不同给氧浓度及时间组合辅助吸痰对ARDS患者氧合的影响
首发时间:2015-04-08
摘要:目的 探讨6种不同给氧浓度及时间组合辅助吸痰对ARDS机械通气患者氧合的影响,寻找改善ARDS患者吸痰过程中低氧血症的最佳辅助给氧组合。方法 前瞻性自身对照法分析30例ARDS机械通气患者。使用随机数字表法,将6种给氧浓度及时间组合辅助吸痰以随机顺序依次实施予每例患者。给氧组合分别为:(1)A组,给氧浓度(FiO2)为100%,给氧时间(t)为2min;(2)B组,FiO2为100%,t为5min;(3)C组,FiO2为60%,t为2min;(4)D组,FiO2为60%,t为5min;(5)E组,FiO2为40%,t为2min;(6)F组,FiO2为40%,t为5min。比较6组患者吸痰前、后SpO2、PaO2、SaO2、氧合指数的变化。结果 吸痰前后各监测时间点的SpO2、PaO2、SaO2、氧合指数之间差异有统计学意义(P<0.05);吸痰后同一时间点6组间SpO2、PaO2、SaO2、氧合指数比较差异均有统计学意义(P<0.05)。结论 6种给氧浓度及时间组合辅助吸痰均可引起ARDS机械通气患者氧合的改变。建议吸痰前后给予患者至多达到FiO2为60%,t为2min的氧气吸入,可能更好的达到预防和改善吸痰过程中的低氧血症,及避免长时间高浓度氧气吸入造成患者肺损伤的目的。
关键词: 护理学 1 急性呼吸窘迫综合征 2 吸痰 3 吸氧 4 氧合 5
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The effect of endotracheal suctioning on oxygenation of patients with ARDS undergoing different combinations of concentration and time on inhaled oxygen
Abstract:Objective To explore the effect of endotracheal suctioning on oxygenation of patients with acute respiratory distress syndrome undergoing different combinations of concentration and time on inhaled oxygen.To find the best combination on inhaled oxygen to improve oxygenation of patients.Methods A total of 30 patients with ARDS requiring mechanical ventilated were included.Application of self-control method of different concentrations and time for inhaled oxygen were conducted before and after endotracheal suction.Six combinations of concentration and time were randomized to each patient: (1)Method A,oxygen concentration (FiO2) was 100%,oxygen time (t) for 2min; (2)Method B,FiO2 was 100%,t for 5min; (3)Method C,FiO2 was 60%, t for 2min; (4)Method D,FiO2 was 60%,t for 5min; (5)Method E,FiO2 was 40%, t for 2min; (6)Method F,FiO2 was 40%,t for 5min.We compared Sp02,Pa02,SaO2 and oxygenation index(Pa02/Fi02) before and after the application of each combinations.Results Parameter difference of Sp02,Pa02,SaO2 and oxygenation index were with statistical significance before and after endotracheal suction (P<0.05);In the same time Sp02,PaO2,SaO2, oxygenation index differences were statistically significant among six groups after endotracheal suction(P<0.05).Conclusions Six combinations could change the oxygenation.Method C(FiO2 was 60%,t for 2min) could effectiveiy prevent the ARDS patients better from hypoxia induced by suction.It also could prevent lung injury in patients with ARDS undergoing high concentration on inhaled oxygen.In this pape.
Keywords: Nurse Acute respiratory distress syndrome suction oxygen oxygenation
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No.4637432104816914****
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不同给氧浓度及时间组合辅助吸痰对ARDS患者氧合的影响
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