Table 7.
Characteristics of included studies on endotracheal suctioning
| Author, year | Study Design | Level of Evidence | Subjects (n) | Study Groups | Study outcomes | Conclusion | Directness of evidence |
|---|---|---|---|---|---|---|---|
| He, 2017 [36] | Environmental study | N/A | N/A | Air samples in PICU | Air samples from rooms in PICU were measured for particle concentration and mass. | Tracheal suction was a main indoor source for particle generation within PICU. | Direct |
| Chung, 2015 [37] | Environmental study | N/A | N/A | Air samples in respiratory centre |
1. Air quality samples were taken over 1 year and measured for particle mass and concentration. 2. Agar plates were used to identify organisms found in the air |
1. Open suctioning has been associated with raised levels of indoor air pollutants and bacteria. 2. The mean concentration of particulate matter increased significantly during open suctioning |
Direct |
| Thompson, 2013 [38] | Descriptive, cross sectional study | N/A | 39 | Hospitalized patients with lower respiratory tract infections | RT-PCR of viral DNA in air samples | Respiratory/airway suctioning shows an increased risk of producing viral particles above baseline, but not statistically significant | Direct |
| Mousa, 2019 [39] | Descriptive, cross sectional study | N/A | 10 | Patients with Acinetobacter baumannii infection on ventilation | Cultures of air samples | Endotracheal suctioning increased the risk of air contamination | Direct |
| Loeb, 2004 [30] | Case control study | 4 | 32/11 | HCWs with/without SARS contact | SARS infection in HCWs | Suctioning after intubation was not associated with SARS infection rate. | Indirect |
| Raboud, 2010 [34] | Retrospective cohort study | 3 | 624 | HCWs with/without SARS contact | SARS infection in HCWs | Suctioning before and after intubation were not statistically significant risk factors for SARS transmission. However, a trend exists and may be associated with transmission. | Indirect |
| Teleman, 2004 [40] | Case control study | 4 | 36/50 | HCWs with/without SARS contact | SARS infection in HCWs | Suction of body fluids is not a procedure significantly associated with the development of SARS among HCWs | Indirect |
PICU pediatric intensive care unit
RT-PCR real time polymerase chain reaction
DNA deoxyribonucleic acid
HCWs health care workers
SARS severe acute respiratory syndrome