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Closed versus open endotracheal suctioning in extremely low-birth-weight neonates: a randomized, crossover trial

Sabine M Pirr1, Matthias Lange, Carolin Hartmann

  • 1Department of Pediatric Pulmonology, Allergology and Neonatology, Hanover Medical School, Hanover, Germany. Pirr.Sabine@mh-hannover.de

Neonatology
|December 5, 2012
PubMed

Insights

Closed endotracheal suctioning (CS) improved oxygenation in extremely low-birth-weight (ELBW) neonates compared to open suctioning (OS). While CS reduced hypoxemia frequency and improved oxygen saturation, further research is needed to confirm overall superiority.

Area of Science:

  • Neonatal Intensive Care
  • Respiratory Support
  • Pediatric Critical Care

Background:

  • Endotracheal suctioning is common in mechanically ventilated patients.
  • Complications can arise, particularly in extremely low-birth-weight (ELBW) neonates with compromised lung function.

Purpose of the Study:

  • To compare the efficacy of closed endotracheal suctioning (CS) versus open endotracheal suctioning (OS).
  • To determine if CS reduces hypoxemia and bradycardia in ELBW neonates.

Main Methods:

  • A randomized crossover trial involving 15 ventilated ELBW neonates.
  • Both CS and OS techniques were used.
  • Collected data included oxygen saturation (SpO2), heart rate (HR), blood pressure, blood gases, and procedure duration.

Main Results:

  • CS significantly decreased the frequency of hypoxemia (<85%) compared to OS (0.5 vs. 1.1).
  • Mean minimum SpO2 was higher with CS (87%) versus OS (84%).
  • CS resulted in significantly higher mean arterial PO2 and oxygenation ratio post-procedure.

Conclusions:

  • Closed suctioning demonstrates superiority in improving oxygenation values in ELBW neonates.
  • Further research is necessary to establish overall superiority and guide clinical practice.
  • Current recommendation is individualized administration of CS for this patient group.
Abstract

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