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Oropharyngeal suctioning in neonates immediately after delivery: influence on cerebral and peripheral tissue oxygenation.

Abstract：

BACKGROUND:Routine oropharyngeal suctioning in term vigorous neonates immediately after birth is a questionable practice. Current recommendations favor suctioning only in the presence of considerable obstruction due to secretions, blood or other matter. We aimed to analyze the influence of oropharyngeal suctioning on cerebral and peripheral muscle oxygenation in term neonates during transition immediately after birth. METHODS:We included term neonates after elective cesarean section for this prospective observational study. Oropharyngeal suctioning was performed based on the clinicians' judgment of threatening airway obstruction. From a total of 138 enrolled neonates, 36 were suctioned and then compared to 36 controls matched for gestational age. Heart rate (HR) and pre/postductal arterial oxygen saturation (SpO2pre/SpO2post) were measured by pulse oximetry. Cerebral (rSO2brain) and pre/postductal peripheral muscle tissue oxygenation (rSO2pre/rSO2post) were measured by near infrared spectroscopy during the first 15min of life. RESULTS:All neonates in both groups experienced normal postnatal transition with normal Apgar scores (Apgar 9/10/10) and with no events of apnea or bradycardia induced by suctioning. SpO2pre values were slightly lower at 2 and 4min after birth. Suctioning had no main and interaction effect on HR, SpO2post, rSO2brain, rSO2pre and rSO2post in the first 15min after birth. CONCLUSION:In the present study we were able to show that, in term neonates, when correctly indicated, immediate postnatal oropharyngeal suctioning does not compromise cerebral and peripheral muscle tissue oxygenation. However, any suction maneuver must be performed with caution and strict indication during neonatal transition.

journal_name

Early Hum Dev

journal_title

Early human development

authors

Pocivalnik M,Urlesberger B,Ziehenberger E,Binder C,Schwaberger B,Schmölzer GM,Avian A,Pichler G

doi

10.1016/j.earlhumdev.2015.01.005

subject

Has Abstract

pub_date

2015-02-01 00:00:00

pages

153-7

issue

2

eissn

0378-3782

issn

1872-6232

pii

S0378-3782(15)00018-3

journal_volume

91

pub_type

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