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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, MD, FRCOG, Joachim W.

Ed. by Bancalari, Eduardo / Chappelle, Joseph / Chervenak, Frank A. / D'Addario , Vincenzo / Genc, Mehmet R. / Greenough, Anne / Grunebaum, Amos / Konje, Justin C. / Kurjak M.D., Asim / Romero, Roberto / Zalud, MD PhD, Ivica

IMPACT FACTOR 2018: 1.361
5-year IMPACT FACTOR: 1.578

CiteScore 2018: 1.29

SCImago Journal Rank (SJR) 2018: 0.522
Source Normalized Impact per Paper (SNIP) 2018: 0.602

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Volume 33, Issue 5


Effects of open vs. closed system endotracheal suctioning on cerebral blood flow velocities in mechanically ventilated extremely low birth weight infants

Hannes Rieger / Stefan Kuhle / Osman S. Ipsiroglu / Harald Heinzl / Christian N. Popow
Published Online: 2005-09-13 | DOI: https://doi.org/10.1515/JPM.2005.077


Background: Endotracheal (ET) suctioning causes cardiovascular side effects and may impair cerebral hemodynamics. Subjectively, these effects are worse if patients are disconnected from the ventilator (open system suctioning, OSS) than if they remain connected to the ventilator during suctioning (closed system suctioning, CSS). It is uncertain whether the response to ET suctioning is similar in conventionally (CV) and high frequency (HF) ventilated patients.

Objectives: To investigate if the mode of suctioning or of mechanical ventilation influences cerebral blood flow velocities (CBFVs) in extremely low birth weight (ELBW) infants.

Methods: Transcranial Doppler sonography in the middle cerebral artery during OSS and CSS in CV and HF ventilated ELBW infants.

Results: Forty-one measurements were performed in 19 infants within the first two weeks of life. Mean CBFVs decreased during suctioning from baseline 18.8 to 14.3 cm/s (−24%), increased thereafter to 24.7 cm/s (73%) and then returned to baseline (20.8 cm/s). Changes in CBFV were less pronounced in infants with higher baseline CBFVs. Heart rate decreased during ET suctioning and thereafter returned to baseline values. The alterations in CBFV and heart rate were both independent of the mode of ventilation or suctioning.

Conclusions: The mode of suctioning or ventilation does not influence CBFVs in ELBW infants.

Keywords: Cerebral blood flow velocities; endotracheal suctioning; extremely low birth weight infants; mechanical ventilation; newborn

About the article

Corresponding author: Stefan Kuhle, MD Stollery Children's Hospital Department of Pediatrics Dentistry Pharmacy Centre, Room 1130 11304-85 Ave. Edmonton, AB, T6G 2N8 Canada Tel.: +1 780 407 1070 Fax: +1 780 407 1221

Received: July 14, 2004

Revised: April 21, 2005

Accepted: May 17, 2005

Published Online: 2005-09-13

Published in Print: 2005-10-01

Citation Information: Journal of Perinatal Medicine, Volume 33, Issue 5, Pages 435–441, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/JPM.2005.077.

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