Closed Suction Systems for Safer, Smarter Airway Management

Reduce infection risk and enhance patient comfort with Ballard™ closed suction systems—trusted worldwide for in-line, continuous ventilation suctioning.

Summary

Managing airway secretions in intubated or tracheostomised patients is a daily challenge in critical care. Traditional open suctioning increases the risk of infection, ventilation interruption, and oxygen desaturation. In contrast, a closed suction system—such as the Ballard™ closed suction catheter range by Avanos—allows healthcare professionals to clear secretions without disconnecting the patient from the ventilator. This page explores the function, design, and advantages of closed suction systems, and why Ballard™ remains the leading name in respiratory hygiene for adult, paediatric, and neonatal care.

What Is a Closed Suction System?

A closed suction system is a sterile, in-line device that allows endotracheal or tracheal suctioning without breaking the ventilator circuit. It comprises a catheter enclosed in a protective sheath, integrated with a swivel elbow or T-piece that remains connected to the ventilator tubing.

Key components:

Suction catheter: Inserted into the airway for secretion removal
Protective sleeve: Prevents microbial contamination
Thumb valve or control switch: Regulates suction application
Swivel or Y-connector: Maintains airway continuity during suction
Optional saline port or TURBO flush system for clearing catheter debris

Ballard™ systems also include oral care suction handles, Yankauer devices, and self-cleaning technology for extended use.

Overview of Ballard™ Closed Suction Systems

The Avanos Ballard™ product range includes systems for every patient group and clinical scenario, offering both single-use and extended-use designs.

Key Products:

Ballard Closed Suction System – Double Swivel Elbow (Adult)
Ballard TURBO Cleaning Closed Suction System with in-line saline flush
Ballard 14Fr–5.4mm T-piece Suction System with MDI and Irrigation Port
Neonatal/Paed Closed Suction Catheter with Y-adapter or elbow
Ballard Self-Cleaning Yankauer and Oral Suction Handle for oral secretion control

Product Features:

Available in multiple French sizes (5Fr–16Fr)
Designed for up to 72-hour use or as single-use
Suited for tracheostomy or endotracheal tubes
Compact, soft sheath for easy catheter reinsertion
Options for MDI port and prefilled saline cleaning packs

These systems are trusted in high-acuity ICUs, emergency transport, paediatric wards, and neonatal intensive care.

Innovation: TURBO Cleaning & Self-Cleaning Suction

Two of the standout innovations from Avanos Ballard™ include:

TURBO Cleaning Closed Suction System:

In-line saline vial clears secretion residue from inside the catheter
Reduces resistance and cross-contamination risk
Eliminates need for external saline instillation
Ideal for high-viscosity or copious secretions

Self-Cleaning Yankauer & Oral Suction:

Designed for oropharyngeal care alongside tracheal suction
Available with covers, handles, and toothbrush attachments
Prevents biofilm buildup on oral suction tools
Enhances overall VAP prevention strategy

Journal of Hospital Infection found that comprehensive suction protocols, including oral care tools, reduce nosocomial pneumonia by 29%.

How to Use a Closed Suction System

Closed suctioning should follow institutional protocols and national guidelines. The typical procedure includes:

Wash hands and wear PPE
Verify catheter size and integrity
Insert catheter while ventilator remains connected
Activate suction using thumb valve
Withdraw catheter gently while rotating
Flush catheter using saline vial or TURBO function if available
Document secretion characteristics and patient response

Maintenance Tips:

Replace catheter every 72 hours or per protocol
Perform oral care every 4 hours in ventilated patients
Do not disconnect ventilator unless medically necessary

Best Practice Applications and Use Cases

Suitable for:

Mechanically ventilated adults (ICU, theatre, ED)
Neonates and infants (NICU care)
Long-term tracheostomised patients in acute or aged care
Emergency intubation where time and sterility matter
Paediatric wards needing delicate catheter sizing

Clinical Outcomes Supported:

Maintains positive end-expiratory pressure (PEEP) during suctioning
Decreases airway contamination
Minimises interruption to oxygen and ventilation delivery
Enhances staff efficiency and patient safety

Ballard™ systems are also used in conjunction with oral care programs to reduce aspiration and bacterial colonisation.

Choosing the Right Closed Suction System

When selecting a closed suction system, consider:

1. Patient Group

Adult: 12Fr–16Fr
Paediatric: 8Fr–10Fr
Neonatal: 5Fr–6Fr

2. Connector Type

Swivel elbow for endotracheal tubes
Y-adapter for tracheostomy tubes
MDI port integration if administering medication inline

3. Duration of Use

Standard single-use or extended up to 72 hours
Self-cleaning and TURBO models recommended for long-term ventilation

4. Additional Features

TURBO flush for clog-prone patients
Pre-attached saline vials
Oral care integration

Products like the Ballard™ TURBO Cleaning Closed Suction Catheter with Elbow and Self-Cleaning Yankauer deliver next-generation infection prevention.

Conclusion

Closed suction systems have become the gold standard for respiratory secretion management in ventilated patients. They enhance oxygenation, maintain PEEP, and drastically reduce the risk of ventilator-associated pneumonia when used properly. The Avanos Ballard™ closed suction range—featuring TURBO cleaning, self-cleaning Yankauer, and neonatal options—offers clinicians high-quality, user-friendly, and evidence-based tools for infection control and respiratory safety.

From the ICU to the NICU, these systems streamline care without compromising safety.