Abstract
Transcutaneous PO2, heart rate, and aortic blood pressure were measured i 10 mechanically-ventilated newborn infants to assess the degree and course of hypoxaemia, and to monitor the cardiovascular and respiratory changes during tracheal toilet. Five infants weighed less than 1250 (mean 994), g and 5 infants weighed greater than 1750 (mean 2216) g. During tracheal suction the TcPO2 fell from 68 +/- 27 (mean +/- SD) to 43 +/- 23 mmHg, and the heart rate from 144 +/- 8 to 123 +/- 25 beats/minute, but the blood pressure increased from 44 to +/- 24 to 49 +/- 24 mmHg. Hypoxaemia (TcPO2 less than 50 mmHg) occurred in 7 of 8 initially well-oxygenated infants when suctioned. The decrease in TcPO2 was similar for both groups of infants. It was greater in infants with controlled ventilation and an F1O2 greater than or equal to 0.8 than in infants with intermittent mandatory ventilation and an F1O2 less than 0.8. The TcPO2 fall correlated well with the TcPO2 during the control period but not during the time that the infants were disconnected from the respirator. A critical re-evaluation of routine tracheal toilet is needed.
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- Biscoe T. J., Purves M. J., Sampson S. R. The frequency of nerve impulses in single carotid body chemoreceptor afferent fibres recorded in vivo with intact circulation. J Physiol. 1970 May;208(1):121–131. doi: 10.1113/jphysiol.1970.sp009109. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Brandstater B., Muallem M. Atelectasis following tracheal suction in infants. Anesthesiology. 1969 Nov;31(5):468–473. doi: 10.1097/00000542-196911000-00023. [DOI] [PubMed] [Google Scholar]
- Cohn H. E., Sacks E. J., Heymann M. A., Rudolph A. M. Cardiovascular responses to hypoxemia and acidemia in fetal lambs. Am J Obstet Gynecol. 1974 Nov 15;120(6):817–824. doi: 10.1016/0002-9378(74)90587-0. [DOI] [PubMed] [Google Scholar]
- Fox W. W., Schwartz J. G., Shaffer T. H. Pulmonary physiotherapy in neonates: physiologic changes and respiratory management. J Pediatr. 1978 Jun;92(6):977–981. doi: 10.1016/s0022-3476(78)80381-3. [DOI] [PubMed] [Google Scholar]
- Gregory G. A. Respiratory care of newborn infants. Pediatr Clin North Am. 1972 May;19(2):311–324. doi: 10.1016/s0031-3955(16)32702-x. [DOI] [PubMed] [Google Scholar]
- Pelletier C. L. Circulatory responses to graded stimulation of the carotid chemoreceptors in the dog. Circ Res. 1972 Sep;31(3):431–443. doi: 10.1161/01.res.31.3.431. [DOI] [PubMed] [Google Scholar]
- ROSEN M., HILLARD E. K. The effects of negative pressure during tracheal suction. Anesth Analg. 1962 Jan-Feb;41:50–57. [PubMed] [Google Scholar]
- SEGAL S. ENDOBRONCHIAL PRESSURE AS AN AID TO TRACHEO-BRONCHIAL ASPIRATION. Pediatrics. 1965 Feb;35:305–312. [PubMed] [Google Scholar]
- Shim C., Fine N., Fernandez R., Williams M. H., Jr Cardiac arrhythmias resulting from tracheal suctioning. Ann Intern Med. 1969 Dec;71(6):1149–1153. doi: 10.7326/0003-4819-71-6-1149. [DOI] [PubMed] [Google Scholar]
- Simbruner G., Götz M. Neonatal respirator allowing simultaneous ventilation and suction. Klin Padiatr. 1976 Nov;188(6):532–538. [PubMed] [Google Scholar]
- Urban B. J., Weitzner S. W. Avoidance of hypoxemia during endotracheal suction. Anesthesiology. 1969 Nov;31(5):473–475. doi: 10.1097/00000542-196911000-00024. [DOI] [PubMed] [Google Scholar]
- Versmold H. T., Linderkamp O., Holzmann M., Strohhacker I., Riegel K. P. Limits of tcPO2 monitoring in sick neonates: relation to blood pressure, blood volume, peripheral blood flow and acid base status. Acta Anaesthesiol Scand Suppl. 1978;68:88–90. doi: 10.1111/j.1399-6576.1978.tb01399.x. [DOI] [PubMed] [Google Scholar]