Comparison of Two Methods Open and Closed Endotracheal Suctioning on Clinical Outcomes in Preterm Neonates in NICUs: Randomized Clinical Trial.

Abstract

Abstract: Introduction: Maintenance of breathing and airway patency, is the primary purpose in the care of premature infants. Endotracheal tube suctioning is a frequently performed procedure to achieve that. There are two methods of endotracheal suctioning, open and closed suction. Efficient suctioning, with minimal damage, is the primary goal of respiratory care in premature neonates. The aim of this study is the comparison of open and closed endotracheal suctioning on clinical outcomes in preterm neonates in NICUs of Al Zahra and Taleghani Teaching Hospitals, Tabriz, 2012. Methods: This study is a single blind clinical trial in order to compare clinical outcomes of two methods, open and closed endotracheal suctioning. A population of preterm neonates with 27-34 weeks of gestational age born at Al Zahra and Taleghani hospitals of Tabriz were studied; whom after their admission to NICU, were intubated with in maximum 24 hours and been under mechanical ventilation at least for 48 hours. After verifying sample size, the neonates were elected by available simple sampling method and randomly divided between two study groups. First group were suctioned by open and second suctioned by closed method. In both groups, suctioning as PRN and were continued for at least 48 hours. BP, HR, O2SAT in both groups was recorded one minute before, one and five minutes after procedure and registered in the special data forms designed by research team. However frequency of suctioning and side effects as pulmonary hemorrhage, IVH, Pneumothorax, Pneumonia and septicemia until extubation and duration of hospitalization were investigated. Side effects was confirmed by a specialist who was blind to suction kind. Finally the above mentioned results were compared for both groups. Analysis of data was performed by using SPSS, descriptive and inferential statistical analysis such as chi square test, T test and Mixed model and then reported. Results: There were significant statistical differences on mean BP within three days and it was lower in closed suction. There were significant statistical differences on recovery time of HR, mean BP and the time was longer in open suction method. There were no significant statistical differences on side effects of endotracheal suctioning. Conclusion: Endotracheal closed suctioning method, maintains better physiologic stability in preterm neonates and its side effects are the least.