Infants are typically obligate nasal breathers and the increased mucus production associated with bronchiolitis can impair both breathing and feeding. AAP bronchiolitis guidelines state that the routine use of deep suctioning may not be beneficial.
This was an observational study of 121 infants aged 2-23 months with bronchiolitis who received either nasal suction (31), deep suction (68) or a combination (52). Groups were based on clinician discretion. Respiratory scores and pulse ox were obtained pre-suction and at 30 and 60 minutes post suction.
There was no difference between suction type and respiratory score. However, there was an improvement in respiratory score between the 0-30 and 0-60 time point with any suctioning. Suction type had no effect on pulse ox, airway adjunct escalation, length of stay or outpatient outcomes.
The study also showed no association between albuterol use and respiratory scores (albuterol is not recommended by the AAP in the management of bronchiolitis).
Bottom line: In this small study, nasal aspiration and deep suction appear to be equal in improving respiratory scores up to 1 hour post suction suggesting that deep suctioning may not be needed.
References
Hedland JL, Chang TP, Schmidt AR, Festekjian A. Suctioning in the management of bronchiolitis: A prospective observational study. Am J Emerg Med. 2024;82:57-62. doi:10.1016/j.ajem.2024.05.013
