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NICU guideline identifier

Continuous Positive Airway Pressure (CPAP) - Hudson suctioning

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Indications for Hudson CPAP suctioning

  • Increased secretions
  • Increased respiratory effort 
  • Increased oxygen requirement 
  • Increased respiratory distress 
  • Increased apnoeas

Equipment required

  • Suction catheter sizes 7,8 
  • Non-Sterile Gloves 

Suction pressure

Pressure should be set at 100 - 150mmHg as appropriate for gestational age. 

Frequency of suctioning

  • First 6 hours - suction 2-4hrly 
  • Following this suction a minimum of 6 hourly 
  • NB: When Hudson CPAP is discontinued, suctioning will be required at least six hourly
    more frequently if symptomatic for the first 24 hours then as required to maintain a clear airway. 

Nursing management

Follow the steps below to suction baby.  This is a two person procedure (one could be a parent) to support and comfort the baby through this procedure.

  1. Ensure Neopuff is checked and within reach if needed. 
  2. Consider the need to Pre-oxygenate by
    - Using blowby Oxygen, OR 
    - Removing only one side of the CPAP prong at a time. 
  3. Suction mouth first, as this clears oropharynx and lubricates catheter. 
  4. Measure from nose to pinna then add half that distance to measurement already obtained. Ensure the catheter passes to the back of nasopharynx to clear secretions. 
  5. Baby should be suctioned at least twice down each nostril. 
  6. If unable to get down a nostril due to trauma, use finger port at nares and kink suction catheter. 
  7. Note on observation chart, colour, type, and amount of secretions and infant's tolerance of the procedure. 

Note: Saline (NaCl 0.9%) instillation is only used if secretions are deemed to be thick and tenacious on individual assessment.

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Document Control

  • Date last published: 26 November 2015
  • Document type: Clinical Guideline
  • Services responsible: Neonatology
  • Owner: Newborn Services Clinical Practice Committee
  • Editor: Sarah Bellhouse
  • Review frequency: 2 years