ENDOTRACHEAL SUCTIONING IN HEAD INJURED ADULTS

这项研究的目的是扩展先前关于以下方面的研究 成人颅脑损伤患者的气管内吸引术 高氧治疗方案。这些协议将在ET之间进行管理 PASS作为一种控制颅内压升高和 防止脑灌注压受损。这一行动的具体目标 研究内容如下：1)比较两种高氧方案的效果： [过度换气/过度充气(HV/HI)方案与四次呼吸方案 恶性充气(HI)方案]按平均值在两次ETS通行证之间实施 动脉压(MAP)、平均颅内压(MICP)、大脑 灌流压(CPP)、心率(HR)、血氧饱和度(SaO2)、 成人颅脑损伤患者潮气二氧化碳(PETco2)和分泌物恢复； 2)确定这两种高氧方案的差异 开放性与闭合性颅脑损伤患者的比较；以及2)确定 开放式与封闭式两种高氧方案的差异 头部受伤的病人。这是一个准实验，在受试者内部， 组间重复测量设计。自变量为 高氧方案(HV/HI与HI方案)。被依赖的人 变量为MAP、MICP、CPP的生理测量值(计算 值)、HR、SaO2、PETco2和分泌物恢复。吸力变量到 要控制的是F10s、抽吸流量和抽吸持续时间。六 生理参数(MAP、MICP、CPP(计算)、HR、SaO2、PETco2) 将在节前、节中和节后同时录制 古尔德TA2000记录仪的气管内吸痰序列。全 压力传感器(MAP和MICP)将根据以下柱子进行校准 水银；PETco2和SaO2将通过动脉血气在Pre 和POST协议；HR将由受试者的EKG监护仪进行验证； 分泌物回收率将通过PM 460精确度来测量 电子梅特勒天平精确到千分之一克。资料分析 具体目标1将包括主体内的双向，重复 测量方差分析以确定HV/HI对 关于因变量的HI协议。针对特定目标2数据分析 将由受试者内部、组间、重复测量分析组成 以确定HI方案对开放和关闭的影响 头部损伤成人对因变量和受试者内的影响， 组间重复测量方差分析确定HV/HI的影响 受养人头部开放性损伤与闭合性头部损伤的协议 变量。

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.