ENDOTRACHEAL SUCTIONING IN NEWBORNS

这项研究的目的是扩展先前关于以下方面的研究 新生儿气管内吸引术(ETS) 提供高氧呼吸的方法和两种水平的 部分生理学受控ETS手术中的高氧血症 变量。具体目标是：(1)比较高氧呼吸 使用手动复苏袋(MRB)，而不使用呼吸机 血氧饱和度(Sa)2)、颅内压(ICP)、心率(HR)、 经皮二氧化碳分压(TcCO2)、平均气道压(Paw)和 早产儿样本中的分泌物恢复；(2)比较 FIO2比基线增加10%的高氧呼吸 相比之下，SaO2、ICP、HR、tcCO2、Paw和 同一早产儿标本分泌物恢复情况；(3)测定 如果疾病的严重程度与患者的能力之间存在关系 高氧给药方法(MRB与呼吸机)和水平 高氧(FiO2增加10%与20%)以防止吸入诱导 低氧血症、心动过缓、高/低碳酸血症和颅内压升高。样本 将由40名插管和机械通气的早产儿组成 符合入学标准的学生。每个婴儿都将作为他们自己的孩子 控制5个受控ETS程序：1个基线ETS和4个随机ETS 确定的方案：MRB增加10%的FiO2，MRB增加20% 增加了FIO2。吸气间隔将被标准化，每个 婴儿。六项生理参数中的五项(SaO2、ICP、HR、TcpO2和 PAW)将在之前、期间和之后同时收集 在校准的古尔德TA 2000上以每秒50个样本的吸气顺序 录音机。分泌物的恢复将通过减去前- 吸出的导管和吸出后导管的粘液捕获量 粘液诱人体重。抽吸管重量的差异 粘液捕捉器将被总计以确定分泌物的重量 恢复了。数据将使用受试者内的重复测量进行分析 多元方差分析(RM-MANOVA)和其他统计检验，如 恰如其分。这项研究的结果将决定 提供高氧呼吸的两种方法和两种水平的 并为建立高氧基础研究提供数据基础 ETS方案在呼吸机早产儿中的应用

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.