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ENDOTRACHEAL SUCTIONING--OPEN VS. CLOSED SYSTEMS

气管内吸引——开放式与非开放式

基本信息

批准号：
3391446
负责人：
MARA M BAUN
金额：
$ 6.6万
依托单位：
UNIVERSITY OF NEBRASKA MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
1987
资助国家：
美国
起止时间：
1987-03-17 至 1991-03-16
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/3391446
关键词：
adult respiratory distress syndrome cardiac output disease /disorder model dogs intracardiac pressure oxygen tension oxygen therapy positive pressure breathing pulmonary hypertension respiratory airway pressure respiratory gas level respiratory therapy thoracic pressure vascular resistance

项目摘要

The aim of this study is to compare an open system of delivery of supplemental oxygen requiring disconnection from the ventilator to a closed system using an adapter and volume controlled ventilator. Lung inflations at both tidal volume and 150% tidal volume will be administered prior to, during and following endotracheal suctioning at zero end expiratory pressure and two levels of positive end expiratory pressure (PEEP). The selected indices of cardiopulmonary status will be monitored in the oleic acid-injured model of acute respiratory failure with normal pulmonary vascular resistance and with increased pulmonary vascular resistance. Mongrel dogs (22-27 kg) (n=56) will be anesthetized, intubated, and mechanically ventilated ((MA-1). Right atrial, pulmonary arterial, aortic, intrathoracic, and airway pressures and aortic blood flow will be measured continuously. Arterial samples (for arterial blood gases) will be drawn at baseline, before and after each of three suction/inflation periods, at 30 sec. intervals for 1 min. post return to maintenance ventilation, and at 1 min. intervals for 8 additional min. Simultaneous arterial and pulmonary arterial samples (for arterial and mixed venous oxygen tension and saturation) and pulmonary capillary wedge pressure will be obtained at baseline, at 1 min. post return to maintenance ventilation, and at 9 min.. From these direct measures aveolar-arterial oxygen tension differences, arterial-venous oxygen tension differences, cardiac shunt, oxygen transport, right ventricular filling pressure, right ventricular afterload, left ventricular preload, total peripheral resistance, and pulmonary vascular resistance will be calculated. Since a maximum of six variations can be run on a single animal, this study will be conducted in four series, three with 2 x 3 factorial designs and one with a 2 x 2 factorial design, with the variations applied according to a Latin Square design balanced for residual effects. Data will be analyzed by ANOVA for repeated measures and appropriate post hoc analyses will be performed.

本研究的目的是比较开放式交付系统需要断开呼吸机的补充氧气使用适配器和音量控制的封闭系统呼吸机。潮气量和 150% 潮气时的肺部充气情况体积将在之前、期间和之后进行管理零呼气末压力和两个气管内抽吸呼气末正压 (PEEP) 水平。所选择的心肺状态指数将在油酸中进行监测正常人急性呼吸衰竭酸损伤模型肺血管阻力增加，肺血管阻力增加血管阻力。杂种狗 (22-27 公斤) (n=56) 将麻醉、插管和机械通气 ((MA-1)。右心房、肺动脉、主动脉、胸内和气道将连续测量压力和主动脉血流量。动脉样本（动脉血气）将在基线，三个吸气/充气周期之前和之后， 30 秒时间隔1分钟。返回维护后通风，并在 1 分钟后。额外间隔 8 分钟。同时采集动脉和肺动脉样本（对于动脉和混合静脉氧分压和饱和度）和肺氧分压毛细管楔压将在 1 分钟时在基线处获得。返回维持通气后，并在 9 分钟时.. 从这些直接测量肺泡动脉氧张力差异，动静脉氧张力差异、心脏分流、氧气运输、右心室充盈压、右心室后负荷、左心室前负荷、总外周阻力、并计算肺血管阻力。自从一个最多可以在单个动物上运行六种变化，这研究将分四个系列进行，其中三个系列采用 2 x 3 阶乘设计和 2 x 2 因子设计，以及变化根据平衡残差的拉丁方设计应用影响。数据将通过方差分析进行分析以进行重复测量并将进行适当的事后分析。