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Is the closed suction catheter a perfect alternative to open suction catheter

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Update time : 2020-12-24 10:10:01

Is the closed suction catheter a perfect alternative to open suction catheter

Modern mechanical ventilation technology is a treatment method commonly used to treat critically ill patients in modern clinical practice. In the past mechanical ventilation suction work, open suction catheter is the most-frequently-used suction method. Because this suction method is in an open state, the patient's ventilator needs to be stopped during suction, which affects the ventilation effect. The closed suction catheter is fully enclosed, and it can also avoid taking off the ventilator. It is a new type of sputum suction method.



The closed suction tube is composed of a transparent three-way, two liquid injection ports, a sputum suction tube, a transparent film sheath, a negative pressure control valve, and a connecting tube. One end of the transparent tee is connected with the endotracheal tube or tracheostomy tube, and the other end is connected with the ventilator. 2 injection ports, 1 humidification, 1 connected to the flushing tube of the saline infusion set, and connected to the negative pressure suction device. Open the suction device during suction, fix the artificial airway with the left hand, insert the suction tube into the tracheal intubation or cannula with the right hand along the airway opening, and withdraw 0.5~1.0cm after encountering resistance, press the negative pressure control valve to rotate the suction, and rotate the suction Withdraw while sucking the tube. The best time for each suction should not exceed 15s. Then flush the suction tube with normal saline. Loosen the control valve to complete the suction. The operator does not need to wear sterile gloves.



The use of closed suction catheter has the following advantages:

1

Reduce the incidence of ventilator-associated pneumonia (VAP)

Generally, patients who need mechanical ventilation are in critical condition. At this time, the body’s immune capacity has been severely reduced, and the airway has lost the function of warming and humidifying the inhaled air due to tracheotomy or intubation. Endogenous infection. Respiratory secretions can increase due to the stimulation of tracheal intubation. Therefore, it is necessary to strengthen the suction treatment for patients with artificial airway mechanical ventilation. However, because suction is an invasive operation, effective suction measures are taken to prevent or reduce the respiratory tract. Infection is of great significance.

The entire suction process of closed suction is carried out in a closed environment, which avoids the repeated opening of the ventilator pipeline for open suction and increases the chance of cross infection. At the same time, it will not cause environmental pollution due to the patient's coughing and spraying during sputum suction, avoiding cross-infection and reducing the occurrence of adverse reactions.

2

Maintain effective ventilation and prevent hypoxemia

The ventilator must be disconnected when performing open suction. Although the patient is given sufficient oxygen and lung ventilation before suction, leaving the ventilator during suction can reduce the patient’s alveolar gas exchange capacity and increase its risk This makes it more difficult for patients to exchange gas in the lungs, leading to a significant decrease in lung capacity and loss of positive end-expiratory pressure, which makes the patient unable to maintain good oxygenation, resulting in increased heart rate and decreased arterial oxygen saturation. Once hypoxemia occurs, the time required for the blood oxygen level to return to the normal value is significantly increased, up to about 11 minutes, which poses a corresponding threat to the patient's life safety. The closed suction can be implemented without disconnecting the ventilator, which can effectively reduce the decrease in lung volume and alveolar atrophy caused by suction, and prevent the imbalance of ventilation and blood flow ratio caused by alveolar atrophy . Thus, the shear force caused by alveolar atrophy and recruitment is alleviated, and the lung tissue is prevented or reduced from being damaged again.

3

Since the closed suction tube avoids disconnecting the ventilator during suction, the continuous airway humidification is interrupted, and the ventilator can be continuously humidified and warmed.

4

Prevent occupational exposure of medical staff

Sputum suction is a source of infection for both the patient and the medical staff. The bacteria in the respiratory tract of the patient can be coughed up at a speed of 120km/h. It is easy to cause the patient to cough when the airway is humidified. Sometimes the sputum will spray on the medical staff. , Face, cause occupational injury to medical staff, closed suction has a complete airtightness, which can prevent the patient from coughing and sputum splashing due to sputum suction, contaminating the hands, clothes and bed unit of medical staff, reducing cross-infection , To protect the safety of medical staff.

5

For patients with frequent sputum suction, the cost of using a closed sputum suction tube is lower than that of an independent sputum suction tube, which reduces patient expenditure and saves consumables.

6

The use of a closed suction catheter can significantly reduce the incidence of sp02 drop during suction

It is currently believed that positive end expiratory pressure (PEEP) plays an important role in reducing lung exudation, reducing the incidence of atelectasis, reducing lung injury during ventilator use, and improving oxygenation, especially for acute lung injury and acute Patients with respiratory distress syndrome.

In the process of using a disposable suction tube to suck sputum, because the airway cannot be maintained tightly, and mechanical ventilation cannot be performed at the same time, the positive end-expiratory pressure cannot be maintained, and the Sp02 drops during the suction process. Closed suction can suck the patient without disconnecting the ventilator, guarantee the patient's lung capacity and blood oxygen saturation, avoid the decrease of lung volume and blood oxygen saturation, and can better maintain the patient's health Oxygenation prevents patients from experiencing reflex heart rate increase and blood pressure increase.