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The effects of closed tracheal suctioning plus volume guarantee on cerebral hemodynamics

Journal of Perinatology volume 31, pages 671–676 (2011)Cite this article

Subjects

Abstract

Objective:

To compare the effects of open tracheal suctioning (OS) plus intermittent mandatory ventilation (IMV) vs closed tracheal suctioning (CS) plus volume guarantee ventilation (VG) on changes in mean cerebral blood-flow velocity (CBFv) of ventilated very low birth weight (VLBW) infants.

Study Design:

A total of 75 normotensive, ventilated VLBW infants (with normal cranial ultrasounds) had monitoring of mean CBFv, PCO2 and mean arterial blood pressure (MABP) before, during and after 220 tracheal suctioning sessions during the first week of life. Multiple linear regression analysis was used to determine the factor(s) influencing the magnitude of relative changes from baseline in mean CBFv after suctioning.

Result:

In all, 49 VLBW infants receiving IMV had monitoring during 124 OS sessions between July 2002 and May 2005; 26 VLBW infants receiving VG had monitoring during 96 CS sessions between January 2006 and July 2007. The average magnitude of relative changes in mean CBFv was significantly less with CS+VG, and was associated with the magnitude of relative changes in PCO2 and suctioning-ventilator group.

Conclusion:

The average magnitude of relative changes in mean CBFv was reduced in VLBW infants with CS+VG vs OS+IMV.

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Acknowledgements

We gratefully acknowledge the technical assistance of Natalie C Sikes and Melanie J Mason, and the support of the University of Arkansas for Medical Sciences neonatologists, NICU nurses, respiratory therapists and ultrasound technicians. This research was presented in part at the 2nd Congress of the European Academy of Paediatrics in Nice, France, October 2008 and at the Pediatric Academic Society, Society for Pediatric Research meeting in Baltimore, Maryland, May 2009. Dr Kaiser was supported by the National Institutes of Health (1 K23 NS43185, RR20146 and 1 R01 NS060674), the University of Arkansas for Medical Sciences Center for Clinical & Translational Research (1UL1RR029884), and the University of Arkansas for Medical Sciences Children's University Medical Group.

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Authors and Affiliations

  1. Departments of Pediatrics and Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    J R Kaiser

  2. Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    C H Gauss & D K Williams

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  1. J R Kaiser
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  3. D K Williams
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Correspondence to J R Kaiser.

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Kaiser, J., Gauss, C. & Williams, D. The effects of closed tracheal suctioning plus volume guarantee on cerebral hemodynamics. J Perinatol 31, 671–676 (2011). https://doi.org/10.1038/jp.2011.8

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