ENDOTRACHEAL SUCTIONING IN NEWBORNS

新生儿气管内吸引术

• 批准号: 3391457
• 负责人: BARBARA S TURNER
• 金额: $ 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/3391457
• 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); nurses; nursing; 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的研究， 新生儿气管内吸痰（ETS），通过系统检查两个 输送高氧合呼吸的方法和两个水平的 在选定的生理条件下，在受控ETS手术期间过度氧合 变量 具体目的是：（1）比较高氧呼吸 使用手动复苏袋（MRB）与呼吸机进行输送 氧饱和度（Sa）2），颅内压（ICP），心率（HR）， 经皮二氧化碳（tcCO 2）、平均气道压（Paw）和 早产儿样本中的分泌物恢复;（2）比较 FIO 2较基线增加10%的过度氧合呼吸 与SaO 2、ICP、HR、tcCO 2、Paw和 同一样本中早产儿的分泌物回收率;（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 vs呼吸机）和 过度氧合（FIO 2增加10% vs 20%），以防止抽吸诱导 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 每一个婴儿都将作为自己的孩子 对照5个对照ETS程序，1个基线ETS和4个随机 确定的方案：FIO 2增加10%的MRB， 增加FIO 2。 抽吸间隔将标准化， 婴儿。 6个生理参数中的5个（SaO 2、ICP、HR、tcpO 2和 Paw）将在 在经校准的Gould TA 2000上以50个样本/秒的抽吸序列 录音机。 分泌物恢复将通过减去前 抽吸后导管的抽吸导管和粘液收集器重量 和粘液捕集器重量。 吸引导管的重量差异 和粘液收集器将被合计以确定分泌物的重量 恢复 将使用受试者内重复测量分析数据 多元方差分析（RM-MANOVA）和其他统计检验， 适当 这项研究的结果将确定的影响， 两种输送高氧呼吸的方法和两种水平的 为建立高氧合的研究基础提供数据 通气早产儿的ETS方案。