Changes in heart rate, mean arterial pressure, and oxygen saturation after open and closed endotracheal suctioning: A prospective observational study

Irene P. Jongerden, Jozef Kesecioglu, Ben Speelberg, Anton G. Buiting, Maurine A. Leverstein-van Hall, Marc J. Bonten

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18 Citations (Scopus)


Purpose: 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 (Spo2) in patients undergoing endotracheal suctioning (ES) with CSS and OSS. Materials and 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 Spo2 were measured before and after ES. Results: In total, 197 complete ES procedures (103 OSS and 94 CSS) were monitored. Mean HR, MAP, and Spo2 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 Spo2, 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 Spo2 were comparable and mild during and after CSS and OSS. Both systems can be considered equally safe.

Original languageEnglish
Pages (from-to)647-654
Number of pages8
JournalJournal of Critical Care
Issue number6
Publication statusPublished - Dec 2012


  • Complications
  • Endotracheal suctioning
  • Intensive care
  • Mechanical ventilation

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