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Table 7 Characteristics of included studies on endotracheal suctioning

From: Clinical evidence based review and recommendations of aerosol generating medical procedures in otolaryngology – head and neck surgery during the COVID-19 pandemic

Author, yearStudy DesignLevel of EvidenceSubjects (n)Study GroupsStudy outcomesConclusionDirectness of evidence
He, 2017 [36]Environmental studyN/AN/AAir samples in PICUAir 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 studyN/AN/AAir samples in respiratory centre1. 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
Thompson, 2013 [38]Descriptive, cross sectional studyN/A39Hospitalized patients with lower respiratory tract infectionsRT-PCR of viral DNA in air samplesRespiratory/airway suctioning shows an increased risk of producing viral particles above baseline, but not statistically significantDirect
Mousa, 2019 [39]Descriptive, cross sectional studyN/A10Patients with Acinetobacter baumannii infection on ventilationCultures of air samplesEndotracheal suctioning increased the risk of air contaminationDirect
Loeb, 2004 [30]Case control study432/11HCWs with/without SARS contactSARS infection in HCWsSuctioning after intubation was not associated with SARS infection rate.Indirect
Raboud, 2010 [34]Retrospective cohort study3624HCWs with/without SARS contactSARS infection in HCWsSuctioning 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 study436/50HCWs with/without SARS contactSARS infection in HCWsSuction of body fluids is not a procedure significantly associated with the development of SARS among HCWsIndirect
  1. PICU pediatric intensive care unit
  2. RT-PCR real time polymerase chain reaction
  3. DNA deoxyribonucleic acid
  4. HCWs health care workers
  5. SARS severe acute respiratory syndrome