{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:28:25Z","timestamp":1790810905183,"version":"4.1.0"},"reference-count":27,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2020,2,18]],"date-time":"2020-02-18T00:00:00Z","timestamp":1581984000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>There is limited evidence supporting an optimum method for removing mucus from the airways of hospitalized infants with bronchiolitis. This study was designed to evaluate short-term physiologic effects between nasal aspiration and nasopharyngeal suctioning in infants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      Sixteen infants requiring hospitalization for supportive management of bronchiolitis were instrumented with transcutaneously measured partial pressure of carbon dioxide (\n                      <jats:inline-formula>\n                        <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" display=\"inline\" overflow=\"scroll\">\n                          <mml:mrow>\n                            <mml:msub>\n                              <mml:mi mathvariant=\"bold\">P<\/mml:mi>\n                              <mml:mrow>\n                                <mml:mi mathvariant=\"bold\">t<\/mml:mi>\n                                <mml:mi mathvariant=\"bold\">c<\/mml:mi>\n                                <mml:mi mathvariant=\"bold\">C<\/mml:mi>\n                                <mml:msub>\n                                  <mml:mi mathvariant=\"bold\">O<\/mml:mi>\n                                  <mml:mn>2<\/mml:mn>\n                                <\/mml:msub>\n                              <\/mml:mrow>\n                            <\/mml:msub>\n                          <\/mml:mrow>\n                        <\/mml:math>\n                      <\/jats:inline-formula>\n                      ) and\n                      <jats:inline-formula>\n                        <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" display=\"inline\" overflow=\"scroll\">\n                          <mml:mrow>\n                            <mml:msub>\n                              <mml:mi mathvariant=\"bold\">S<\/mml:mi>\n                              <mml:mrow>\n                                <mml:mi mathvariant=\"bold\">p<\/mml:mi>\n                                <mml:msub>\n                                  <mml:mi mathvariant=\"bold\">O<\/mml:mi>\n                                  <mml:mn>2<\/mml:mn>\n                                <\/mml:msub>\n                              <\/mml:mrow>\n                            <\/mml:msub>\n                          <\/mml:mrow>\n                        <\/mml:math>\n                      <\/jats:inline-formula>\n                      monitoring. Electrical impedance tomography (EIT) was used to estimate changes in inspiratory and end-expiratory lung volume loss and recovery. Subjects were suctioned with both nasal aspiration and nasopharyngeal suctioning methods in a randomized order (8 received nasal aspiration followed by nasopharyngeal suctioning, and 8 received nasophayrgeal suctioning followed by nasal aspiration). Noninvasive gas exchange and EIT measurements were obtained at baseline (pre-suction) and at 10, 20, and 30 min following each suctioning intervention. Sputum mass was obtained following suctioning, and clinical respiratory severity scores, before and after suctioning, were computed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      There were no differences in inspiratory EIT (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .93), change in end-expiratory lung impedance (\u0394EELI;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .53),\n                      <jats:inline-formula>\n                        <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" display=\"inline\" overflow=\"scroll\">\n                          <mml:mrow>\n                            <mml:msub>\n                              <mml:mi mathvariant=\"bold\">P<\/mml:mi>\n                              <mml:mrow>\n                                <mml:mi mathvariant=\"bold\">t<\/mml:mi>\n                                <mml:mi mathvariant=\"bold\">c<\/mml:mi>\n                                <mml:mi mathvariant=\"bold\">C<\/mml:mi>\n                                <mml:msub>\n                                  <mml:mi mathvariant=\"bold\">O<\/mml:mi>\n                                  <mml:mn>2<\/mml:mn>\n                                <\/mml:msub>\n                              <\/mml:mrow>\n                            <\/mml:msub>\n                          <\/mml:mrow>\n                        <\/mml:math>\n                      <\/jats:inline-formula>\n                      (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .41),\n                      <jats:inline-formula>\n                        <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" display=\"inline\" overflow=\"scroll\">\n                          <mml:mrow>\n                            <mml:msub>\n                              <mml:mi mathvariant=\"bold\">S<\/mml:mi>\n                              <mml:mrow>\n                                <mml:mi mathvariant=\"bold\">p<\/mml:mi>\n                                <mml:msub>\n                                  <mml:mi mathvariant=\"bold\">O<\/mml:mi>\n                                  <mml:mn>2<\/mml:mn>\n                                <\/mml:msub>\n                              <\/mml:mrow>\n                            <\/mml:msub>\n                          <\/mml:mrow>\n                        <\/mml:math>\n                      <\/jats:inline-formula>\n                      (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .88), heart rate (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .31), or breathing frequency (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .15) over the course of suctioning between nasal aspiration and nasopharyngeal suctioning. Sputum mass (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .14) and clinical respiratory score differences before and after suctioning (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .59) were not different between the 2 suctioning interventions. Sputum mass was not associated with \u0394EELI at 30 min for nasal aspiration (\u03c1 = 0.11,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .69), but there was a moderate positive association for nasopharyngeal suctioning (\u03c1 = 0.50,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .048).