ENDOTRACHEAL SUCTIONING IN NEWBORNS

新生儿气管内吸引术

• 批准号: 3391452
• 负责人: BARBARA S TURNER
• 金额: $ 8.77万
• 依托单位: U.S. WALTER REED ARMY MED 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 1990-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3391452
• 关键词: acute disease /disorder; bronchial mucus; catheterization; critical care nursing; head movements; human subject; hyperoxia; intracranial pressure; newborn human (0-6 weeks); nursing skill /technique; pediatric nursing; premature infant human; respirators; respiratory oxygenation; respiratory therapy

Endotracheal suctioning is the primary method used to maintain patency of the airway and remove accumulated secretions and debris from the intubated neonate. Despite the routine nature of the procedure there is little data on the effects of the various components of the procedure on the neonate. The procedure has been associated with complications including hypoxia, bradycardia, increased intracranial pressure, atelectasis and tracheal lesions. In this study 30 intubated newborns will receive 4 endotracheal suctioning procedures within a 6 hour time period to determine the effect of head rotation and number of suction catheter entries during endotracheal suctioning on oxygenation, secretion recovery and intracranial pressure. The independent variables will include head rotation (turning the head to the right and left during suctioning versus no head rotation) combined with 2 or 3 passes of the suction catheter during on suctioning procedure. Oxygenation will be measured transcutaneously by an oxygen saturation monitor connected to a recorder placed on the infant's hand or foot. Intracrancial pressure will be monitored noninvasively by placing a probe over the anterior fontanell of the infant prior to, during and following suctioning. Secretion recovery will be determined by weighing suction catheters and tubing before and immediately following the suctioning procedure. The data will be analyzed by analysis of variance for repeated measures (RM-ANOVA) to determine the effect of the endotracheal suctioning protocol on oxygen saturation, secretion recovery and intracranial pressure. Should the use of head rotation be associated with hypoxia and increased intracranial pressure and yet not facilitate the recovery of secretions then this maneuver could be eliminated from the endotracheal suctioning procedure. Likewise if an extra pass of the suction catheter during endotracheal suctioning does not remove additional secretions yet is associated with hypoxia and changes in intracranial pressure then two passes of the suction catheter during endotracheal suctioning would be adequate.

气管内吸引术是维持 保持呼吸道通畅，清除积聚的分泌物和 插管新生儿的碎片。尽管这是例行公事 关于这一程序的各种影响的数据很少 该程序的组成部分对新生儿。该程序具有 与包括缺氧在内的并发症有关， 心动过缓、颅内压升高、肺不张和 气管损伤。 在这项研究中，30名插管的新生儿将接受4次气管内注射 在6小时内进行抽吸程序以确定 头部旋转和留置导尿管进入次数的影响 气管内吸痰对氧合、分泌物恢复的影响 和颅内压。自变量将包括 头部旋转(将头部向右和向左旋转 吸头与不旋转头部的对比)结合2或3次 抽吸过程中的抽吸导管。氧合作用 会通过皮肤的血氧饱和度来测量 连接到放在婴儿手上的录音机的监视器或 脚。财务压力将由以下人员进行非侵入性监测 在婴儿的前穹窿上方放置一个探头， 在吸痰过程中和之后。分泌物的恢复将是 通过称量吸入导管和导管之前和 紧跟在吸引术之后。 数据采用方差分析进行重复分析 措施(RM-ANOVA)，以确定 气管内吸痰方案对血氧饱和度、分泌物的影响 恢复和颅内压。 头部旋转的使用是否应与缺氧和 颅内压升高，但不利于恢复 的分泌物，那么这个动作就可以从 气管内吸引术。同样，如果额外通过一次 气管内吸引术中的吸引管不 去除额外的分泌物仍与缺氧和 两次吸引术后颅内压的变化 在气管内吸引术中留置导管就足够了。