Tracheal suctioning is a process which is often applied to patients' care who have an artificial airway and whose respiration is achieved via mechanical ventilation. When secretions are not cleaned enough, it causes a variety of complications in the patient from hypoxemia to infection.

It is reported that the studies with nurses in clinical practice have shown that they have opinions such as the closed system does not suction the patients effectively as the open system does; it remains incapable in removing secretions, thus the suctioning process is being applied more frequently.

Therefore this study is designed to examine the amount of secretions and frequency of suctioning as a result of open and closed suctioning systems.

Patients will be monitored for two days. On the first day, the patient will be followed up with an open system and the second day closed suctioning system will be used, or the patient will be followed up with a closed system on the first day and followed with an open system on the second day. The patients are randomly allocated on the first follow up days. The follow-up period has two consecutive days. suctioning will be performed for 12 hours in one day. The number of suctions will be recorded. The amount of secretion will be accumulated in the mucus collection vessel. At the end of the day, the secretion will be weighed with precision weighing.

Inclusion Criteria:

• orally intubated in first 96 hours
• stabilized patients in conditionally
• platelets > 50.000
• not have hemorrhagic secretions

Exclusion Criteria:

• hemodynamically unstabilized patients

There is no plan to share the patients data with other researchers.