MINIMIZING THE HARMFUL SEQUELAE OF ENDOTRACHEAL SUCTIONI

本研究的目的是确定一个最佳的肺过度充气 将产生最小平均动脉压（MAP）变化的体积 防止吸痰后低氧血症。 样本将包括50名男性 冠状动脉旁路移植术后至少4小时的患者 手术并根据设置确定血流动力学稳定 的搜索. 受试者将接受连续三次肺过度充气 以四种随机排序的体积（12 cc/Kg、14 cc/Kg、16 cc/Kg和16 cc/Kg）之一， 18 cc/Kg瘦体重）在15秒内通过Ma 1呼吸机“叹气” 将持续监测FI 02 100%MAP下的对照。 肺 过度充气后立即用14 FR抽吸 导尿管 抽吸（200 mmHg流速16 L/min）将应用于 旋转并撤回导管10秒。 的 三次肺过度充气（在设定的体积下，随后进行抽吸， 重复x 3。 最后一次抽吸后，动脉血气 将在时间0、30、60、120、180和300秒时撤回 抽吸后。 一小时后将重复该方案， 四种植物已经测试过了。 这项研究的结果将提供护士 对危重病人进行肺过度充气的参数 患者

The purpose of this study is to determine an optimum lung hyperinflation volume that will produce minimal changes in mean arterial pressure (MAP) and prevent post-suctioning hypoxemia. The sample will consist of 50 male post-coronary artery bypass graft patients who are at least four hours post surgery and determined to be hemodynamically stable according to set criteria. The subjects will receive three consecutive lung hyperinflations at one of the four randomly ordered volumes (12cc/Kg, 14cc/Kg, 16cc/Kg, and 18cc/Kg of lean body weight) in 15 seconds via the Ma1 ventilator "sigh" control at FI02 100% MAP will be monitored continuously. The lung hyperinflation will be immediately followed by suctioning with a 14FR catheter. Suction (200mmHg flow rate 16L/min) will be applied to the catheter continuously while rotating and withdrawing for 10 seconds. The three lung hyperinflations (at the set volume, followed by suctioning will be repeated x 3. Following the last suction pass, arterial blood gases will be withdrawn at time 0, 30, 60, 120, 180, and 300 seconds post-suctioning. The protocal will be repeated one hour later until all four folumes have tested. The results of this study will provide nurses with parameters for administering lung hyperinflation to critically ill patients.