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The Study on the Effects of Different Recruiment Maneuver Methods in Treatment of Mechanical Ventilation Patients After Endotracheal Suction

Author: ShiJing
Tutor: ChengQingHong
School: Shihezi University
Course: Nursing
Keywords: Recruitment maneuver Increase progressively positive end expiratory pressure Pressurecontrol ventilation Endotracheal Suction
CLC: R472
Type: Master's thesis
Year: 2013
Downloads: 2
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Abstract


Objective: To evaluate the effects of three methods——pure oxygen method, pure oxygen with increaseprogressively positive end expiratory pressure method and pressure control ventilation with pure oxygenmethod——on the respiratory mechanics, and cartery oxygenation, heart rate and blood pressure, aimingto seek a safer, more effective method in preventing the happening of hypoxemia to mechanical ventilationpatients after endotracheal suction.Research Methods: A prospective randomized self contrast trial was employed,40cases of mechanicalventilation patients are collected as subjects in this research. It is conducted with different methods on samepatient. Three different methods——pure oxygen method, pure oxygen with increase progressively positiveend expiratory pressure method and pressure control ventilation with pure oxygen method (are adoptedrandomly), and the interval time between every two methods is longer than2hours at least, ensuring therelative stability of the basic state. Monitoring and recording the changes in data of patients’ respiratorymechanics, hart rate and blood pressure2min before endotracheal suction and10min,20min and30minafter endotracheal suction; monitoring and recording the changes in data of patients’ arterial oxygen partialsaturation(PaO2), arterial blood oxygen saturation(SaO2), and oxygenation index5min before endotrachealsuction and30min after endotracheal suction.Conclusions:1. It is found that pure oxygen method doesn’t exert significant effect on arterial oxygenpartial saturation(PaO2), arterial blood oxygen saturation (SaO2) and the oxygenation index(PaO2/FiO2)(PaO2/FiO2) before and after endotracheal suction(p>0.05), and there is a slight rise of inspiratory peakpressure(Ppeak), inspiratory plateau pressure(Pplat) and mean airway pressure(Pmean) compared with thatof it before the endotracheal suction(p<0.05); pure oxygen method doesn’t exert significant effect on hartrate(HR), systolic blood pressure (SBP), diastolic blood pressure(DBP) and mean arterial pressure (MAP);there is no significant difference in data before and after endotracheal suction(p>0.05), showing a smoothtrend in change between time point;2. Pressure control ventilation with pure oxygen method exerts asignificant effect on PaO2, SaO2and PaO2/FiO2,data tends to rise after endotracheal suction(p<0.05);pressure control ventilation with pure oxygen method exerts a significant effect on Ppeak, Pplat and Pmean,data tend to rise after endotracheal suction compared with that of it before (p<0.05); pressure controlventilation with pure oxygen method exerts significant effect on HR, SBP, DBP and MAP10min afterendotracheal suction; there is a significant rise in data compare with that of it before(p<0.05);3. Pureoxygen with increase progressively positive end expiratory pressure method exerts a significant effect onPaO2, SaO2and PaO2/FiO2(p<0.05), data tend to rise after endotracheal suction; Pure oxygen withincrease progressively positive end expiratory pressure method exerts a significant effect on Ppeak, Pplatand Pmean(p<0.05); There is no significant difference in data before and after endotracheal suction; Pureoxygen with increase progressively positive end expiratory pressure method doesn’t exert significant effecton HR, SBP, DBP and MAP, there is no significant difference in data before and after endotracheal suction(p>0.05), showing a smooth trend in change between time point.Results:1. After endotracheal suction, pure oxygen intervention exerts a temporarily positive effect onanoxia caused by endotracheal suction and it has no influence on blood pressure and hart rate of patient, while it leads to rise in patients’ Ppeak, Pplat and Pmean and leads to no improvement in patients’oxygenation;2. After endotracheal suction, pressure control ventilation with pure oxygen method canimprove patients’ oxygenation index, bring down Ppeak, Pplat and the Pmean, leading to the drop in thebarotraumas; while at the initial stage, it has a negative effect on patients’ hart rate and blood pressure;3.Pure oxygen with increase progressively positive end expiratory pressure method exerts a significant effecton the improvement of patient’s oxygenation, bring down the patients’ Ppeak, Pplat and Pmean and has nonegative influence on patient’s hart rate and blood pressure, therefore it a comparatively safer interventionmethod.

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