title: The effect of the open and closed system suctions on cardiopulmonary parameters: time and costs in patients under mechanical ventilation.
abstract: BACKGROUND
  One of the measures to keep the airway open is suctioning of endotracheal tube in patients under ventilation. This procedure can be accompanied with some complications. Selection of appropriate method of suctioning can prevent incidence of acute complications.
  
  
  OBJECTIVE
  This study aimed to compare the effects of the open and closed system suctioning methods on blood pressure, mean arterial pressure, heart rate, percentage of arterial oxygen saturation, time, and costs in patients under mechanical ventilation.
  
  
  METHODS
  This clinical trial study was conducted on 40 patients in ICU. Patients' blood pressure, heart rate, arterial oxygen saturation, related costs, and length of suctioning procedure were measured and recorded immediately before and one, five, ten, and fifteen minutes after suctioning. Data were analyzed using paired t test and repeated measure analysis of variance.
  
  
  RESULTS
  No significant differences were observed between the two suctioning methods in terms of mean systolic blood pressure (P = 0.075), diastolic blood pressure (P = 0.405), and mean arterial pressure (P = 0.257) in the five consecutive measurements. However, significant changes were observed in heart rate (P = 0.025) and percentage of arterial oxygen saturation (P < 0.001). The mean lengths of time in open and closed suctioning methods were 5.59 ± 0.211 and 4.34 ± 0.039 seconds, respectively (P < 0.001). The cost of the closed system was lower than the open method for the patients who were admitted to ICU for longer than two days.
  
  
  CONCLUSIONS
  Closed suction caused fewer disturbances in patients' hemodynamic condition, took shorter time, and is more economical. Therefore, this method can replace open suction method in caring of severely critically ill patients.
authors.affiliation: Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, IR Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Afshari
authors.affiliation: Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, IR Iran.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Safari
authors.affiliation: Research Center for Maternal and Child Care, Hamadan University of Medical Sciences, Hamadan, IR Iran.
authors.forename: Khodayar
authors.initials: K
authors.lastname: Oshvandi
authors.affiliation: Department of Biostatistics and Epidemiology, Faculty of Health, Hamadan University of Medical Sciences, Hamadan, IR Iran.
authors.forename: Ali Reza
authors.initials: AR
authors.lastname: Soltanian
keywords: Iran; Nursing; Respiration, Artificial; Suction