Closed Suctioning of Intubated Neonates Maintains Better Physiologic Stability: A Randomized Trial

OBJECTIVE: To evaluate the physiological variance in a closed (CS) vs 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 <1000 g had clinically significant decreases in heart rate with the OS method (−18% OS vs −6% CS; p=0.016). Recovery time in the OS group was twice that of the CS cohort (4 vs 2 minutes; p<0.001).CONCLUSION: CS maintains better physiologic stability in intubated infants.