CLOSED VERSUS OPEN ENDOTRACHEAL SUCTIONING IN PRETERM INFANTS - EFFECTS ON CEREBRAL OXYGENATION AND BLOOD-VOLUME

The aim of our study was to compare, using near-infrared spectroscopy (NIRS), the effects on cerebral intracellular oxygenation and cerebral blood volume (CBV) of closed endotracheal suctioning (CS), which perm its continuous ventilation of the patient, with open endotracheal suct ioning (OS), which requires disconnection from the ventilator. Eleven preterm infants were studied. Each patient underwent one CS, followed, after 60 min, by one OS, or vice versa, three times during the same d ay. Modifications in CBV and oxidized cytochrome oxidase (CytO(2)) wer e continuously detected by NIRS; arterial oxygen saturation (SaO(2)) h eart rate (HR), transcutaneous carbon dioxide tension and mean arteria l blood pressure were simultaneously recorded. Significant reductions in HR and SaO(2) were observed following OS; the magnitude and duratio n of these negative effects of suctioning were significantly reduced w ith CS. In addition, the decrease in CBV was more pronounced than foll owing CS. No changes in CytO(2) concentration were seen.