ENDOTRACHEAL SUCTIONING IN NEWBORNS

气管内吸痰是维持 保持气道通畅，清除积聚的分泌物， 插管新生儿的碎片 尽管常规性质的 该程序几乎没有关于各种影响的数据 对新生儿的程序的组成部分。 该程序 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 气管病变 在这项研究中，30名插管新生儿将接受4次气管内 在6小时内进行抽吸程序，以确定 头部旋转和吸引导管进入次数的影响 气管内吸痰期间氧合、分泌物恢复 和颅内压。 独立变量将包括 头部旋转（在旋转过程中将头部向右和向左转动） 抽吸与无头部旋转）结合2或3次 抽吸过程中的抽吸导管。 氧合 将通过血氧饱和度来测量 与放置在婴儿手上的记录器相连的监视器，或 脚 将通过无创监测颅内压 将探针放置在婴儿的前囟上， 在抽吸期间和之后。 分泌物恢复将是 通过称重之前和之后的抽吸导管和管路确定， 在抽吸程序之后立即进行。 将通过方差分析对数据进行重复分析。 测量（RM-ANOVA），以确定 关于氧饱和度、分泌物的气管内吸痰方案 恢复和颅内压。 头部旋转的使用是否与缺氧有关， 颅内压升高，但不利于恢复 分泌物，那么这种机动可以从 气管内吸引术 同样，如果额外通过 在气管内抽吸期间的抽吸导管不 去除额外的分泌物，但与缺氧有关， 颅内压变化，然后抽吸两次 在气管内吸痰过程中使用导管将是足够的。

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.