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Infants with viral bronchiolitis appeared to tolerate both suctioning techniques without adverse short-term physiologic effects, as indicated by the unchanged gas exchange and estimated lung volumes (EIT). Nasopharyngeal suctioning recovered 36% more sputum than did nasal aspiration and there was moderate correlation between sputum mass and end-expiratory lung impedance change at 30 minutes post-suction with nasopharyngeal that was not present with nasal aspiration. It is possible that a subset of patients may benefit from one type of suctioning over another. Future research focusing on important outcomes for suctioning patients with bronchiolitis with varying degrees of lung disease severity is needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.07269","type":"journal-article","created":{"date-parts":[[2020,2,18]],"date-time":"2020-02-18T13:35:55Z","timestamp":1582032955000},"page":"984-993","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Physiologic Effects of Nasal Aspiration and Nasopharyngeal Suctioning on Infants With Viral Bronchiolitis"],"prefix":"10.1177","volume":"65","author":[{"given":"Coral N","family":"Ringer","sequence":"first","affiliation":[{"name":"Clinical Effectiveness, Quality and Safety Support, Seattle Children\u2019s Hospital, Seattle, Washington."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca J","family":"Engberg","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, Seattle Children\u2019s Hospital, Seattle, Washington."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen E","family":"Carlin","sequence":"additional","affiliation":[{"name":"Center for Clinical and Translational Research, Seattle Children\u2019s Research Institute, Seattle, Washington."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig D","family":"Smallwood","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children\u2019s Hospital, Boston, Massachusetts and Harvard Medical School, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert M","family":"DiBlasi","sequence":"additional","affiliation":[{"name":"Respiratory Care Department, Seattle Children\u2019s Hospital, Seattle, Washington and Center for Integrative Brain Research, Seattle Children\u2019s Research Institute, Seattle, Washington."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,2,18]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-3877"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.04491080"},{"issue":"2","key":"e_1_3_3_4_2","first-page":"CD004873","article-title":"Chest physiotherapy for acute bronchiolitis in paediatric patients between 0 and 24 months old","author":"Roqu\u00e9 i Figuls M","year":"2012","unstructured":"Roqu\u00e9 i Figuls M, , Gine-Garriga M, , Granados Rugeles C, , Perrotta C. Chest physiotherapy for acute bronchiolitis in paediatric patients between 0 and 24 months old. Cochrane Database Syst Rev, 2012(2):CD004873.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/000992280104001006"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2013.36"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-2742"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.04685"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1590\/S1413-35552012005000018"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200301-133OC"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2011.02511.x"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s001340101021"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-007-0786-9"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-002-1555-4"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-002-1586-x"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-008-1299-x"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2016-208357"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-009-1663-5"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2012.08.019"},{"key":"e_1_3_3_20_2","unstructured":"Zaman S Beardsley E Crotwell D DiBlasi R Hoffer D Ringer C. Bronchiolitis. Available from: http:\/\/www.seattlechildrens.org\/pdf\/bronchiolitis-pathway.pdf. Accessed on 30 September 2016.."},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4378"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.10425"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-196911000-00023"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.12661"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1203\/PDR.0b013e3181b337ec"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.21607"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-010-1849-x"}],"container-title":["Respiratory Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.4187\/respcare.07269","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4187\/respcare.07269","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4187\/respcare.07269","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T09:13:40Z","timestamp":1775466820000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.4187\/respcare.07269"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,18]]},"references-count":27,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2020,7]]}},"alternative-id":["10.4187\/respcare.07269"],"URL":"https:\/\/doi.org\/10.4187\/respcare.07269","relation":{},"ISSN":["0020-1324"],"issn-type":[{"value":"0020-1324","type":"print"}],"subject":[],"published":{"date-parts":[[2020,2,18]]}}}