الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Ventilator associated pneumonia is a foremost problem in NICUs worldwide and
dramatically increases morbidity and mortality rates of neonates. Mechanically ventilated
neonates are at risk for retained secretions from many causes. As accumulation of
endotracheal secretions is common among those neonates, the principle goal of airway
management is to establish and maintain a patent airway in order to ensure adequate
alveolar ventilation and oxygenation. Tracheal suctioning plays an important role in
keeping respiratory airway free from secretions. It is usually performed through OSS,
where the neonate is disconnected from the ventilator and the suction catheter is introduced
into the endotracheal tube. Although, tracheal suctioning is frequently performed to clear
airway secretion, OSS is associated with a number of complications. Unfortunately,
tracheal suction is also considered the main entry of bacteria to the lower respiratory tract
and increases the risk for VAP development. So, advanced suctioning technique namely
CSS has been introduced into clinical practice with the aim of preventing or reducing the
unwanted effects of OSS. In CSS the suction catheter is usually introduced into the airway
without disconnecting the neonate from the ventilator. So, the risk of complications may be
reduced by minimizing the interference with ventilation during the procedure. Therefore,
the aim of the present study was to determine the effect of closed versus open suction
system on the occurrence of ventilator associated pneumonia in neonates.