Lung recruitment and endotracheal suction in ventilated preterm infants measured with electrical impedance tomography

Hough, Judith L., Shearman, Andrew D., Liley, Helen, Grant, Caroline A., & Schibler, Andreas (2014) Lung recruitment and endotracheal suction in ventilated preterm infants measured with electrical impedance tomography. Journal of Paediatrics and Child Health, 50(11), pp. 884-889.

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Abstract

Aims

Although suctioning is a standard airway maintenance procedure, there are significant associated risks, such as loss of lung volume due to high negative suction pressures. This study aims to assess the extent and duration of change in end-expiratory level (EEL) resulting from endotracheal tube (ETT) suction and to examine the relationship between EEL and regional lung ventilation in ventilated preterm infants with respiratory distress syndrome.

Methods

A prospective observational clinical study of the effect of ETT suction on 20 non-muscle-relaxed preterm infants with respiratory distress syndrome (RDS) on conventional mechanical ventilation was conducted in a neonatal intensive care unit. Ventilation distribution was measured with regional impedance amplitudes and EEL using electrical impedance tomography.

Results

ETT suction resulted in a significant increase in EEL post-suction (P < 0.01). Regionally, anterior EEL decreased and posterior EEL increased post-suction, suggesting heterogeneity. Tidal volume was significantly lower in volume-guarantee ventilation compared with pressure-controlled ventilation (P = 0.04).

Conclusions

ETT suction in non-muscle-relaxed and ventilated preterm infants with RDS results in significant lung volume increase that is maintained for at least 90 min. Regional differences in distribution of ventilation with ETT suction suggest that the behaviour of the lung is heterogeneous in nature.

Impact and interest:

4 citations in Scopus
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2 citations in Web of Science®

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18 since deposited on 29 Jun 2014
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ID Code: 73113
Item Type: Journal Article
Refereed: Yes
Keywords: electrical impedance tomography, infant, newborn, suction, ventilation distribution
DOI: 10.1111/jpc.12661
ISSN: 1034-4810
Subjects: Australian and New Zealand Standard Research Classification > ENGINEERING (090000) > BIOMEDICAL ENGINEERING (090300)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PAEDIATRICS AND REPRODUCTIVE MEDICINE (111400)
Divisions: Current > Schools > School of Chemistry, Physics & Mechanical Engineering
Current > Institutes > Institute of Health and Biomedical Innovation
Current > QUT Faculties and Divisions > Science & Engineering Faculty
Copyright Owner: Copyright 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
Deposited On: 29 Jun 2014 23:17
Last Modified: 19 Sep 2015 10:47

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