Building Evidence for Practice: A Pilot Study of Newborn Bulb Suctioning at Birth

Abstract

The purpose of the study was to examine the effects of bulb suctioning on healthy, term newborns and the feasibility of conducting a large-scale study of this practice. In a randomized, controlled two-group design pilot study, 10 newborns received oronasopharyngeal bulb suctioning at birth and 10 did not. Differences in Apgar scores, heart rates, and oxygen saturation levels were determined. Infants were randomized to groups before delivery. The participants were 20 term, healthy newborns of uncomplicated pregnancies. Apgar scores, heart rates, and oxygen saturation levels in the first 20 minutes of life were the main outcome variables. There were no statistically significant differences in Apgar scores between groups. Apgar scores at 5 and 10 minutes were 9 or 10 for all newborns. Newborns receiving bulb suctioning showed a statistically significant, lower heart rate (P=.042) during the first 20 minutes and a significantly higher SpO2 level (P=.005) by 15 minutes of age. Although statistically significant, these findings were not considered clinically significant because values remained within normal parameters.

Part 15: Neonatal Resuscitation

“…There is evidence that suctioning of the nasopharynx can create bradycardia during resuscitation 21,22 and that suctioning of the trachea in intubated babies receiving mechanical ventilation in the neonatal intensive care unit (NICU) can be associated with deterioration of pulmonary compliance and oxygenation and reduction in cerebral blood flow velocity when performed routinely (ie, in the absence of obvious nasal or oral secretions). 23,24 However, there is also evidence that suctioning in the presence of secretions can decrease respiratory resistance.…”

Oronasopharyngeal Suction versus No Suction in Normal and Term Infants Delivered by Elective Cesarean Section: A Prospective Randomized Controlled Trial

“…The mean heart rates were consistently and signifi cantly lower in the no suction group during the fi rst 6 min except the second one. All neonates without suction had an Apgar score of 10 at the 5th min, while the mean 8 SD for ONPS group ONPS did not show a benefi t in oxygenation of the infants [4][5][6][7] . In studies investigating the SaO 2 levels, study groups were heterogeneous for potential factors (gestational length, birth method, medication, and maternal or fetal/neonatal health status, etc.)…”

Part 11: Neonatal Resuscitation

“…In healthy neonates suctioning of the mouth and nose is associated with cardiorespiratory complications (LOE 1 21,22 ). In infants who are intubated, sedated, or paralyzed following resuscitation, endotracheal suctioning in the absence of secretions may result in a decrease in oxygenation, an increase in cerebral blood flow and intracranial pressure, and a decrease in compliance (LOE 5 23 ).…”