ENDOTRACHEAL SUCTIONING: IN HEAD INJURED ADULTS

气管内抽吸：头部受伤的成人

• 批准号: 3391413
• 负责人: Mary E. Kerr
• 金额: $ 19.19万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 1987
• 资助国家: 美国
• 起止时间: 1987-03-19 至 1995-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3391413
• 关键词: blood pressure; bronchial mucus; carbon dioxide tension; catheterization; critical care nursing; head /neck injury; heart rate; high frequency ventilation; human subject; human therapy evaluation; intracranial pressure; nurses; nursing; oxygen tension; respirators; respiratory gas analyzer; respiratory therapy

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.

这项研究的目的是扩展有关对 通过比较两个 高氧协议。 协议将在ETS之间管理 通过作为控制颅内压增加的手段和 防止脑灌注压力受损。 特定目的 研究是：1）比较两种高氧协议的效果： [过度换气/ - 液化（HV/HI）协议与四个呼吸 在两个ETS之间进行了超充电（HI）协议]均值通过 动脉压（MAP），平均颅内压（MICP），大脑 灌注压力（CPP），心率（HR），氧饱和度（SAO2），末端 成人头部受伤的患者的潮汐二氧化碳，（PETCO2）和分泌恢复； 2）确定这两个高氧协议的差异 在开放与封闭的头部受伤患者中； 2）确定 开放与关闭的这两个高氧协议的差异 头部受伤的患者。 这是一个准实验，在主题中， 在小组重复测量设计之间。 自变量是 高氧协议（HV/HI与HI协议）。 依赖 变量是MAP，MICP，CPP的生理测量（计算 价值），人力资源，SAO2，PETCO2和分泌恢复。 吸力变量 受控的是F10，吸气流量和吸力持续时间。 六 生理参数（MAP，MICP，CPP（计算），HR，SAO2，PETCO2） 将在之前和之后同时记录 通过Gould TA2000记录器，气管吸力序列。 全部 压力传感器（MAP和MICP）将在一列的 汞; PETCO2和SAO2将通过PRE的动脉血液验证 和发布协议；人力资源将由受试者的心电图显示器验证； 分泌恢复将通过PM 460精度来衡量 电子梅特勒平衡至最接近的千克。 数据分析 特定的目标1将由两种主题内部的两种方式组成，重复 方差的测量分析以确定HV/HI与 HI协议上的因变量。 对于特定目标2数据分析 将由受试者内部，组间，重复测量分析组成 差异以确定HI协议对开放与关闭的影响 头部受伤的成年人在因变量和受试者内， 在组之间重复测量方差分析以确定HV/HI的影响 关于开放与闭合头部受伤的成年人的协议 变量。