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Closed suctioning of intubated neonates maintains a better physiologic stability: a randomized trial
Kalyn A, Blatz S, Feuerstake S, Paes B, Bautista C
Journal of Perinatology 2003 Apr-May;23(3):218-222
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To evaluate the physiological variance in a closed (CS) versus an open suction (OS) protocol in intubated infants. STUDY DESIGN: Infants were stratified into three weight groups in a randomized crossover trial. Heart rate, respiratory rate, blood pressure, oxygen saturation, transcutaneous oxygen and carbon dioxide, and end-tidal carbon dioxide were recorded prior to suctioning, during suctioning, and recovery to baseline. Following the procedures, recovery time to baseline parameters was measured. Data were analyzed using repeated measures ANOVA. RESULTS: Overall, there was significantly less deviation from baseline physiological parameters with CS. Infants < 1,000 g had clinically significant decreases in heart rate with the OS method (-18% OS versus -6% CS; p = 0.016). Recovery time in the OS group was twice that of the CS cohort (4 versus 2 minutes; p < 0.001). CONCLUSION: CS maintains better physiologic stability in intubated infants.
Reprinted by permission from Journal of Perinatology, Macmillan Publishers Ltd.

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