{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T03:53:13Z","timestamp":1778212393936,"version":"3.51.4"},"reference-count":46,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T00:00:00Z","timestamp":1615248000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>In mechanically ventilated subjects, intra-tracheal secretions can be aspirated with either open suction systems (OSS) or closed suction systems (CSS). In contrast to CSS, conventional OSS require temporarily disconnecting the patient from the ventilator, which briefly diminishes PEEP and oxygen supply. On the other hand, CSS are more expensive and less effective at aspirating secretions. Thus, it was hypothesized that the 2 procedures differentially affect pulmonary and cardiovascular parameters after suction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      Subjects in the ICU (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      = 66) were quasi-randomized for initial treatment with OSS or CSS in a crossover design. To compare the potential for these suction systems to compromise cardiorespiratory stability, changes in cardiopulmonary physiology were assessed from before to just after use of each suction system (three 10-s aspirations).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      For most pulmonary and cardiovascular parameters (ie, peak inspiratory pressure, airway resistance, pressure plateau, heart rate, and arterial pressures), the effects of aspiration inversely correlated with baseline values for that parameter, with a similar regression slope between suction systems. However, when controlling for baseline values, OSS caused significantly greater increases in airway resistance and peak inspiratory pressure (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001 and &lt; .01 vs CSS, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Elevated airway resistance prior to endotracheal suction may justify use of a CSS and contraindicate a conventional OSS in mechanically ventilated subjects. Adoption of this approach into clinical guidelines may prevent suction-induced pulmonary injury in subjects, especially for those with underlying diseases involving increased airway resistance or increased alveolar pressure. (ClinicalTrials.gov registration: NCT03256214.)<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.08511","type":"journal-article","created":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T14:45:44Z","timestamp":1615301144000},"page":"785-792","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Open and Closed Endotracheal Suction Systems Divergently Affect Pulmonary Function in Mechanically Ventilated Subjects"],"prefix":"10.1177","volume":"66","author":[{"given":"Rodrigo Daminello","family":"Raimundo","sequence":"first","affiliation":[{"name":"Laborat\u00f3rio de delineamento de estudos e escrita cient\u00edfica, Faculdade de Medicina do ABC, Santo Andr\u00e9, S\u00e3o Paulo, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica Akemi","family":"Sato","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de delineamento de estudos e escrita cient\u00edfica, Faculdade de Medicina do ABC, Santo Andr\u00e9, S\u00e3o Paulo, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Talita Dias","family":"da Silva","sequence":"additional","affiliation":[{"name":"Departamento de Educa\u00e7\u00e3o Integrada em Sa\u00fade, Universidade Federal do Esp\u00edrito Santo (UFES), Vit\u00f3ria, Esp\u00edrito Santo, Brazil. Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts."},{"name":"Departamento de Cardiologia, Universidade Federal de S\u00e3o Paulo, S\u00e3o Paulo, S\u00e3o Paulo, Brazil."},{"name":"Faculdade de Medicina, Universidade Cidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luiz Carlos","family":"de Abreu","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de delineamento de estudos e escrita cient\u00edfica, Faculdade de Medicina do ABC, Santo Andr\u00e9, S\u00e3o Paulo, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vitor Engr\u00e1cia","family":"Valenti","sequence":"additional","affiliation":[{"name":"Departamento de estudos sobre o Sistema nervoso auton\u00f4mico, Faculdade de Ci\u00eancias e Tecnologia, Universidade Estadual Paulista, Presidente Prudente, S\u00e3o Paulo, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel William","family":"Riggs","sequence":"additional","affiliation":[{"name":"Diabetes and Obesity Center, Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, Kentucky."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Perrow Carll","sequence":"additional","affiliation":[{"name":"Departamento de Educa\u00e7\u00e3o Integrada em Sa\u00fade, Universidade Federal do Esp\u00edrito Santo (UFES), Vit\u00f3ria, Esp\u00edrito Santo, Brazil. Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts."},{"name":"Diabetes and Obesity Center, Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, Kentucky."},{"name":"Department of Physiology, School of Medicine, University of Louisville, Louisville, Kentucky."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,3,9]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3182a2c2b1"},{"issue":"6","key":"e_1_3_3_3_2","first-page":"756","article-title":"Patterns of ventilation in anesthesia: a retrospective study","volume":"52","author":"Vieira JE","year":"2002","unstructured":"Vieira JE, , Silva AR, , Garcia DJ. Patterns of ventilation in anesthesia: a retrospective study. 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