We evaluated the ability of a new device (Neo2Safe) to minimize hypoxemia during suctioning, in a randomized prospective study of 15 low-birthweight infants (< 1520 g) admitted to our Neonatal Intensive Care Unit. The device, which can be attached at the patient Y of commercial infant ventilator circuits, consists of a plastic core that houses a silicone grommet of duck-bill design. When a suction catheter in the size range used for neonates is inserted through the device, the valve seals around the catheter to maintain a closed airway system and possibly to minimize the loss of PEEP during suctioning. METHODS AND MATERIALS: Each patient was subjected both to a conventional suctioning procedure (with inflation via a self-inflating resuscitator bag and hyperoxygenation) and the alternate technique, which employs the valve system. The procedures were performed in random sequence. Each infant served as his or her own control. Oxygenation was monitored by pulse oximetry for 5 min following each procedure, with continuous recordings of pulse-oximeter saturation (Spo 2 ) and cardiac rates and rhythms. RESULTS: The mean Spo 2 (± SD) prior to suctioning was 88 ± 4 torr 11.7 ± 0.5 kPa in the control and 89 ± 5 torr 11.9 ± 0.7 kPa in the study procedures. The mean drop in Spo 2 was 22 torr 2.9 kPa in the control and 9.8 torr 1.3 kPa in the study procedures. Baseline saturation values were restored in all patients within 5 min; however, baseline values in 50% of the study group were restored in < 3 min. CONCLUSION: We conclude that hypoxemia, a possibly deleterious side effect of endotracheal suctioning in neonates, can be significantly minimized by the routine use of a valve to provide a closed ventilator system. The valve may contribute to increased survival in critically ill infants.
Bodai et al. (Mon,) studied this question.