TY  - JOUR
AU  - Ramírez-Torres, Carmen Amaia
AU  - Rivera-Sanz, Félix
AU  - Sufrate-Sorzano, Teresa
AU  - Pedraz-Marcos, Azucena
AU  - Santolalla-Arnedo, Ivan
PY  - 2023
DA  - 2023/1/10
TI  - Closed Endotracheal Suction Systems for COVID-19: Rapid Review
JO  - Interact J Med Res
SP  - e42549
VL  - 12
KW  - endotracheal suctioning
KW  - closed suction system
KW  - rapid review
KW  - suction
KW  - mechanical ventilation
KW  - COVID-19
KW  - intensive care unit
KW  - health intervention
KW  - endotracheal
KW  - patient care
KW  - healthcare
KW  - ventilator
KW  - health benefit
AB  - Background: The increase in admissions to intensive care units (ICUs) in 2020 and the morbidity and mortality associated with SARS-CoV-2 infection pose a challenge to the analysis of evidence of health interventions carried out in ICUs. One of the most common interventions in patients infected with the virus and admitted to ICUs is endotracheal aspiration. Endotracheal suctioning has also been considered one of the most contaminating interventions. Objective: This review aims to analyze the benefits and risks of endotracheal suctioning using closed suction systems (CSS) in COVID-19 patients. Methods: A rapid review was carried out using the following databases: PubMed, MEDLINE, CINAHL, LILACS, the Cochrane Library, and IBECS. The data search included articles in English and Spanish, published between 2010 and 2020, concerning adult patients, and using the key words “endotracheal,” “suction,” and “closed system.” Results: A total of 15 articles were included. The benefits and risks were divided into 3 categories: patient, care, and organization. Relating to the patient, we found differences in cardiorespiratory variables and changes in the ventilator, for example, improvement in patients with elevated positive and end-expiratory pressure due to maladaptation and alveolar collapse. Relating to care, we found a shorter suctioning time, by up to 1 minute. Relating to organization, we found fewer microorganisms on staff gloves. Other conflicting results between studies were related to ventilator-associated pneumonia, bacterial colonization, or mortality. Conclusions: Aside from the need for quality research comparing open suction systems and CSS as used to treat COVID-19 patients, closed endotracheal suctioning has benefits in terms of shorter stay in the ICU and reduced environmental contamination, preventing ventilator disconnection from the patient, reducing the suctioning time—though it does produce the greatest number of mucosal occlusions—and preventing interpatient and patient-staff environmental contamination. New evidence in the context of the SARS-CoV-2 virus is required in order to compare results and establish new guidelines. 
SN  - 1929-073X
UR  - https://www.i-jmr.org/2023/1/e42549
UR  - https://doi.org/10.2196/42549
UR  - http://www.ncbi.nlm.nih.gov/pubmed/36548
DO  - 10.2196/42549
ID  - info:doi/10.2196/42549
ER  -