Endotracheal closed suction systems for COVID19: a rapid review. (Preprint)

BACKGROUND In 2020, the increase in admissions to intensive care units (ICUs) and the morbidity and mortality of the disease pose a challenge to the analysis of evidence of health interventions carried out in ICUs. One of the most common interventions in patients admitted to ICUs for covid19 is endotracheal aspiration. Endotracheal suctioning has also been considered one of the most contaminating interventions. OBJECTIVE To analyse the benefits and risk of endotracheal suctioning using closed suction systems (CSS), with application to the COVID- 19 patients. METHODS A Rapid Review was carried out using the following databases: Pubmed, MEDLINE, CINAHL, LILACS, Cochrane Library and IBECS. It included articles in English and Spanish, published between 2010 and 2020, concerning adult patients and using the key words “endotracheal”, “suction” and “closed system”. RESULTS A total of 15 articles are included. The benefits and risks have been divided into three categories: relating to the patient, care and organisation. The most noteworthy benefits of CSSs are: preventing the ventilator from disconnecting from the patient, reducing the time taken to use the suctioning technique albeit that it produces the greatest number of mucosal occlusions, and avoiding inter-patient and patient-staff environmental contamination. CONCLUSIONS Aside from the need for quality research comparing open suction systems (OSS) and CSSs, in the case of COVID-19 patients, closed endotracheal suctioning has benefits related to ICU stay times and, above all, the reduction of environmental contamination. New evidence in the COVID-19 context should be generated to compare results and establish new indicators for guidelines. CLINICALTRIAL None