Background: Non-invasive ventilation (NIV) in preterm infants often leads to secretion-related airway obstructions, requiring suctioning. Traditional oro/nasopharyngeal suction techniques may cause mucosal trauma, pain, and physiological instability. Objective: To evaluate the effects of a novel non-traumatic oro/nasopharyngeal suction technique on physiological and behavioral parameters in preterm infants receiving NIV. Methods: A randomized controlled trial was conducted with 100 preterm infants (32 0/6 - 36 6/7 weeks gestation) admitted to a Level IV NICU. Infants were randomized into intervention (non-traumatic suction) and control (routine suction) groups. Data on heart rate, respiratory rate, SpO₂, skin color, and pain/sedation scores (N-PASS) were collected before, during, and after suctioning.
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Inclusion Criteria: Gestational age between 32 0/6 and 36 6/7 weeks Receiving non-invasive ventilation (NIV) via nasal CPAP Clinically stable prior to suctioning Parental or legal guardian informed consent obtained Age within first 7 days of life at time of first suction procedure Exclusion Criteria: Major congenital anomalies (e.g., craniofacial malformations, cardiac defects) Suspected or confirmed neurological disorders (e.g., intraventricular hemorrhage Grade III/IV) Presence of upper airway obstruction or nasal anomalies Infants requiring invasive mechanical ventilation at the time of study Any condition requiring continuous sedation or analgesia Hemodynamically unstable infants (e.g., hypotension requiring inotropes) Parental refusal or withdrawal of consent