ENDOTRACHEAL SUCTIONING IN ACUTELY ILL ADULTS

重症成人的气管内抽吸

• 批准号: 3391466
• 负责人: Kathleen S. Stone
• 金额: $ 23.78万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1987
• 资助国家: 美国
• 起止时间: 1987-04-01 至 1995-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3391466
• 关键词: blood pressure; catheterization; critical care nursing; heart rate; heart rhythm; human subject; nurses; nursing administration; oxygen therapy; respirators; respiratory airway pressure; respiratory gas level; respiratory surgery

The purpose of this study is to determine the effect of two endotracheal suctioning (ETS) techniques, off vs. on ventilator ETS (Ballard Trach Care System) on cardiopulmonary status in acutely ill adults. The specific aims of this study are to determine the effect of hyperoxygenation (FIO.2 1.0) via a ventilator (vent) followed by off vs. on vent ETS and 2 vs. 3 hyperoxygenation-suction (H-S) sequences on systolic and diastolic arterial pressure, mean arterial pressure (MAP), heart rate (HR) and rhythm, airway pressure (Paw), arterial blood gases (ABG's) and secretion recovery (SR) in acutely ill adults. The sample will consist of 60 M & F intubated and mechanically ventilated patients who meet specific criteria. Each of the subjects will be exposed to the following randomly ordered (Latin Square Design) treatments once each hour for four consecutive hours: 1) 3 H-S followed by off vent ETS, 2) 3 H-S followed by on vent ETS, 3) 2 H-S followed by off vent ETS, 4) 2 H-S followed by on vent ETS. The subjects will be hyperoxygenated at FIO.2 1.0 with four breaths at 135% of prescribed tidal volume in 20 secs. via their vent. Immediately following hyperoxygenation, the subjects will be suctioned (flow rate 16L/min) continuously for 10 secs. with a 14 French catheter either off the vent or on the vent. The effects of off vs. on vent ETS on systolic and diastolic arterial pressure, MAP, Paw, HR and rhythm will be monitored continuously by a calibrated graphic recorder (Gould 2800), stored on magnetic tape (Hewlett-Packard), and later analyzed using ASYST software. The effects of hyperoxygenation followed by off vs. on vent on ABG's (Corning 158) and oxygen saturation (Physiocontrol) will be monitored. SR will be determined by pre and post weight in grams using the Mettler balance. The data will be analyzed using ANOVA for repeated measures to determine the effect of off vs. on vent ETS and 2 vs. 3 H-S sequences on the selected physiological variables. The results of this study will determine the effect of the two techniques on cardiopulmonary parameters and provide data for the establishment of safe ETS protocols in acutely ill adults.

本研究的目的是确定两种气管内导管的效果 抽吸 (ETS) 技术，关闭与打开呼吸机 ETS (Ballard Trach Care 系统）对急性病成人心肺状态的影响。具体目标 本研究的目的是确定过度氧合的影响 (FIO.2 1.0) 通过呼吸机（通风口），然后关闭与打开通风口 ETS 以及 2 与 3 收缩期和舒张期动脉的高氧合-吸力 (H-S) 序列 压力、平均动脉压 (MAP)、心率 (HR) 和节律、气道 血压 (Paw)、动脉血气 (ABG) 和分泌恢复 (SR) 患有急性疾病的成年人。样本将由 60 个 M & F 插管和 符合特定标准的机械通气患者。每个 受试者将接触以下随机排序的（拉丁方 设计）每小时处理一次，连续四小时：1）3 H-S 然后是排气 ETS，2) 3 H-S，然后是排气 ETS，3) 2 H-S 随后是排气 ETS，4) 2 H-S，随后是排气 ETS。科目 在 FIO.2 1.0 时将处于高氧状态，在 135% 的情况下进行四次呼吸 20秒内规定的潮气量。通过他们的通风口。紧接着 过度氧合，受试者将被吸引（流量16L/min） 连续10秒。使用 14 French 导管，要么离开排气口，要么 在通风口上。关闭与打开排气 ETS 对收缩压和舒张压的影响 将持续监测动脉压、MAP、Paw、HR 和心律 通过校准的图形记录仪（Gould 2800），存储在磁带上 （惠普），后来使用 ASYST 软件进行分析。的影响 过度氧合，然后关闭 ABG 上的通风口与开启通风口 (Corning 158) 和 将监测氧饱和度（Physiocontrol）。 SR将被确定 使用梅特勒天平计算前后重量（以克为单位）。数据将是 使用方差分析进行重复测量以确定关闭的效果 与排气 ETS 对比以及所选生理学上 2 与 3 H-S 序列的对比 变量。这项研究的结果将决定两者的效果 心肺参数技术，为心肺参数提供数据 为患有急性疾病的成人建立安全的 ETS 协议。