ENDOTRACHEAL SUCTIONING--IN ACUTELY ILL ADULTS

本研究的目的是确定两种气管内插管的效果。 吸痰(ETS)技术，关闭与使用呼吸机(Ballard Trach Care) 系统)对急性疾病成人的心肺状况的影响。具体目标 这项研究的目的是确定高氧的影响(FIO.2 1.0) 通过通风器(通风口)，然后关闭与通风口ETS和2与3 收缩期和舒张期动脉的高氧-抽吸(H-S)序列 血压、平均动脉压(MAP)、心率(HR)和节律、呼吸道 血压(Paw)、动脉血气(ABG‘s)和分泌物恢复(SR) 病情严重的成年人。样品将由60个M&F插管和 符合特定标准的机械通气患者。每一位 受试者将接受以下随机排序(拉丁方 设计)每小时治疗一次，连续四小时：1)3H-S 然后是Off Vent ETS，2)3H-S，然后是On Fent ETS，3)2H-S 然后是关闭排气ETS，4)2 H-S，然后是On排气ETS。主题 在FIO.2 1.0下呼吸四次，呼吸135% 规定潮气量在20秒内。通过他们的通风口。紧随其后 高氧时，受试者将被抽吸(流速16L/分钟)。 连续10秒。用一根14英寸的导管从通风口或者 在通风口上。Off与On对Ets收缩和舒张压的影响 将持续监测动脉压、MAP、Paw、HR和节律 用刻度的图形记录器(古尔德2800)存储在磁带上 (惠普)，后来使用ASYST软件进行了分析。的影响 在ABG上，高氧之后关闭与打开通气口(康宁158)和 将监测血氧饱和度(PhysioControl)。SR将被确定 通过使用梅特勒天平以克为单位的前后重量。数据将是 采用方差分析方法对重复测量结果进行分析，确定停用的效果 与Event ETS和2与3 H-S序列的选择 变量。这项研究的结果将决定两者的效果 有关心肺参数的技术，并为 在急性疾病成人中建立安全的ETS方案。

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.