ENDOTRACHEAL SUCTIONING IN NEWBORNS

新生儿气管内吸引术

• 批准号: 3391454
• 负责人: BARBARA S TURNER
• 金额: $ 14.11万
• 依托单位: U.S. MADIGAN ARMY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 1987
• 资助国家: 美国
• 起止时间: 1987-05-01 至 1994-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3391454
• 关键词: bronchial mucus; carbon dioxide tension; catheterization; critical care nursing; heart rate; human subject; human therapy evaluation; hyperoxia; intracranial pressure; newborn human (0-6 weeks); nursing skill /technique; oxygen tension; pediatric nursing; premature infant human; respirators; respiratory airway pressure; respiratory oxygenation; respiratory therapy

The purpose of this study is to extend prior research on the effects of endotracheal suctioning (ETS) in newborns by systematically examining two methods of delivering hyperoxygenation breaths and two levels of hyperoxygenation during a controlled ETS procedure on selected physiologic variables. Specific aims are: (1) to compare hyperoxygenation breaths delivered with a manual resuscitation bag (MRB) versus a ventilator on oxygen saturation (Sa)2), intracranial pressure (ICP), heart rate (HR), transcutaneous carbon dioxide (tcCO2), mean airway pressure (Paw) and secretion recovery in a sample of premature infants; (2) to compare hyperoxygenation breaths in which the FIO2 is increased 10% over baseline versus those increased 20% over baseline on SaO2, ICP, HR, tcCO2, Paw and secretion recovery in the same sample of premature infant; (3) to determine if there is a relationship between severity of illness and the ability of a hyperoxygenation delivery method (MRB vs ventilator) and level of hyperoxygenation (10% vs 20% increase in FIO2) to prevent suction induced hypoxemia, bradycardia, hyper/hypocarbia and increased ICP. The sample will consist of 40 intubated and mechanically ventilated premature infants who meet the entrance criteria. Each infant will serve as their own control for 5 controlled ETS procedures' 1 baseline ETS and 4 randomly determined protocols: MRB with a 10% increase in FIO2, MRB with a 20% increase in FIO2. The suctioning interval will be standardized for each infant. Five of the six physiological parameters (SaO2, ICP, HR, tcpO2 and Paw) will be collected simultaneously prior to, during and following the suctioning sequence at 50 samples/second on a calibrated Gould TA 2000 recorder. Secretion recovery will be determined by subtracting the pre- suctioned catheter and mucus trap weights from the post-suction catheter and mucus trap weights. Differences in weights of the suction catheters and mucus traps will be totaled to determine the weight of secretions recovered. Data will be analyzed using within subject repeated measures multiple analysis of variance (RM-MANOVA) and other statistical tests as appropriate. The results of this study will determine the effect of the two methods of delivering hyperoxygenated breaths and two levels of hyperoxygenation and provide data for the establishment of research based ETS protocols in ventilated premature infants.

本研究的目的是扩展先前对以下因素影响的研究： 通过系统地检查两个新生儿的气管内抽吸（ETS） 提供高氧呼吸的方法和两个级别 在受控 ETS 程序期间对选定的生理学进行过度氧合 变量。 具体目标是：（1）比较高氧呼吸 配备手动复苏袋 (MRB) 与使用呼吸机进行交付 氧饱和度 (Sa)2)、颅内压 (ICP)、心率 (HR)、 经皮二氧化碳 (tcCO2)、平均气道压 (Paw) 和 早产儿样本中的分泌物恢复； (2)比较 高氧合呼吸，其中 FIO2 比基线增加 10% 与那些在 SaO2、ICP、HR、tcCO2、Paw 和 早产儿同一样本中的分泌恢复； (3) 确定 如果疾病的严重程度和患者的能力之间存在关系 高氧输送方法（MRB 与呼吸机）和水平 过度氧合（FIO2 增加 10% 与 20%）以防止吸力诱导 低氧血症、心动过缓、高/低碳酸血症和ICP升高。 样品 将包括 40 名插管和机械通气的早产儿 符合入学标准的人。 每个婴儿都将作为自己的婴儿 控制 5 个受控 ETS 程序，其中 1 个基线 ETS 和 4 个随机 确定方案：MRB FIO2 增加 10%，MRB 增加 20% FIO2 增加。 每个吸痰间隔将标准化 婴儿。 六个生理参数中的五个（SaO2、ICP、HR、tcpO2 和 Paw）将在之前、期间和之后同时收集 在经过校准的 Gould TA 2000 上以 50 个样本/秒的速度进行抽吸序列 录音机。 分泌物回收率将通过减去预 抽吸导管和抽吸后导管的粘液捕集器重量 和粘液陷阱重量。 抽吸导管的重量差异 和粘液收集器将被总计以确定分泌物的重量 恢复了。 将使用受试者内重复测量来分析数据 多重方差分析（RM-MANOVA）和其他统计检验 合适的。 这项研究的结果将决定该方案的效果 两种提供高氧呼吸的方法和两种水平 超氧合并为建立研究基础提供数据 通气早产儿的 ETS 协议。