Effect of closed endotracheal suction in high-frequency ventilated premature infants measured with electrical impedance tomography

Abstract
To determine the global and regional changes in lung volume during and after closed endotracheal tube (ETT) suction in high-frequency ventilated preterm infants with respiratory distress syndrome (RDS). Prospective observational clinical study. Neonatal intensive care unit. Eleven non-muscle relaxed preterm infants with RDS ventilated with open lung high-frequency ventilation (HFV). Closed ETT suction. Changes in global and regional lung volume were measured with electrical impedance tomography. ETT suction resulted in an acute loss of lung volume followed by spontaneous recovery with a median residual loss of 3.3% of the maximum volume loss. The median stabilization time was 8 s. At the regional level, the lung volume changes during and after ETT suction were heterogeneous in nature. Closed ETT suction causes an acute, transient and heterogeneous loss of lung volume in premature infants with RDS treated with open lung HFV.