[The effect of intracranial pressure caused by airway suction in hypertensive intracerebral hemorrhagic comatose patients].
Ten hypertensive intracerebral hemorrhagic comatose patients in the Neurosurgical Intensive Care Unit were involved in this study. The ten were within the range of 5 to 8 by Glasgow Coma Scale, and all had undergone tracheostomy. During suction of the airway for 20 seconds in 4 areas (trachea, bronchus, nasal and oral cavities), the data of intracranial pressure (ICP), arterial blood pressure, pulse rate (PR) and respiration rate (RR) were recorded. Results were analyzed for ICP, mean arterial blood pressure (MABP), PR, RR, and cerebral perfusion pressure (CPP) at the 5th, 10th, 15th and 20th seconds in the above-mentioned areas. The ICP was found to be significantly increased, and above the 20 mmHg mark, during suction of the bronchus or nasal cavity for 5 seconds. The MABP also showed significant increase, to above the 110 mmHg mark during 5-second suction of the trachea or nasal cavity or during suction of the bronchus or oral cavity for 10 seconds. However, during the suction of the four airway areas, PR and RR were less influenced and the CPP was not decreased or significantly changed. The conclusion of this study was that suction in the areas of trachea, bronchus and nasal cavity, should not exceed 5 to 10 seconds; in the oral cavity, it may be done within 10 to 15 seconds and at each procedure of airway suction. If it is not possible to clean the sputum or secretion in one procedure, the patient should be allowed to rest for about one minute or become stabilized as determined by watching the monitors of ICP, BP, PR, and RR.(ABSTRACT TRUNCATED AT 250 WORDS)
Wang
M H
MH
Neurosurgical Intensive Care Unit, Taichung Veterans General Hospital.
Cheng
S Y
SY
Wang
Y C
YC
Lee
B W
BW
Lin
Y Y
YY
Tseng
C L
CL
D000328:Adult; D000368:Aged; D002543:Cerebral Hemorrhage / Q000503:physiopathology*; D003128:Coma / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D007427:Intracranial Pressure; D008297:Male; D008875:Middle Aged; D013183:Sputum; D013396:Suction; D013997:Time Factors