What is the difference between closed and in-line suctioning of tracheostomy?

Same. In an effort to reduce infections in ventilated patients, the use of a closed or in- line suctioning system has been utilized. This reduces the chances of introducing bacteria either by the person suctioning or from the outside environment. The drawback is that the catheters used are usually plastic, and can cause tracheal irritation, injury, and bleeding. Softer rubber catheters are less traumati.