2001 OPEN FORUM Abstracts
COMPARISON OF CLOSED-SYSTEM ENDOTRACHEAL TUBE SUCTION TECHNIQUE TO OPEN SUCTIONING IN SURFACTANT DEFICIENT NEWBORN PIGLETS.
Pat Meyers RRT, C Worwa RCP, M Mammel MD. Infant Pulmonary Research Center, Children?s Hospital, St. Paul,MN
Introduction: We compared hemodymanics, arterial blood gases and change in FRC (Respitrace?, Ardsley, NY) while using a closed-system suction adaptor (Neo-Link?, Corpak Medsystems, Wheeling,Il) to open endotracheal tube suctioning in 12 Newborn piglets with saline lavage induced lung injury. We hypothesized that open suctioning (OS) would produce greater hemodynamic and blood gas change than closed suctioning (CS).
Methods: A crossover design was used; 6 animals received OS then CS, 6 CS then OS. With each treatment, suction catheters were inserted to 5 mm beyond the tip of the endotracheal tube, and suction pressure (-100 mm Hg) was applied for 10 seconds. Data were collected before and at 1, 5, 10, 15 minutes following the procedure. Arterial blood gases were continuously monitored (Paratrend 7, Diametrics Medical, St. Paul, MN). Data were analyzed using ANOVA and techniques for crossover design.
Results:
| Time | BP | pH | PCO2 | PO2 | ||||
| OS | CS | OS | CS | OS | CS | OS | CS | |
| Before | 47 | 48 | 7.29 | 7.30 | 44 | 43 | 49 | 53 |
| 1 min | 46 | 47 | 7.26* | 7.31 | 48* | 42 | 35* | 55 |
| 5 min | 46 | 47 | 7.29 | 7.31 | 43 | 42 | 53 | 55 |
| 10 min | 47 | 48 | 7.29 | 7.31 | 43 | 43 | 54 | 56 |
| 15 min | 49 | 48 | 7.28 | 7.31 | 45 | 42 | 50 | 58 |
| Time | a/A | OI | sFRC ml/kg | |||
| OS | CS | OS | CS | OS | CS | |
| Before | .075 | .081 | 27 | 24 | ||
| 1 min | .055* | .085 | 26* | 24 | -4.3* | - 0.89 |
| 5 min | .081 | .083 | 25 | 23 | ||
| 10 min | .083 | .086 | 24 | 23 | ||
| 15 min | .077 | .090 | 26 | 23 | ||
*p<0.01 OS vs CS at 1 minute
Conclusions: We saw no hemodynamic differences of the means between OS and CS techniques. However, percent change from absolute value at 1 minute was significant for HR and BP, p<0.01, OS vs CS. At 1 minute after OS, pH was significantly lower with higher pCO2, while pO2 and a/A were lower and OI was higher than corresponding values obtained during CS. Change in lung volume was significant OS vs CS. These data suggest CS techniques may provide better physiologic stability during and after endotracheal suctioning. Neo-Link? and partial funding provided by Corpak Medsystems.
OF-01-009