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Tracheal suctioning is associated with prolonged disturbances of cerebral hemodynamics in very low birth weight infants

Journal of Perinatology volume 28, pages 34–41 (2008)Cite this article

Abstract

Objectives:

Examining the effects of tracheal suctioning on cerebral hemodynamics of normotensive ventilated very low birth weight (VLBW) infants with normal cranial ultrasounds; determining the factor(s) influencing changes in mean cerebral blood flow velocity (CBFv) after suctioning.

Methods:

Seventy-three VLBW infants had continuous monitoring of mean arterial blood pressure (MABP), PaCO2, PaO2 and mean CBFv before, during, and after 202 suctioning sessions during the first week of life. Peak (or nadir) and relative changes of the four variables for 45 min after suctioning were calculated. Multiple linear regression was used to determine the factor(s) influencing changes in mean CBFv after suctioning.

Result:

Birth weight was 928±244 g; gestational age was 27.0±2.0 weeks. Mean CBFv increased to 31.0±26.4% after suctioning and remained elevated for 25 min. PaCO2 was highly associated with mean CBFv (P<0.001), whereas MABP and PaO2 were not.

Conclusion:

We observed prolonged increases of mean CBFv following suctioning in ventilated VLBW infants that were previously unrecognized. This is concerning since disturbances of CBF may be associated with subsequent brain injury.

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Acknowledgements

The technical assistance of Natalie C Sikes and Melanie Mason, and the support of the University of Arkansas for Medical Sciences neonatologists, NICU nurses, respiratory therapists and ultrasound technicians, are gratefully acknowledged. JR Kaiser was supported by a National Institute of Neurological Disorders and Stroke Grant 1 K23 NS43185. The University of Arkansas for Medical Sciences, Center for Translational Neuroscience (RR20146) and General Clinical Research Center (M01RR14288) also supported this study. This study was presented, in part, at the 2006 Pediatric Academic Society, Society for Pediatric Research meeting, San Francisco, CA, April 29-May 2, 2006. There are no potential, perceived, or real conflicts of interest.

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Authors and Affiliations

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

    J R Kaiser

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

    C H Gauss

  3. Department of Biostatistics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    D K Williams

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  1. J R Kaiser
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  2. C H Gauss
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Correspondence to J R Kaiser.

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Kaiser, J., Gauss, C. & Williams, D. Tracheal suctioning is associated with prolonged disturbances of cerebral hemodynamics in very low birth weight infants. J Perinatol 28, 34–41 (2008). https://doi.org/10.1038/sj.jp.7211848

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