不同吸痰方式对急性呼吸窘迫综合征血流动力学影响的实验研究

The experimental study of effect of hemodynamics on ARDS by the different ways of endotracheal suctioning

目的研究更适宜急性呼吸窘迫综合征(ARDS)机械通气气管内吸痰的方式。方法采用静脉注射油酸制备动物ARDS模型;每只犬随机选择使用开放式气管内吸痰(OS)和密闭式气管内吸痰(CS)2种吸痰方式。于吸痰前后记录血流动力学等监测指标的数据。结果OS和CS后,犬平均肺动脉压(MPAP)与吸痰前比较均明显升高(P<0.05);OS后平均动脉压(MAP)显著升高(P<0.05)。结论OS、CS均可影响血流动力学的稳定。本研究提示,在护理工作中,对ARDS机械通气者应重视吸痰引起的继发性损害,加强吸痰前后血流动力学等监测。

Objective The aim of our study is to find the better ways of endotracheal suctioning and caring in the mechanical ventilated patients with acute respiratory distress syndrome (ARDS). Methods Tracheal intubated mongrel dogs were injured by injecting oleic acid to build up ARDS models. Both opened endotracheal suctioning(OS) and closed endotracheal suctioning(CS) techniques were performed on each dog in randomized order. The indexes of hemodynamics were recorded before and after suctioning. Results In the two suction ways, the data of mean pulmonary arterial pressure (MPAP) significantly raised after suction (P< 0.05), but only mean arterial pressure (MAP) raised after performing OS (P<0.05). Conclusion In our study, we found that both OS and CS had obvious influencing on hemodynamics and it remind us that we should pay more attention to the potential damages that caused by suction ways and we should intensify monitoring the hemodynamics changes during performing endotracheal suction ways in clinical nursing practice.