Table 7 Characteristics of included studies on endotracheal suctioning

He, 2017 [36]

Environmental study

N/A

N/A

Air samples in PICU

Air 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 study

N/A

N/A

Air samples in respiratory centre

1. 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

Direct

Thompson, 2013 [38]

Descriptive, cross sectional study

N/A

39

Hospitalized patients with lower respiratory tract infections

RT-PCR of viral DNA in air samples

Respiratory/airway suctioning shows an increased risk of producing viral particles above baseline, but not statistically significant

Direct

Mousa, 2019 [39]

Descriptive, cross sectional study

N/A

10

Patients with Acinetobacter baumannii infection on ventilation

Cultures of air samples

Endotracheal suctioning increased the risk of air contamination

Direct

Loeb, 2004 [30]

Case control study

4

32/11

HCWs with/without SARS contact

SARS infection in HCWs

Suctioning after intubation was not associated with SARS infection rate.

Indirect

Raboud, 2010 [34]

Retrospective cohort study

3

624

HCWs with/without SARS contact

SARS infection in HCWs

Suctioning 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 study

4

36/50

HCWs with/without SARS contact

SARS infection in HCWs

Suction of body fluids is not a procedure significantly associated with the development of SARS among HCWs

Indirect