ENDOTRACHEAL SUCTIONING IN ACUTELY ILL ADULTS

本研究的目的是确定两种气管内 吸痰（ETS）技术，关闭与打开呼吸机ETS（Ballard Trach Care 系统）对急性病成人心肺状态的影响。具体目标 本研究的目的是确定高氧合的影响（FIO.2 1.0） 通过呼吸机（通气），然后关闭与打开通气ETS，2与3 收缩期和舒张期动脉的高氧吸入（H-S）序列 血压、平均动脉压（MAP）、心率（HR）和心律、气道 血压（Paw）、动脉血气（ABG）和分泌恢复（SR） 成人急性病。样本将包括60例插管的M & F， 符合特定标准的机械通气患者。每个 受试者将暴露于以下随机顺序（拉丁方 设计）每小时处理一次，连续4小时：1）3 H-S 随后关闭排气口ETS，2）3 H-S随后打开排气口ETS，3）2 H-S 然后关闭排气ETS，4）2 H-S然后打开排气ETS。受试者 将在FIO.2 1.0下进行四次呼吸，呼吸频率为135% 20秒内达到规定的潮气量通过他们的通风口。后立即 氧合过度，受试者将被抽吸（流速16 L/min） 连续10秒。用一根14 F的导管从通气管上拔下来， 在通风口。关闭与开启通气ETS对收缩压和舒张压的影响 将持续监测动脉压、MAP、Paw、HR和心律 通过经校准的图形记录器（Gould 2800），存储在磁带上 （Hewlett-Packard），随后使用ASYST软件进行分析。的影响 在ABG（Corning 158）上，氧合过度，随后关闭vs.通气， 将监测氧饱和度（Physiocontrol）。将确定SR 通过使用Mettler天平的前后重量（以克为单位）。数据将 使用重复测量的ANOVA进行分析，以确定关闭 vs.通气ETS和2与3 H-S序列对选定的生理 变量这项研究的结果将决定两者的效果 心肺参数的技术，并为 在急性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.