Dam V, Wild M C, Baun M M
College of Nursing, University of Nebraska Medical Center, Omaha 68198-5330.
Am J Crit Care. 1994 May;3(3):191-7.
BACKGROUND Numerous studies have demonstrated the need for increased inspired oxygen with endotracheal suctioning to prevent hypoxemia; however, increased arterial pressure has been reported as a consequence of lung hyperinflation/inflation used to deliver hyperoxygenation. OBJECTIVES To compare insufflation during endotracheal suctioning with a standard procedure of hyperoxygenation using a ventilator on arterial pressure, pulmonary artery pressure, heart rate, arterial oxygen saturation, and blood gases in intubated, mechanically ventilated coronary artery bypass graft patients. METHODS A within-subjects, repeated-measures design was used to measure arterial pressure (systolic, diastolic, and mean), pulmonary artery pressure (systolic, diastolic, and mean), airway pressure, heart rate and rhythm, arterial oxygen tension, arterial carbon dioxide tension, pH, and arterial oxygen saturation during an oxygen insufflation protocol and a hyperoxygenation protocol via the ventilator. RESULTS Using analysis of variance for repeated measures, statistically significant time effects were found for all variables. Statistically significant differences between protocols over time were found for arterial pressure, arterial oxygen tension, and arterial oxygen saturation. CONCLUSIONS Oxygen insufflation resulted in less increase in arterial pressure than did the hyperoxygenation protocol. The hyperoxygenation protocol resulted in hyperoxia. Based on this study, oxygen insufflation is a safe alternative for providing oxygen during endotracheal suctioning.
大量研究表明，气管内吸痰时需要增加吸入氧以预防低氧血症；然而，据报道，用于进行高氧通气的肺过度充气/充气会导致动脉压升高。目的：比较气管内吸痰时的吹氧与使用呼吸机进行高氧通气的标准程序对冠状动脉搭桥术后插管并机械通气患者的动脉压、肺动脉压、心率、动脉血氧饱和度和血气的影响。方法：采用受试者内重复测量设计，在通过呼吸机进行吹氧方案和高氧通气方案期间，测量动脉压（收缩压、舒张压和平均压）、肺动脉压（收缩压、舒张压和平均压）、气道压、心率和心律、动脉血氧分压、动脉血二氧化碳分压、pH值和动脉血氧饱和度。结果：使用重复测量方差分析，发现所有变量均有统计学意义的时间效应。随着时间的推移，两种方案在动脉压、动脉血氧分压和动脉血氧饱和度方面存在统计学显著差异。结论：与高氧通气方案相比，吹氧导致的动脉压升高较小。高氧通气方案导致了高氧血症。基于本研究，吹氧是气管内吸痰时提供氧气的一种安全替代方法。
