Suction

for preventing neonatal asphyxia

Prevention
Prevention
  • PREVENTION
  • DIAGNOSTIC
  • TREATMENT
  • OVERVIEW
  • TECHNOLOGY Characteristics
  • Suction
    Representative Product

    GLOBAL ANNUAL DEATHS ASSOCIATED WITH ASPHYXIA

    PERCENT (%)
    NUMBER

    Maternal

    N/A
    N/A

    Neonatal

    25%
    770,000

    Stillbirth

    N/A
    N/A

    Condition

    Birth asphyxia occurs when a neonate is unable to breathe sufficiently in their first few minutes of life. One way that this occurs is when the infant still has amniotic fluid in their airway. Suction can help remove this fluid and allow the infant to breathe. Additionally, some infants aspirate mecomium which can cause irritation, infection and other damage and so must be removed immediately after birth.

     

    Mechanism of Action
    There are four classes of suction devices that can be used to clear the infant’s airways. Electrical pumps may be used to generate negative pressure which can be connected to a trap and soft suction catheter. The negative pressure is regulated under 100 mmHg for neonatal use to avoid damaging the tissues of the airway. Manual pump suction devices allow users to create suction using a hand or foot powered bellows.

     

    Mucus aspirator bulbs are the simplest devices, consisting of only a simple small rubber bulb which narrows to a soft flexible tip. The user compresses the bulb and then inserts the narrow point into the infant’s nose / mouth before the bulb is released. The bulb’s expansion provides suction.

    Current Use in High-Resource Settings
    Most high-resource setting hospitals have a negative pressure source readily available in the delivery room, either through a centralized negative pressure source that might serve several rooms (often called “wall suction”) or a dedicated vacuum pump in the room. Caregivers typically connect a mucus trap to the vacuum line and use a thumb hole to control flow. The other end is connected to a disposable, sterile, single use mucus catheter. In addition, high-resource caregivers may have hand operated equipment like a disposable mucus aspirator bulb available as a complementary or back up device.

    Application in Low-Resource Settings
    In low-resource setting hospitals, electric suction machines are common. They are typically used for both operations and deliveries. Small, portable DeLee suction devices and mucus aspirator bulbs are more common in clinic settings, and may be re-used across multiple newborns. Aspirator bulbs are less expensive, but provide less suction and can be difficult to clean depending on design.

    REPRESENTATIVE DEVICES

    MAKE
    MODEL
    PRICE*
    TECH
    STATUS
    NOTES

    Gomco

    Model 405
    $780
    Electric
    Marketed
    Electric vacuum pump for medical use

    Generic

    Foot Operated
    $12
    Pedal
    Marketed
    Re-usable floor pump

    Generic

    Suction Catheters
    $2
    Pedal/Electric
    Marketed
    Sizes from 8-14 French are common

    Laerdal

    NeoNatalie Suction
    $3
    Bulb
    Marketed
    Designed for easy cleaning

    Argyle

    20cc Mucus Trap
    $2
    DeLee
    Marketed
    Resusable, needs to be sterilized

    Generic

    Mucus Bulb
    $0.50
    Bulb
    Marketed
    Reusable, bulk price

    * Prices are approximated. Actual pricing can, and will vary by marketplace and market conditions.

  • CHARACTERISTICS OF REPRESENTATIVE PRODUCT

    TECHNOLOGY CHARACTERISTICS

    OPERATIONAL PARAMETERS

    POTENTIAL OPPORTUNITIES FOR IMPROVEMENT

    SKILLS

    REQUIRED

    Intended end user
    Training required
    Time required per use
    Physician, Nurse, Skilled attendant
    Hours
    Minutes

    In addition to training on the correct use of the device, additional training may be required to reinforce the importance of cleaning and sterilization between uses.

    ENVIRONMENT/ INFRASTRUCTURE

    Power required
    Waste collection
    Complementary technologies required
    Temperature and storage
    Maintenance
    None
    Biohazard
    None
    None
    Steam sterilize

    The ability to fully open the bulb is important for complete cleaning.

    COST

    Device Cost (Approx)
    Cost/course (Approx)
    $1-$10
    Cost of sterilization

    OTHER

    Portability
    Regulatory
    Efficacy
    <50g

    Additional devices required for impact: Depending on the situation, infants who require suction may also require resuscitation among other interventions.

Sources: A Deorari et al. Neonatal Equipment: Everything that you would like to know! 3rdEdition. 2006. Sagar Publications. Delhi. A Peter et al. The Epidemiology of Meconium Aspiration Syndrome: Incidence, Risk Factors, Therapies, and Outcome. Pediatrics 2006;117;1712-1721. Dave Woods, Perinatal Education Programme (PEP) -Maternal Care Manual Unit 36 Resuscitation, 2004. WHO. Basic newborn resuscitation: a practical guide. Safe Motherhood Project. 1998. J Lipton et al. Prevention and Management of Meconium Aspiration in Henretig et al. Textbook of pediatric emergency procedures. Ch 39. Williams & Watkins. 1997