Determine the effect of the artificial airway of open suctioning based on the standard criteria that need to have suction in the hemodynamic status and also pulmonary patients hospitalized in the intensive care units.

The purpose of the study: The purpose of this study was to determine the effect of the artificial airway of open suctioning based on the standard criteria that need to have suction in the hemodynamic status and also pulmonary patients hospitalized in the intensive care units. Generally this study is designed based on the mentioned issues. The design of the study: This study is a randomized clinical trial (RCT) with a pretest and Post-Test design and with one control group. The participants of the study. Inclusion criteria: Having a minimum age of 18 and maximum age of 70 years؛ An artificial airway in the ventilator circuit؛ having vital signs within normal limits. Exclusion criteria: Not having cardiac and pulmonary monitoring, A serve heart or lung disease؛ Chronic obstructive disease high intracranial pressure؛ Pulmonary parameters and vital signs within normal limits؛ Dopamine medication؛ Dubatomin؛ nitroglycerin and increasing the blood pressure_lowering drugs؛ Removal of the ventilator؛ And the patient death during the study؛ Having significant problem after the first suction or having an urgent need to have second suction؛ And also the patients who do not have suction problems (Airway bleeding؛ Fractures؛ Et) and the patients under cmv mode will not be considered in this study. The number of participants in each group was 30 and totally were 60 participants. The samples will be selected randomly and based on a randomized block allocation in the two groups will be compared. Standard criteria of suction will be designed based on the investigation of valid sources and references and after the evaluation of its validity with ten clinical experts of pulmonary experts, ICU, and also the faculty members of Tehran and Zanjan nursing medical Universities will be used for training mediatory nurses to suction the patients in the experimental group. Then the routine criteria will be used to have artificial airway suctioning with the help of nurses in the intensive care units and they are based on the conducted interviews and observations. Then the standard suction method with other standard criteria in suctioning will be taught to control and experimental group nurses in the educational workshops. In the experimental group, the patients will be evaluated in terms of their need to artificial airway suction, and if needed, the suction will be performed by the standard methods. In the control group, having suction with standard protocol will be conducted but they are based on the routine criteria of suctioning. Finally, for each patient suction will be in three times and the measurement of dependent variables will be six times before and after each suction. The study will be lasted for 5 months. The main variables of the study: They included pulmonary hemodynamic status and Pulmonic parameters. In order to measure and record data on the hemodynamic and respiratory parameters through direct observation at the besides of patients, changes in the vital signs and hemodynamic status (Bp; MAP;RP;Spo2;HR) and respiratory parameters (TV; Resistance airway;Compliance; Pmean; MV) will be examined.

Other costs will be paid by Vice chancellor for research (science and technology), ethical deputy committee, Zanjan University of Medical Sciences.