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Closed Suctioning of Intubated Neonates Maintains Better Physiologic Stability: A Randomized Trial

Journal of Perinatology volume 23, pages 218–222 (2003)Cite this article

Abstract

OBJECTIVE: To evaluate the physiological variance in a closed (CS) vs an open suction (OS) protocol in intubated infants.

STUDY DESIGN: Infants were stratified into three weight groups in a randomized crossover trial. Heart rate, respiratory rate, blood pressure, oxygen saturation, transcutaneous oxygen and carbon dioxide, and end-tidal carbon dioxide were recorded prior to suctioning, during suctioning, and recovery to baseline. Following the procedures, recovery time to baseline parameters was measured. Data were analyzed using repeated measures ANOVA.

RESULTS: Overall, there was significantly less deviation from baseline physiological parameters with CS. Infants <1000 g had clinically significant decreases in heart rate with the OS method (−18% OS vs −6% CS; p=0.016). Recovery time in the OS group was twice that of the CS cohort (4 vs 2 minutes; p<0.001).

CONCLUSION: CS maintains better physiologic stability in intubated infants.

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Acknowledgements

We acknowledge CORPAK MedSystems for donation of the Neo-LINK™ adaptors and SpaceLabs Medical for donation of the research monitor. We would like to thank the other members of the team (Marianne Janes, Jackie Cusworth, Byron Gutoskie) as well as the research assistants (Patti Bosher, Judy D'Ilario, Steve Turner and Jody Locke). We thank Kelly Smith for the statistical analysis and interpretation, and all the parents and babies that participated in this study.

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Authors and Affiliations

  1. Department of Pediatrics (Neonatal Division), Acute Children's Services, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, Ontario, Canada

    Angela Kalyn RNC, MHSc, NNP, Susan Blatz RNC, MEd, PhD,  Sandra Feuerstake RN, MHSc, NNP, Bosco Paes MD, FRCP (I), FRCP(C) & Carlos Bautista RRT

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  1. Angela Kalyn RNC, MHSc, NNP
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  2. Susan Blatz RNC, MEd, PhD
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  3. Sandra Feuerstake RN, MHSc, NNP
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  4. Bosco Paes MD, FRCP (I), FRCP(C)
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  5. Carlos Bautista RRT
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This work was funded by The Hamilton Health Sciences Foundation and Neonatal Donations Committee.

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Kalyn, A., Blatz, S., Sandra Feuerstake et al. Closed Suctioning of Intubated Neonates Maintains Better Physiologic Stability: A Randomized Trial. J Perinatol 23, 218–222 (2003). https://doi.org/10.1038/sj.jp.7210883

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