Mechanical ventilation with or without daily changes of in-line suction catheters

Am J Respir Crit Care Med. 1997 Aug;156(2 Pt 1):466-72. doi: 10.1164/ajrccm.156.2.9612083.


The purpose of this study was to determine the safety and cost-effectiveness of not routinely changing in-line suction catheters for patients requiring mechanical ventilation. Patients were randomly assigned to receive either no routine in-line suction catheter changes (n = 258) or in-line suction catheter changes every 24 h (n = 263). The main outcome measure was the incidence of ventilator-associated pneumonia. Other outcomes evaluated included hospital mortality, acquired organ system derangements, duration of mechanical ventilation, lengths of intensive care and hospital stay, and the cost for in-line suction catheters. Ventilator-associated pneumonia was seen in 38 patients (14.7%) receiving no routine in-line suction catheter changes and in 39 patients (14.8%) receiving in-line suction catheter changes every 24 h (relative risk, 0.99; 95% CI, 0.66 to 1.50). No statistically significant differences for hospital mortality, lengths of stay, the number of acquired organ system derangements, death in patients with ventilator-associated pneumonia, or mortality directly attributed to ventilator-associated pneumonia were found between the two treatment groups. Patients receiving in-line suction catheter changes every 24 h had 1,224 catheter changes costing a total of $11,016; patients receiving no routine in-line suction catheter changes had a total of 93 catheter changes costing $837. Our findings suggest that the elimination of routine in-line suction catheter changes is safe and can reduce the costs associated with providing mechanical ventilation.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Catheterization / adverse effects
  • Catheterization / economics
  • Catheterization / instrumentation
  • Catheterization / statistics & numerical data
  • Cost-Benefit Analysis
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pneumonia, Bacterial / epidemiology
  • Pneumonia, Bacterial / etiology
  • Prospective Studies
  • Respiration, Artificial / adverse effects
  • Respiration, Artificial / economics
  • Respiration, Artificial / instrumentation*
  • Respiration, Artificial / statistics & numerical data
  • Risk Factors
  • Severity of Illness Index
  • Suction / adverse effects
  • Suction / economics
  • Suction / instrumentation
  • Suction / statistics & numerical data
  • Time Factors