Evaluation of antihypoxemic maneuvers before tracheal aspiration in mechanically ventilated newborns

Periodical tracheal aspiration in mechanically ventilated patients is necessary to remove mucus from the airways. In children and adults, this procedure causes transient hypoxemia, which may be prevented by hyperoxia and/or hyperventilation. These findings, however, have not been sufficiently assess...

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Bibliographic Details
Published in:Pediatric pulmonology 2005-01, Vol.39 (1), p.46-50
Main Authors: González-Cabello, Héctor, Furuya, María E.Y., Vargas, Mario H., Tudón, Hugo, Garduño, Juan, González-Ayala, Jorge
Format: Article
Language:English
Subjects:
airway clearance
Biological and medical sciences
Cross-Over Studies
Female
Humans
Hyperoxia
hyperventilation
Hypoxia - etiology
Hypoxia - prevention & control
Infant
Infant, Newborn
Intensive Care Units, Neonatal
Male
mechanical ventilation
Medical sciences
Mucus
Oximetry
Oxygen - blood
Pneumology
Prospective Studies
pulse oximetry
Respiration, Artificial - methods
Suction - methods
Trachea
tracheal aspiration
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Summary:Periodical tracheal aspiration in mechanically ventilated patients is necessary to remove mucus from the airways. In children and adults, this procedure causes transient hypoxemia, which may be prevented by hyperoxia and/or hyperventilation. These findings, however, have not been sufficiently assessed in newborn infants. Thus we investigated the usefulness of hyperoxia and/or hyperventilation as antihypoxemic maneuvers before tracheal aspiration in newborn infants. Our design was a prospective, randomized, multiple crossover study. The setting was the NICU of a third‐level pediatric hospital in Mexico City. Patients included 15 newborn infants under mechanical ventilation. Within a 12‐hr period, every patient received, in random order, three antihypoxemic maneuvers during 1 min just before tracheal aspiration: hyperoxia (10% increase of baseline FiO2), hyperventilation (50% increase of ventilator cycling rate), or both. Additionally, a control (sham) maneuver was also applied. Pulse oximeter saturation (SpO2) was recorded before and after each antihypoxemic maneuver, and at 0, 15, 30, 60, and 300 sec after tracheal aspiration. Basal values of SpO2 (81.5 ± 1.5%) increased with all three antihypoxemic maneuvers (SpO2 over 90%, P 
ISSN:8755-6863
1099-0496
DOI:10.1002/ppul.20130