Open versus closed suctioning on lung volume and oxygenation in ARDS patients with PEEP 5-10 cmH2O: A randomized controlled trial

To compare the effects of open suctioning (OS) versus closed suctioning (CS) on lung volume and oxygenation in acute respiratory distress syndrome (ARDS) patients receiving mechanical ventilation with positive end-expiratory pressure (PEEP) of 5-10 cmH2O.

This single-center, prospective randomized controlled trial enrolled 60 ARDS patients, who were randomly assigned to OS (n = 30) or CS (n = 30). All patients received lung-protective ventilation with volume-controlled mode. SpO2 was recorded before suctioning and at 1, 10, 20, and 30 minutes post-suctioning. Arterial blood gas analysis was performed at 30 minutes to calculate the oxygenation index (PaO2/FiO2). Changes in end-expiratory lung impedance (ΔEELI) were monitored using electrical impedance tomography (EIT) for the whole lung and four regions of interest (ROI). Secondary outcomes included extubation and survival, analyzed using Kaplan-Meier curves and Cox regression.