ENDOTRACHEAL SUCTIONING IN NEWBORNS

新生儿气管内吸引术

• 批准号: 3391456
• 负责人: BARBARA S TURNER
• 金额: $ 2.38万
• 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 1990-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3391456
• 关键词: acute disease /disorder; bronchial mucus; catheterization; critical care nursing; head movements; human subject; hyperoxia; intracranial pressure; newborn human (0-6 weeks); nursing skill /technique; pediatric nursing; premature infant human; respirators; respiratory oxygenation; respiratory therapy

Endotracheal suctioning is the primary method used to maintain patency of the airway and remove accumulated secretions and debris from the intubated neonate. Despite the routine nature of the procedure there is little data on the effects of the various components of the procedure on the neonate. The procedure has been associated with complications including hypoxia, bradycardia, increased intracranial pressure, atelectasis and tracheal lesions. In this study 30 intubated newborns will receive 4 endotracheal suctioning procedures within a 6 hour time period to determine the effect of head rotation and number of suction catheter entries during endotracheal suctioning on oxygenation, secretion recovery and intracranial pressure. The independent variables will include head rotation (turning the head to the right and left during suctioning versus no head rotation) combined with 2 or 3 passes of the suction catheter during on suctioning procedure. Oxygenation will be measured transcutaneously by an oxygen saturation monitor connected to a recorder placed on the infant's hand or foot. Intracrancial pressure will be monitored noninvasively by placing a probe over the anterior fontanell of the infant prior to, during and following suctioning. Secretion recovery will be determined by weighing suction catheters and tubing before and immediately following the suctioning procedure. The data will be analyzed by analysis of variance for repeated measures (RM-ANOVA) to determine the effect of the endotracheal suctioning protocol on oxygen saturation, secretion recovery and intracranial pressure. Should the use of head rotation be associated with hypoxia and increased intracranial pressure and yet not facilitate the recovery of secretions then this maneuver could be eliminated from the endotracheal suctioning procedure. Likewise if an extra pass of the suction catheter during endotracheal suctioning does not remove additional secretions yet is associated with hypoxia and changes in intracranial pressure then two passes of the suction catheter during endotracheal suctioning would be adequate.

气管吸力是用于维护的主要方法 气道通畅并取出累积的分泌物和 插管新生儿的碎片。 尽管有常规的性质 该过程几乎没有关于各种影响的数据 新生儿的过程的组成部分。 该过程具有 与包括缺氧在内的并发症有关， 心动过缓，颅内压升高，肺不张症和 气管病变。 在这项研究中，30个插管新生儿将获得4个气管 在6小时内的抽吸程序确定 头部旋转和吸力导管条目的影响 在气管氧合的气管内吸入期间，分泌恢复 和颅内压。 自变量将包括 头部旋转（将头向左右转动 吸力与无头部旋转）与2或3次通过 抽吸程序期间的吸气导管。 氧合 将通过氧饱和度经过头皮测量 监视器连接到婴儿手上的记录员或 脚。 牙周压将通过 在婴儿的前叉孔上放置探针，然后 在抽吸期间和之后。 分泌恢复将是 通过称重吸力导管和管道来确定 立即遵循抽吸程序。 将通过分析重复的方差分析数据 措施（RM-ANOVA）确定 氧气饱和，分泌的气管内吸气方案 恢复和颅内压。 头部旋转的使用是否与缺氧有关 增加颅内压，但不能促进恢复 然后可以从分泌物中删除这种操作 气管吸力程序。 同样，如果额外的通过 气管吸力期间的吸气导管不会 去除其他分泌物，但与缺氧和 颅内压的变化，然后两次通过 气管吸力期间的导管足够。