MINIMIZING THE HARMFUL SEQUELAE OF ENDOTRACHEAL SUCTIONI

本研究的目的是确定最佳的肺过度膨胀。 对平均动脉压(MAP)产生最小变化的容量 并防止吸痰后低氧血症。样本将包括50名男性 冠状动脉搭桥术后至少四小时的患者 手术，并根据SET确定血流动力学稳定 标准。受试者将接受连续三次肺过度充气 在四个随机排序的卷(12cc/kg、14cc/kg、16cc/kg和 18cc/kg瘦体重)通过MA1呼吸机在15秒内 将持续监测FI02 100%MAP的控制情况。肺脏 恶性通货膨胀之后将立即用14FR吸气 导管。吸力(200毫米汞柱流速16L/分钟)将应用于 持续旋转和抽出导管10秒。这个 三次肺过度充气(在设定的容量下，然后进行吸气 重复x3。在最后一次吸气后，动脉血气 将在0、30、60、120、180和300秒时撤回 后抽吸术。协议将在一小时后重复，直到所有 已经测试了四种树叶。本研究的结果将为护士提供 对危重病患者实施肺过度膨胀管理的参数 病人。

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 Following the last suction pass, arterial blood gases will be withdrawn at time 0, 30, 60, 120, 180, and 300 seconds post-suctioning.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.