SynthesisIntensive care medicine2015
Impact of closed versus open tracheal suctioning systems for mechanically ventilated adults: a systematic review and meta-analysis.
Synthesis in Intensive care medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- Industry-funded versus non-profit-funded critical care research: a meta-epidemiological overview.Intensive care medicine · 2018Pooled it
- Open versus Closed Suctioning Among Mechanically Ventilated Pediatric Patients: A Randomised Control Trial.Indian journal of pediatrics · 2025Trial
- Open versus Closed Suctioning Among Mechanically Ventilated Pediatric Patients: A Randomised Control Trial - Authors' Reply-2.Indian journal of pediatrics · 2025Article
- [Suctioning in intubated and tracheotomized patients : A narrative review].Die Anaesthesiologie · 2024Review
- Airway and Respiratory Devices in the Prevention of Ventilator-Associated Pneumonia.Medicina (Kaunas, Lithuania) · 2023Review
- Application of a New Type of Protective Sputum Suction Device in Clinic against Cross-Infection between Medical Staff and Patients.Critical care research and practice · 2023Article
- Comparison of Closed vs Open Suction in Prevention of Ventilator-associated Pneumonia: A Systematic Review and Meta-analysis.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2022Article
- Effect of open versus closed endotracheal suctioning on intracranial pressure in severe brain-injured children: Study protocol for a randomized controlled trial.Nursing open · 2021Article
- Closed tracheal suctioning systems in the era of COVID-19: is it time to consider them as a gold standard?Journal of infection prevention · 2021Article
- The Effect of the Open and Closed System Suctions on Pain Severity and Physiological Indicators in Mechanically Ventilated Patients with Traumatic Brain Injury: A Randomised Controlled Trial.Turkish journal of anaesthesiology and reanimation · 2020Article
- The Effects of Open and Closed Suction Methods on Occurrence of Ventilator Associated Pneumonia; a Comparative Study.Archives of academic emergency medicine · 2020Article
- Ten ineffective interventions to prevent ventilator-associated pneumonia.Intensive care medicine · 2018Article
- Comparison of the Effect of Open and Closed Endotracheal Suctioning Methods on Pain and Agitation in Medical ICU Patients: A Clinical Trial.Anesthesiology and pain medicine · 2016Article
- Effect of incomplete withdrawal of a closed-suction catheter on airway resistance.Intensive care medicine · 2015Article
- Open and Closed Endotracheal Suctioning and Arterial Blood Gas Values: A Single-Blind Crossover Randomized Clinical Trial.Critical care research and practice · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeWhether closed tracheal suctioning systems (CTSS) reduce the incidence of ventilator-associated pneumonia (VAP) compared with open tracheal suctioning systems (OTSS) is inconclusive. We conducted a systematic review and meta-analysis of randomized controlled trials that compared CTSS and OTSS.
methodsPubMed, the Cochrane Central Register of Controlled Trials, the Web of Science, Google Scholar, and a clinical trial registry from inception to October 2014 were searched without language restrictions. Randomized controlled trials of CTSS and OTSS that compared VAP in mechanically ventilated adult patients were included. The primary outcome was the incidence of VAP. Secondary outcomes were mortality and length of mechanical ventilation. Data were pooled using the random effects model.
resultsSixteen trials with 1,929 participants were included. Compared with OTSS, CTSS was associated with a reduced incidence of VAP (RR 0.69; 95 % CI 0.54-0.87; Q = 26.14; I (2) = 46.4 %). Compared with OTSS, CTSS was not associated with reduction of mortality (RR 0.96; 95 % CI 0.83-1.12; Q = 2.27; I (2) = 0.0 %) or reduced length of mechanical ventilation (WMD -0.45 days; 95 % CI -1.25 to 0.36; Q = 6.37; I (2) = 5.8 %). Trial sequential analysis suggested a lack of firm evidence for 20 % RR reduction in the incidence of VAP. The limitations of this review included underreporting and low quality of the included trials, as well as variations in study procedures and characteristics.
conclusionsBased on current, albeit limited evidence, it is unlikely that CTSS is inferior to OTSS regarding VAP prevention; however, further trials at low risk of bias are needed to confirm or refute this finding.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.