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The Effect of Open and Closed Endotracheal Tube Suctioning System on Cardio- respiratory Parameters of Infants Undergoing Mechanical Ventilation
Narges Asgari, Parvin Taheri, Mehri Golchin, Dr Majid Mohammadizadeh,
Volume 10, Issue 0 (9-2013)
Abstract

  Background and Objective: Mechanical ventilation is used for some infants in neonatal intensive care unit (NICU) due to many physiological and clinical causes. The practice of endotracheal suctioning of ventilator- treated patients is necessary to remove secretions to prevent obstruction of the endotracheal tube and lower airways. This study aimed at determining the effect of open and closed suctioning methods on cardio-respiratory parameters of infants undergoing mechanical ventilation.

  

  Material and Methods: In this clinical trail, forty-four infants underwent mechanical ventilation in NICU were selected by simple continuous sampling. The samples were randomly divided into two groups. In the first group: first, open suctioning and then after three hours of cleaning, closed suctioning was performed. In the second group, first closed suctioning and after three hours of cleaning, open suctioning was implemented. Respiratory rate (RR), oxygen saturation, pulse rate and blood pressure were assessed before ( in three, two and one minutes ) , during and after ( in one , two and three minutes ) each type of suctioning. The Data was analyzed by Software SPSS-16 using ANOVA with repeated measures and independent t-test.

  

  Results: There was a significant difference between mean respiratory rate and oxygen saturation in infants during and after the closed and open suctioning (p<0.05). Oxygen saturation had a significant reduction in open method compared to closed method during and immediately after suctioning. Respiratory rate had a significant reduction in 3 minutes after open suctioning in both steps. The mean of diastolic pressure in second step of open method and in both steps of closed method was significant (p<0.05). There was a significant difference between the mean pulse rate in different times of open suctioning in the first step (p<0.05), Pulse rate drop significantly was lower in closed suction than open one (p<0.05).

  

  Conclusion: because of little changes caused by closed suctioning in hemodynamic condition, it is recommended using the closed suctioning to prevent from respiratory complications and pulse rate dropping in infants.

 


Effect of white noise on physiological parameters and pain levels during airway suctioning in preterm infants admitted to a neonatal intensive care unit: A randomized clinical trial
Reihane Moghimian Shahrbabaki, Zohreh Khoshnood, Saide Arya, Najmeh Soltaninejad, Monirsadat Nematollahi ,
Volume 23, Issue 2 (6-2026)
Abstract
Background: Preterm neonates are frequently exposed to painful procedures in neonatal intensive care units (NICUs), including endotracheal suctioning. Non-pharmacological interventions such as white noise may help reduce pain and improve physiological stability. This study aimed to investigate the effect of white noise on pain intensity and physiological parameters in preterm neonates during airway suctioning.
Methods: This parallel-group randomized controlled clinical trial was conducted on 50 preterm neonates admitted to the NICU of Afzalipour Hospital, Kerman, Iran. Eligible neonates were randomly assigned to intervention and control groups using a random number table. Allocation concealment was ensured using sequentially numbered, opaque, sealed envelopes prepared by an independent researcher. Neonates in the intervention group were exposed to white noise at 45 dB from 5 minutes before until 10 minutes after suctioning, whereas those in the control group received routine care. Pain was assessed using the Neonatal Infant Pain Scale (NIPS). Physiological parameters, including heart rate, oxygen saturation, respiratory rate, and body temperature, were recorded before, during, and after suctioning. Body temperature was measured using the skin temperature probe integrated into the neonatal vital signs monitor. Data were analyzed using SPSS v23. Repeated-measures analysis of variance with Greenhouse–Geisser correction was used to evaluate changes over time between groups. Independent t-test, Chi-square test, and Fisher’s exact test were applied where appropriate. A P-value <0.05 was considered statistically significant.
Results: The intervention group showed significantly lower pain scores (P=0.001), heart rate (P<0.001), and respiratory rate (P=0.010) during suctioning compared with the control group. Oxygen saturation levels were significantly higher in the intervention group during the procedure (P<0.001). No significant differences were observed in body temperature between groups (P=1.000).
Conclusion: White noise reduced pain scores and improved heart rate, respiratory rate, and oxygen saturation during airway suctioning in preterm neonates. These findings support the use of white noise as a complementary non-pharmacological intervention in NICU care.

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