胸腔挤压对机械通气患者气道分泌和呼吸参数的影响:一项介入性研究。

IF 1.4 Q3 EDUCATION, SCIENTIFIC DISCIPLINES
Journal of Education and Health Promotion Pub Date : 2025-02-28 eCollection Date: 2025-01-01 DOI:10.4103/jehp.jehp_695_24
P Thenmozhi, P Dineshkumar, G Bhuvaneswari, T Mary Minolin, S Tamilselvi
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引用次数: 0

摘要

背景:预防呼吸机相关性肺炎最常见的方法是通过气管内或气管吸痰清除分泌物,维持气道间隙以实现有效的气体交换。通过各种技术,包括胸腔挤压,可以有效地清理气道。因此,本研究旨在确定胸腔挤压对机械通气患者气道清除率和呼吸参数的影响。材料与方法:对60例符合icu纳入标准的机械通气患者进行真实实验研究,随机分为研究组(n = 30)和对照组(n = 30)。两组均在吸痰前测量干预前气道分泌、血氧饱和度、呼吸频率和心率。研究组在吸痰前5分钟进行胸部挤压,对照组接受医院常规护理。干预后评估1和2分别在吸痰后立即和15分钟进行测量,两组均持续3天。结果:采用重复测量方差分析比较干预前和干预后评估1和2的气道分泌、呼吸速率、血氧饱和度和心率的平均得分。结果显示,两组气道分泌物、氧饱和度差异有高度统计学意义(P < 0.001),呼吸频率差异有统计学意义(P < 0.05)。然而,心率没有明显变化。非配对t检验显示,研究组受试者在气道分泌和氧饱和度方面显著(P < 0.001)优于对照组受试者。结论:本研究结果表明,气管插管和气管吸痰前胸腔挤压可提高机械通气患者的分泌物清除、氧饱和度和呼吸频率,但心率无明显变化。它的显著影响可以为决策者提供有价值的见解,以做出明智的决策,重点是改善医疗保健系统和结果,特别是在重症监护病房内。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Thoracic squeezing on airway secretion and respiratory parameters in mechanically ventilated patients: An interventional study.

Background: The most common method for preventing ventilator-associated pneumonia is maintaining airway clearance for efficient gas exchange, achieved by removing secretion through endotracheal or tracheal suctioning. Clearing the airway can be effectively achieved through various techniques, including thoracic squeezing. Thus, this study aimed to determine the effectiveness of thoracic squeezing on airway clearance, and respiratory parameters among mechanically ventilated patients.

Materials and methods: A true experimental study was conducted with 60 mechanically ventilated patients who met the inclusion criteria in the ICUs and were randomly assigned to the study group (n = 30) and the control group (n = 30). Pre-intervention assessments of airway secretion, oxygen saturation, respiratory rate, and heart rate were measured before suctioning for both groups. Thoracic squeezing was administered to the study group 5 minutes before suctioning, while the control group received the hospital's routine care practices. Post-intervention assessments 1 and 2 were measured immediately and 15 minutes after suctioning, and the same process continued for three days in both groups.

Results: The mean scores of airway secretion, respiratory rate, oxygen saturation, and heart rate from the pre- and post-intervention assessments 1 and 2 were compared using repeated measures ANOVA. The results revealed a high level of statistical significance (P < 0.001) for airway secretion and oxygen saturation and statistical significance (P < 0.05) for respiratory rate. However, no significant changes were observed in heart rate. An unpaired t-test revealed that participants in the study group were significantly (P < 0.001) more effective in airway secretion and oxygen saturation than in the control group participants.

Conclusion: The current study's findings concluded that thoracic squeezing before endotracheal and tracheal suctioning enhances secretion removal, oxygen saturation, and respiratory rate without significant changes in heart rate among mechanically ventilated patients. Its notable influence could provide policymakers with valuable insights to make well-informed decisions, focused on improving healthcare systems and outcomes, especially within intensive care units.

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来源期刊
CiteScore
2.60
自引率
21.40%
发文量
218
审稿时长
34 weeks
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