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Closed versus Open Endotracheal Suctioning in Extremely Low-Birth-Weight Neonates: A Randomized, Crossover Trial.
MedLine Citation:
PMID:  23208319     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: Endotracheal suctioning, which is frequently necessary in mechanically ventilated patients, might cause complications, especially in patients with compromised lung function such as extremely low-birth-weight (ELBW) neonates. Objectives: To investigate whether closed endotracheal suctioning (CS) reduces the frequency of hypoxemia and bradycardia in ELBW neonates compared to open suctioning (OS). Methods: In a randomized, crossover trial, 15 ventilated ELBW neonates (mean birth weight 655 g) underwent suctioning with both techniques. Data on oxygen saturation (SpO(2)), heart rate (HR), arterial blood pressure, arterial blood gases, duration of the suctioning procedure and recovery time were collected. Statistical analysis was done using the SPSS t test for paired samples. Results: The mean frequency of hypoxemia <85% was significantly decreased (p = 0.012) during CS (0.5) versus OS (1.1). The mean minimum SpO(2) was significantly higher (p = 0.012) during CS (87%) compared to OS (84%), and a significantly less steep drop in mean SpO(2) (p = 0.007) (CS: -5%, OS: -8%) was found. Mean arterial PO(2) (p = 0.035; CS: 59 mm Hg, OS: 53 mm Hg) and mean oxygenation ratio (p = 0.016; CS: 197, OS: 171) were significantly higher after CS. No significant differences were found in HR, incidence or duration of bradycardia, recovery time, arterial blood pressure, duration of suctioning, number of complications, or duration of hypoxemia. Conclusion: CS was superior to OS on oxygenation values. To prove its overall superiority, further research is required. So, in this group of patients, CS should currently be administered on an individual basis.
Authors:
Sabine M Pirr; Matthias Lange; Carolin Hartmann; Bettina Bohnhorst; Corinna Peter
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-01
Journal Detail:
Title:  Neonatology     Volume:  103     ISSN:  1661-7819     ISO Abbreviation:  Neonatology     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101286577     Medline TA:  Neonatology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  124-130     Citation Subset:  -    
Copyright Information:
Copyright © 2012 S. Karger AG, Basel.
Affiliation:
Department of Pediatric Pulmonology, Allergology and Neonatology, Hanover Medical School, Hanover, Germany.
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