New endotracheal tube adaptor reducing cardiopulmonary effects of suctioning

Cabal, Luis A; Devaskar, Sherin U.; Siassi, Bijan; Plajstek, Carolyn; Waffarn, Feizal; Blanco, Carlos; Hodgman, Joan E.

doi:10.1097/00003246-197912000-00009

Cited by 37 publications

(20 citation statements)

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“…Our results support the findings of smaller studies that evaluated length of recovery time using CS vs OS suction in the neonatal population. 8,9 The heart rate variable during the OS method demonstrated the greatest difference in recovery time compared to the CS method. For all infants, a significantly greater decline in HR was experienced during the OS method.…”

Section: Discussionmentioning

confidence: 96%

“…The sample sizes appear to be relatively small (range: 8-15) with the exception of Tan's study (N ¼ 56), in which the participants were not well described. [8][9][10][11][12][13] This limits the generalizability and external validity of the data. This is the first study to evaluate methodically the effect of CS in a large stratified NICU population.…”

Section: Discussionmentioning

confidence: 99%

“…Three previous studies evaluating the effects of OS vs CS protocols on HR also found the decline in HR to be significantly greater during OS methods. [9][10][11] Two other studies found no significant differences in HR. 8,13 In a subgroup analysis, infants <1000 g had clinically and statistically significant greater decreases in heart rate than infants 1000-2000 and >2000 g. This study is the first to establish that infants <1000 g react differently to the suction process with regard to HR stability.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2003

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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 (À18% OS vs À6% CS; p ¼ 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.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

et al. 2003

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“…Two randomized crossover (33,34) and two nonrandomized crossover (35,36) trials examined the effects of adaptors designed to maintain pressure and/or ventilation during suctioning. Two studies (33,34) used a modified Wye adaptor with an end hole for suctioning, while the other two (35,36) used a modified ETT adaptor that allows suctioning through a side hole.…”

Section: Recommendationsmentioning

confidence: 99%

“…Two studies (33,34) used a modified Wye adaptor with an end hole for suctioning, while the other two (35,36) used a modified ETT adaptor that allows suctioning through a side hole. All studies showed a beneficial effect for the use of an adaptor on oxygenation.…”

Section: Recommendationsmentioning

confidence: 99%

Clinical Practice Guideline for Suctioning the Airway of the Intubated and Non-Intubated Patient

Brooks

Anderson²,

Carter³

et al. 2001

Canadian Respiratory Journal

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OBJECTIVE: To provide physicians, physiotherapists, nurses and respiratory therapists with guidelines for the application of airway suctioning. DESIGN: This clinical practice guideline was developed using the model by Browman and colleagues. A working group of representatives from four professional colleges (nurses, physicians and surgeons, physiotherapists and respiratory therapists) and research experts was formed to conduct a systematic review, develop evidence-based recommendations and generate clinical practice guidelines. MEDLINE (1966 to 1998), CINAHL (1982) and EMBASE (1974 as well as the reference lists of identified articles were searched. Inclusion of articles was determined by at least two group members, and studies were classified according to type. Randomized, controlled; randomized; and nonrandomized crossover and comparative cohort trials were grouped by type of intervention and population for use in the development of recommendations. Other observational and animal studies dealing with adverse effects of suctioning were included in the review but were not used in the development of recommendations. Input on the evidencebased recommendations was sought and incorporated from members of all four professions and from experts on content and methodology. SETTING: Any setting (hospital or home) where suctioning is performed. POPULATION: Intubated and nonintubated adults, infants and children. RESULTS AND CONCLUSIONS: An attempt was made to develop recommendations in each of the subcategories of suctioning techniques addressed by at least one study. In some subcategories, definite recommendations were made (13 in adults, and three in children and infants); in other subcategories, insufficient evidence precluded recommendations. The recommendations addressed the following aspects of suctioning: preoxygenation, hyperinflation, insufflation, hyperoxygenation, hyperventilation, saline instillation, adaptor use, medication use, open and closed systems, and various types of catheters.

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Partially Ventilated Endotracheal Suction

Gunderson¹

1986

Am J Dis Child

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New endotracheal tube adaptor reducing cardiopulmonary effects of suctioning

Cited by 37 publications

References 0 publications

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

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

Clinical Practice Guideline for Suctioning the Airway of the Intubated and Non-Intubated Patient

Partially Ventilated Endotracheal Suction

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