Brucia J, Rudy E
University of Pittsburgh School of Nursing, Pa, USA.
Heart Lung. 1996 Jul-Aug;25(4):295-303. doi: 10.1016/s0147-9563(96)80065-3.
To determine the effect of suction catheter insertion and tracheal stimulation on cerebrovascular and systemic vascular status in adults with severe traumatic brain injury.
Quasi-experimental, within-subject design.
Two university-affiliated critical care units.
Thirty intubated and mechanically ventilated adults with severe brain injury. The participants' average age was 31 +/- 15 years.
Mean intracranial pressure (MICP), mean arterial pressure (MAP), cerebral perfusion pressure (CPP), and heart rate (HR) were measured.
Endotracheal suction catheter insertion with tracheal stimulation was performed.
Suction catheter insertion and tracheal stimulation, isolated from other components of the suctioning procedure, significantly increased MICP, MAP, and CPP. HR was not significantly increased. During the application of negative pressure for actual suctioning, MICP and HR significantly increased, whereas MAP and CPP did not significantly change compared with catheter insertion.
Tracheal stimulation during suction catheter insertion initiates both cerebrovascular and systemic vascular responses during the suctioning procedure. Study findings suggest that a potentially productive direction for intervention research is to identify ways to minimize airway stimulation during the suctioning procedure.
确定吸痰管插入和气管刺激对重度创伤性脑损伤成人脑血管和全身血管状态的影响。
准实验性、受试者自身对照设计。
两个大学附属医院的重症监护病房。
30例重度脑损伤且已插管并接受机械通气的成人。参与者的平均年龄为31±15岁。
测量平均颅内压（MICP）、平均动脉压（MAP）、脑灌注压（CPP）和心率（HR）。
进行气管内吸痰管插入并给予气管刺激。
与吸痰操作的其他部分分开来看，吸痰管插入和气管刺激显著增加了MICP、MAP和CPP。HR没有显著增加。在实际吸痰施加负压期间，MICP和HR显著增加，而与吸痰管插入相比，MAP和CPP没有显著变化。
吸痰管插入期间的气管刺激在吸痰过程中引发了脑血管和全身血管反应。研究结果表明，干预研究的一个潜在有效方向是确定在吸痰过程中尽量减少气道刺激的方法。
