镇静机械通气成人对有害刺激的反应。
Responses to noxious stimuli in sedated mechanically ventilated adults.
机构信息
Adult Health and Nursing Systems Department, School of Nursing, Virginia Commonwealth University, Box 980567, Richmond, VA 23298-0567, USA.
University of South Florida, Tampa, FL, USA.
出版信息
Heart Lung. 2014 Jan-Feb;43(1):6-12. doi: 10.1016/j.hrtlng.2013.10.012. Epub 2013 Oct 25.
OBJECTIVE
To determine the effect of sedation on physiologic responses and comfort before, during and after a noxious stimulus (endotracheal tube suctioning).
METHODS
The sample was a subset of a larger, longitudinal descriptive study, blood for endorphins and saliva for alpha-amylase were obtained before and after suctioning. Heart rate (HR), respiration rate (RR), oxygen saturation (SPO2), and arm and leg actigraphy were continuously recorded.
RESULTS
67 subjects from medical and surgical ICUs were primarily deeply (37%) or mildly sedated (54%) prior to suctioning. Alpha-amylase increased post suctioning (p = 0.04); endorphins did not change (p = 0.58). Neither were modified by sedation. There were no changes in HR, RR or SPO2 post suctioning. Arm (p = 0.007) and leg actigraphy (p = 0.057) changed from baseline and depended on sedation level (p = 0.0005).
CONCLUSIONS
While a stress marker did increase during suctioning, only the measure of patient arm movement was significantly affected by sedation level.
目的
在有创性刺激（气管内吸痰）前、中、后，确定镇静对生理反应和舒适度的影响。
方法
本样本是一项更大的纵向描述性研究的子样本，在吸痰前后采集内啡肽的血液和α-淀粉酶的唾液样本。连续记录心率（HR）、呼吸频率（RR）、血氧饱和度（SPO2）以及手臂和腿部活动计。
结果
在吸痰前，来自内科和外科 ICU 的 67 名患者主要处于深度（37%）或轻度镇静（54%）状态。吸痰后α-淀粉酶增加（p=0.04）；内啡肽没有变化（p=0.58）。镇静也没有改变它们。吸痰后 HR、RR 或 SPO2 没有变化。手臂（p=0.007）和腿部活动计（p=0.057）与基线相比发生了变化，并且依赖于镇静水平（p=0.0005）。
结论
虽然在吸痰过程中应激标志物确实增加，但只有患者手臂运动的测量受到镇静水平的显著影响。
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