Effects of open endotracheal suction on lung volume in infants receiving HFOV.
OBJECTIVE
To describe the pattern and magnitude of lung volume change during open endotracheal tube (ETT) suction in infants receiving high-frequency oscillatory ventilation (HFOV).


METHODS
Prospective observational clinical study.


METHODS
Tertiary neonatal intensive care unit.


METHODS
Seven intubated and muscle-relaxed newborn infants receiving HFOV.


METHODS
Open ETT suction was performed for 6 s at -100 mmHg using a 6-F catheter passed to the ETT tip after disconnection from HFOV. The HFOV was then recommenced at the same settings as prior to ETT suction.


RESULTS
Change in lung volume (DeltaV (L)) referenced to baseline lung volume before suction was measured with a calibrated respiratory inductive plethysmography recording from 30 s before until 60 s after ETT suction. In all infants ETT suction resulted in significant loss of lung volume. The mean DeltaV (L) during suctioning was -13 ml/kg (SD 4 ml/kg) (p<0.0001 vs. baseline, repeated-measures ANOVA), with a mean 76.5% (SD 14.1%) of this volume loss being related to circuit disconnection. After recommencing HFOV lung volume was rapidly regained with mean DeltaV (L) at 60 s being 1 ml/kg (SD 4 ml/kg) below baseline (p>0.05, Tukey post-test).


CONCLUSIONS
Open ETT suction caused a significant but transient loss of lung volume in muscle-relaxed newborn infants receiving HFOV.
Tingay
D G
DG
Department of Neonatology, Royal Children's Hospital, Flemington Rd, 3052, Parkville, VIC, Australia. david.tingay@rch.org.au
Copnell
B
B
Mills
J F
JF
Morley
C J
CJ
Dargaville
P A
PA
D006612:High-Frequency Ventilation / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000628:therapy*; D007363:Intensive Care Units, Neonatal; D007442:Intubation, Intratracheal / Q000379:methods*; D008176:Lung Volume Measurements; D010991:Plethysmography; D013396:Suction