Liang Zhenghua, Liao Qian, Xu Jinlong, Wang Simei, Liu Qiuyu, Liu Zefang, Wen Dan
Intensive Care Unit, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan Province, China.
Gynecology and Obstetrics, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan Province, China.
Aust Crit Care. 2025 Mar;38(2):101106. doi: 10.1016/j.aucc.2024.08.003. Epub 2024 Sep 5.
There are two types of suction methods used clinically: closed tracheal suction system (CTSS) and open tracheal suction system (OTSS). However, the safety and efficacy of these two suction systems for patients remain to be analysed.
The objective of this study was to assess the safety and efficacy of OTSSs and CTSSs in adult mechanical ventilation.
Computer searches were conducted on PubMed, Web of science, MEDLINE, CINAHL, and Cochrane Library databases. The search spanned from the inception of each database to December 2023. Two researchers independently reviewed and extracted data from the literature. Quality assessment was performed using the Cochrane Manual of Systematic Reviews, and meta-analysis was conducted using RevMan 5.3 software.
A total of 13 articles, involving 2822 patients, were included in the analysis. The meta-analysis showed that the CTSS could reduce the incidence of ventilator-associated pneumonia (odds ratio [OR] = 0.77, 95% confidence interval [CI]: [0.61, 0.98], P = 0.03). However, no significant difference existed in the microbial colonisation rate in the respiratory tract (OR = 1.40, 95% CI: [0.91, 2.15], P = 0.13), mechanical ventilation time (mean difference = -0.33, 95% CI: [-1.43, 0.78], P = 0.56), length of intensive care unit stay (mean difference = 0.23, 95% CI: [-0.90, 1.35], P = 0.69), and mortality (OR = 1.01, 95% CI: [0.84, 1.22], P = 0.89).
In comparison to the OTSS, the CTSS proves effective in reducing the incidence of ventilator-associated pneumonia. However, additional high-quality evidence is needed to evaluate respiratory microbial colonisation rates, the duration of mechanical ventilation, length of intensive care unit stay, and mortality.
临床上使用两种吸痰方法：封闭式气管吸痰系统（CTSS）和开放式气管吸痰系统（OTSS）。然而，这两种吸痰系统对患者的安全性和有效性仍有待分析。
本研究的目的是评估OTSS和CTSS在成人机械通气中的安全性和有效性。
在PubMed、Web of science、MEDLINE、CINAHL和Cochrane图书馆数据库中进行计算机检索。检索时间跨度为每个数据库创建之初至2023年12月。两名研究人员独立审查并从文献中提取数据。使用Cochrane系统评价手册进行质量评估，并使用RevMan 5.3软件进行荟萃分析。
共纳入13篇文章，涉及2822例患者。荟萃分析表明，CTSS可降低呼吸机相关性肺炎的发生率（比值比[OR]=0.77，95%置信区间[CI]：[0.61，0.98]，P=0.03）。然而，呼吸道微生物定植率（OR=1.40，95%CI：[0.91，2.15]，P=0.13）、机械通气时间（平均差=-0.33，95%CI：[-1.43，0.78]，P=0.56）、重症监护病房住院时间（平均差=0.23，95%CI：[-0.90，1.35]，P=0.69）和死亡率（OR=1.01，95%CI：[0.84，1.22]，P=0.89）方面无显著差异。
与OTSS相比，CTSS在降低呼吸机相关性肺炎发生率方面被证明是有效的。然而，需要更多高质量的证据来评估呼吸道微生物定植率、机械通气时间、重症监护病房住院时间和死亡率。
