive Care Medicine, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands. i.p.jongerden@umcutrecht.nl
authors.forename: Irene P
authors.initials: IP
authors.lastname: Jongerden
authors.forename: Jozef
authors.initials: J
authors.lastname: Kesecioglu
authors.forename: Ben
authors.initials: B
authors.lastname: Speelberg
authors.forename: Anton G
authors.initials: AG
authors.lastname: Buiting
authors.forename: Maurine A
authors.initials: MA
authors.lastname: Leverstein-van Hall
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Bonten
mesh_terms: D000328:Adult; D000368:Aged; D062186:Arterial Pressure; D018592:Cross-Over Studies; D005260:Female; D006339:Heart Rate; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*; D011446:Prospective Studies; D012121:Respiration, Artificial; D013396:Suction / Q000379:methods*
chemical_list: D010100:Oxygen