title: The effects of closed tracheal suctioning plus volume guarantee on cerebral hemodynamics.
abstract: OBJECTIVE
  To compare the effects of open tracheal suctioning (OS) plus intermittent mandatory ventilation (IMV) vs. closed tracheal suctioning (CS) plus volume guarantee ventilation (VG) on changes in mean cerebral blood-flow velocity (CBFv) of ventilated very low birth weight (VLBW) infants.
  
  
  METHODS
  A total of 75 normotensive, ventilated VLBW infants (with normal cranial ultrasounds) had monitoring of mean CBFv, PCO2 and mean arterial blood pressure (MABP) before, during and after 220 tracheal suctioning sessions during the first week of life. Multiple linear regression analysis was used to determine the factor(s) influencing the magnitude of relative changes from baseline in mean CBFv after suctioning.
  
  
  RESULTS
  In all, 49 VLBW infants receiving IMV had monitoring during 124 OS sessions between July 2002 and May 2005; 26 VLBW infants receiving VG had monitoring during 96 CS sessions between January 2006 and July 2007. The average magnitude of relative changes in mean CBFv was significantly less with CS+VG, and was associated with the magnitude of relative changes in PCO2 and suctioning-ventilator group.
  
  
  CONCLUSIONS
  The average magnitude of relative changes in mean CBFv was reduced in VLBW infants with CS+VG vs. OS+IMV.
authors.affiliation: Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72202, USA. kaiserjeffreyr@uams.edu
authors.forename: J R
authors.initials: JR
authors.lastname: Kaiser
authors.forename: C H
authors.initials: CH
authors.lastname: Gauss
authors.forename: D K
authors.initials: DK
authors.lastname: Williams
mesh_terms: D001783:Blood Flow Velocity; D001794:Blood Pressure; D002245:Carbon Dioxide / Q000097:blood; D002560:Cerebrovascular Circulation; D004453:Echoencephalography; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007385:Intermittent Positive-Pressure Ventilation; D007442:Intubation, Intratracheal; D012121:Respiration, Artificial; D013396:Suction
chemical_list: D002245:Carbon Dioxide