Suctioning in the preterm infant: effects on cerebral blood flow velocity, intracranial pressure, and arterial blood pressure.

The relationship of suctioning to changes in the cerebral circulation was studied in 35 premature newborn infants. The objectives of the study were to determine whether important alterations occur in cerebral hemodynamics with suctioning and whether such alterations relate to systemic hemodynamic events. A transcutaneous Doppler technique was used to measure blood flow velocity in the anterior cerebral arteries. A prominent increase in cerebral blood flow velocity was documented in nearly all patients. Accompanying the increase in cerebral flow velocity was a marked increase in blood pressure; thus, the increased cerebral flow velocity appeared to reflect directly changes in systemic hemodynamic events. Also accompanying the increase in cerebral flow velocity was a marked increase in intracranial pressure. These data suggest potentially deleterious effects of suctioning in the preterm infant at risk for the occurrence of intraventricular hemorrhage and raise questions regarding the advisability of routine suctioning of such infants.