Effects of open endotracheal suction on lung volume in infants receiving HFOV

Intensive Care Med. 2007 Apr;33(4):689-93. doi: 10.1007/s00134-007-0541-2. Epub 2007 Feb 28.


Objective: To describe the pattern and magnitude of lung volume change during open endotracheal tube (ETT) suction in infants receiving high-frequency oscillatory ventilation (HFOV).

Design: Prospective observational clinical study.

Setting: Tertiary neonatal intensive care unit.

Patients and participants: Seven intubated and muscle-relaxed newborn infants receiving HFOV.

Interventions: Open ETT suction was performed for 6 s at -100 mmHg using a 6-F catheter passed to the ETT tip after disconnection from HFOV. The HFOV was then recommenced at the same settings as prior to ETT suction.

Measurements and results: Change in lung volume (DeltaV (L)) referenced to baseline lung volume before suction was measured with a calibrated respiratory inductive plethysmography recording from 30 s before until 60 s after ETT suction. In all infants ETT suction resulted in significant loss of lung volume. The mean DeltaV (L) during suctioning was -13 ml/kg (SD 4 ml/kg) (p<0.0001 vs. baseline, repeated-measures ANOVA), with a mean 76.5% (SD 14.1%) of this volume loss being related to circuit disconnection. After recommencing HFOV lung volume was rapidly regained with mean DeltaV (L) at 60 s being 1 ml/kg (SD 4 ml/kg) below baseline (p>0.05, Tukey post-test).

Conclusions: Open ETT suction caused a significant but transient loss of lung volume in muscle-relaxed newborn infants receiving HFOV.

MeSH terms

  • High-Frequency Ventilation / methods*
  • Humans
  • Infant, Newborn
  • Infant, Newborn, Diseases / therapy*
  • Intensive Care Units, Neonatal
  • Intubation, Intratracheal / methods*
  • Lung Volume Measurements
  • Plethysmography
  • Suction