ENDOTRACHEAL SUCTIONING IN HEAD INJURED ADULTS

头部受伤成人的气管内抽吸

• 批准号: 3391414
• 负责人: BARBARA DALY
• 金额: $ 12.09万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 1987
• 资助国家: 美国
• 起止时间: 1987-03-19 至 1995-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3391414
• 关键词: blood pressure; bronchial mucus; carbon dioxide tension; catheterization; critical care nursing; head /neck injury; heart rate; human subject; human therapy evaluation; intracranial pressure; nurses; nursing; oxygen tension; respirators; respiratory gas analyzer; respiratory therapy

The purpose of this study is to extend prior research on the effects of endotracheal suctioning (ETS) in head-injured adults by comparing two hyperoxygenation protocols. The protocols will be administered between ETS passes as a means of controlling increases in intracranial pressure and preventing compromised cerebral perfusion pressure. Specific aims of this study are: 1) to compare the effects of two hyperoxygenation protocols: [hyperventilation/-hyperinflation (HV/HI) protocol versus four breath hyperinflation (HI) protocol] administered between two ETS passes on mean arterial pressure (MAP), mean intracranial pressure (MICP), cerebral perfusion pressure (CPP), heart rate (HR), oxygen saturation (SaO2), end- tidal CO2, (PETco2), and secretion recovery in adult head-injured patients; and 2) to determine the difference in these two hyperoxygenation protocols in open versus closed head-injured patients; and 2) to determine the difference in these two hyperoxygenation protocols in open versus closed head-injured patients. This is a quasi-experimental, within subject, between group repeated measure design. The independent variables is the hyperoxygenation protocol (HV/HI versus HI protocol). The dependent variables are the physiological measurements of MAP, MICP, CPP (calculated value), HR, SaO2, PETco2 and secretion recovery. The suction variables to be controlled are F10s, suction flow rate and suction duration. Six physiological parameters (MAP, MICP, CPP (calculated), HR, SaO2, PETco2) will be recorded simultaneously prior to, during and following the endotracheal suctioning sequence by means of a Gould TA2000 recorder. All pressure transducers (MAP & MICP) will be calibrated against a column of mercury; PETco2 and SaO2 will be validated by arterial blood gases at pre and post protocol; HR will be validated by the subject's EKG monitor; secretion recovery will be measured by means of a PM 460 Precision Electronic Mettler Balance to the nearest thousandth gram. Data analysis of Specific Aim 1 will consist of a two way within-subject, repeated measure analysis of variance to determine the effects of the HV/HI versus HI protocol on the dependent variables. For specific Aim 2 data analysis will consist of a within-subject, between-group, repeated measures analysis of variance to determine the effects of HI protocol on open versus closed head injured adults on the dependent variables and a within-subject, between group repeated measures ANOVA to determine the effects of HV/HI protocol on open versus closed head injured adults on the dependent variables.

本研究的目的是扩展先前的研究， 通过比较两种方法， 高氧合方案。 方案将在ETS之间实施 作为控制颅内压升高的一种手段， 防止脑灌注压受损 具体目标 研究内容包括：1）比较两种高氧方案的效果： [过度通气/过度充气（HV/HI）方案与四次呼吸 过度充气（HI）方案]在平均两次ETS通过之间给药 动脉压（MAP）、平均颅内压（MICP）、脑动脉压（MAP） 灌注压（CPP）、心率（HR）、血氧饱和度（SaO 2）、终末- 成人颅脑损伤患者的潮气CO2（PETco 2）和分泌物恢复; 以及2）确定这两种高氧合方案的差异 开放性与闭合性颅脑损伤患者; 2）确定 这两种高氧合方案在开放式与封闭式中的差异 头部受伤的病人 这是一个准实验性的，在受试者中， 组间重复测量设计 自变量是 高氧合方案（HV/HI vs HI方案）。 从属 变量是MAP、MICP、CPP的生理测量（计算的 值）、HR、SaO 2、PETco 2和分泌恢复。 吸力变量， 应控制的参数是F10、抽吸流量和抽吸持续时间。 六 生理参数（MAP、MICP、CPP（计算值）、HR、SaO 2、PETco 2） 将同时记录之前，期间和之后， 使用Gould TA 2000记录仪记录气管内抽吸序列。 所有 压力传感器（MAP和MICP）将根据以下列进行校准： 汞; PETco 2和SaO 2将通过术前动脉血气进行验证 和方案后; HR将由受试者的EKG监护仪验证; 将通过PM 460 Precision测量分泌物回收率 电子Mettler天平精确到千分之一克。数据分析 具体目标1将包括双向受试者内，重复 测量方差分析，以确定HV/HI与 因变量的HI方案。 对于特定目标2数据分析 将包括受试者内、组间、重复测量分析 以确定HI方案对开放与封闭 头部受伤的成年人对因变量和受试者内， 组间重复测量ANOVA，以确定HV/HI的影响 开放性与闭合性成人颅脑损伤的治疗方案 变量