ENDOTRACHEAL SUCTIONING IN NEWBORNS

新生儿气管内吸引术

• 批准号: 3391454
• 负责人: BARBARA S TURNER
• 金额: $ 14.11万
• 依托单位: U.S. MADIGAN ARMY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 1987
• 资助国家: 美国
• 起止时间: 1987-05-01 至 1994-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3391454
• 关键词: bronchial mucus; carbon dioxide tension; catheterization; critical care nursing; heart rate; human subject; human therapy evaluation; hyperoxia; intracranial pressure; newborn human (0-6 weeks); nursing skill /technique; oxygen tension; pediatric nursing; premature infant human; respirators; respiratory airway pressure; respiratory oxygenation; respiratory therapy

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.

这项研究的目的是扩展有关对 新生儿中的气管吸力（ETS）通过系统地检查两个 传递高氧呼吸和两个级别的方法 在选定生理学的受控ETS过程中的高氧化 变量。 具体目的是：（1）比较高氧呼吸 用手动复苏袋（MRB）与呼吸机交付 氧饱和度（SA）2），颅内压（ICP），心率（HR）， 经皮二氧化碳（TCCO2），平均气道压力（PAW）和 早产婴儿样本中的分泌恢复； （2）比较 高氧呼吸，其中FIO2比基线增加了10％ 与SAO2，ICP，HR，TCCO2，PAW和 在同一婴儿样本中的分泌恢复； （3）确定 如果疾病的严重程度与某人的能力之间存在关系 高氧递送方法（MRB与呼吸机）和水平 高氧（10％vs fio2增加20％）以防止吸力引起 低氧血症，心动过缓，高/次生性和ICP增加。 样本 将由40个插管和机械通风的早产婴儿组成 符合入学条件的人。 每个婴儿都会成为自己的 控制5个受控的ETS程序的1基线ET和4个随机控制 确定的方案：MRB的FIO2增加了10％，MRB为20％ FIO2的增加。 抽吸间隔将标准化每个 婴儿。 六个生理参数中的五个（SAO2，ICP，HR，TCPO2和 paw）将在之前，之中和之后同时收集 在校准的Gould TA 2000上以50样品/秒的吸力序列 录音机。 分泌恢复将通过减去前 吸入导管和粘液陷阱重量来自后导管 和粘液陷阱重量。 吸管导管的重量差异 和粘液陷阱将总计确定分泌物的重量 恢复。 将使用受试者重复措施内分析数据 多重分析方差分析（RM-Manova）和其他统计检验 合适的。 这项研究的结果将确定 两种传递高氧呼吸和两个级别的方法 高氧并为建立基于研究的数据提供数据 通风过早婴儿中的ETS方案。