Kerr M E, Rudy E B, Brucia J, Stone K S
University of Pittsburgh School of Nursing, Pennsylvania 15261.
J Neurosci Nurs. 1993 Apr;25(2):86-91. doi: 10.1097/01376517-199304000-00004.
Endotracheal suctioning (ETS) is a conventional nursing intervention used to decrease pulmonary complications in the critically ill patient. ETS provides a particular dilemma for the head-injured patient because it increases intracranial pressure and may put the patient at increased risk for intracranial hypertension and cerebral ischemia. Research in endotracheal suctioning targets understanding the ETS response in the severely head-injured patient. This article reviews the major research focused on suctioning the head-injured patient. The guidelines for practice based on this research include preoxygenating patients prior to suctioning, limiting suction duration to 10 seconds, limiting suction passes to 1-2 per procedure, using hyperventilation with caution, not rotating the head, keeping negative suction pressure under 120 mm Hg, and not using suction catheters with outer to inner diameter ratios greater than .50.
气管内吸痰（ETS）是一种用于降低重症患者肺部并发症的传统护理干预措施。对于颅脑损伤患者而言，气管内吸痰带来了一个特殊难题，因为它会增加颅内压，并可能使患者发生颅内高压和脑缺血的风险升高。气管内吸痰的研究旨在了解重度颅脑损伤患者对吸痰的反应。本文回顾了针对颅脑损伤患者吸痰的主要研究。基于该研究的实践指南包括：吸痰前对患者进行预充氧，将吸痰持续时间限制在10秒以内，每次操作将吸痰次数限制在1 - 2次，谨慎使用过度通气，不转动头部，将负压吸引压力保持在120毫米汞柱以下，以及不使用外径与内径之比大于0.50的吸痰导管。
