Pilot study comparing closed versus open
tracheal suctioning in postoperative neonates and
infants with complex congenital heart disease

Tume, LN; Baines, P; Guerrero, R; Hurley, M; Johnson, R; Kalantre, A; Ramaraj, R; Ritson, P; Walsh, L; Arnold, P

Abstract

Objectives: To determine the hemodynamic effect of tracheal suction
method in the first 36 hours after high-risk infant heart surgery on
the PICU and to compare open and closed suctioning techniques.
Design: Pilot randomized crossover study.
Setting: Single PICU in United Kingdom.
Participants: Infants undergoing surgical palliation with Norwood
Sano, modified Blalock-Taussig shunt, or pulmonary artery banding
in the first 36 hours postoperatively.
Interventions: Infants were randomized to receive open or closed
(in-line) tracheal suctioning either for their first or second study
tracheal suction in the first 36 hours postoperatively.
Measurements and Main Results: Twenty-four infants were
enrolled over 18 months, 11 after modified Blalock-Taussig
shunt, seven after Norwood Sano, and six after pulmonary artery
banding.
Thirteen patients received the open suction method first
followed by the closed suction method second, and 11 patients
received the closed suction method first followed by the open
suction method second in the first 36 hours after their surgery.
There were statistically significant larger changes in heart rate
(p = 0.002), systolic blood pressure (p = 0.022), diastolic blood
pressure (p = 0.009), mean blood pressure (p = 0.007), and
arterial saturation (p = 0.040) using the open suction method,
compared with closed suctioning, although none were clinically
significant (defined as requiring any intervention).
Conclusions: There were no clinically significant differences
between closed and open tracheal suction methods; however,
there were statistically significant greater changes in some hemodynamic
variables with open tracheal suctioning, suggesting that
closed technique may be safer in children with more precarious
physiology.

Citation

infants with complex congenital heart disease. Pediatric Critical Care Medicine, 18(7), 647-654. https://doi.org/10.1097/PCC.0000000000001192

• Journal Article Type: Article
• Publication Date: Jan 1, 2017
• Deposit Date: Sep 4, 2019
• Journal: Pediatric Critical Care Medicine
• Print ISSN: 1529-7535
• Publisher: Lippincott, Williams & Wilkins
• Volume: 18
• Issue: 7
• Pages: 647-654
• DOI: https://doi.org/10.1097/PCC.0000000000001192
• Publisher URL: http://dx.doi.org/10.1097/PCC.0000000000001192
• Related Public URLs: https://journals.lww.com/pccmjournal/pages/default.aspx
• Additional Information: Funders : AlderHey Children's Hospital Charity; Projects : CHRIS Study: Cardiac High Risk Infant Suction Study