The Science Journal of the American Association for Respiratory Care

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

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