Intensive and Critical Care Nursing (2005) 21, 234—242 ORIGINAL ARTICLE Closed versus partially ventilated endotracheal suction in extremely preterm neonates: physiologic consequences A.M. Tan a,* , J.M. Gomez b,1 , J. Mathews b , M. Williams c,2 , J. Paratz d,3 , V.S. Rajadurai b,1 a 10 Tampines Street 73 #04-04 Singapore 528827, Singapore b KK Women’s and Children’s Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore c University of South Australia, G.P.O. Box 2471, Adelaide, SA 5001, Australia d La Trobe University, Vic. 3086, Australia Accepted 24 August 2004 KEYWORDS Preterm infants; Neonates; Critical care; Endotracheal suction; Closed suction Summary This randomized cross over study aimed to compare the severity and incidences of desaturation and bradycardia between the partially ventilated en- dotracheal suction method (PVETS) and closed tracheal suction system (CTSS) in extremely preterm neonates. Fifteen intubated and ventilated extremely low birth weight preterm infants (mean birth weight 689 g) randomly underwent both suction techniques within a 12-h period to obtain a paired reading group. The process was repeated 24—48 h apart until three pairs of reading groups were collected. Changes in oxygen saturation measured with pulse oximetry and heart rate changes measured with electrocardiogram were recorded using Hewlett-Packard m240A monitor trend- ing software. The mean of each parameter’s variation from baseline was obtained using SPSS descriptive statistics and analyzed using SPSS repeated measures ANOVA. Fisher Exact Test was used to analyze the incidence of desaturation and bradycardia. The closed tracheal suction system reported a significantly smaller degree of oxygen Abbreviations: ETS, endotracheal suction; PVETS, partially ventilated endotracheal suction; CTSS, closed tracheal suction system; SpO 2 , oxygen saturation; vSpO 2 , decrement in SpO 2 value from baseline; HR, heart rate; bpm, beats per minute; vHRlow, decrement in HR from baseline; vHRhigh, increment in HR from baseline; NICU, Neonatal Intensive Care Unit; IMV, intermittent mandatory ventilation; BW, birth weight; RDS, respiratory distress syndrome; FRC, functional residual capacity; ECG, electrocardiogram; V/Q, ventilation/perfusion; PEEP, positive end expiratory pressure * Corresponding author. Tel.: +65 6435 3041. E-mailaddresses: aimay70@hotmail.com, tan ai may@hpb.gov.sg (A.M. Tan), jmgomez@kkh.com.sg (J.M. Gomez), marie.williams@unisa.edu.au (M. Williams), j.paratz@alfred.org.au (J. Paratz), samuel@kkh.com (V.S. Rajadurai). 1 Tel.: +65 6293 41221. 2 Tel.: +61 8 830 22554. 3 Tel.: +61 3 9479 5766. 0964-3397/$ — see front matter © 2004 Elsevier Ltd. All rights reserved. doi:10.1016/j.iccn.2004.08.006