Collard P, Wautelet F, Delwiche J P, Prignot J, Dubois P
Service de Pneumologie, Cliniques de l'Université Catholique de Louvain à Mont-Godinne, Yvoir, Belgium.
Eur Respir J. 1989 Sep;2(8):778-81.
In 36 severely hypoxaemic patients (arterial oxygen tension (PaO2) less than 7.3 kPa or 55 mmHg), candidates for long-term oxygen therapy, we compared the effectiveness of three oxygen-delivery systems, the standard nasal prongs, a so-called oxygen-conserving reservoir device ("Oxymizer Pendant") and the reference pharyngeal catheter, at a preset flow rate of 2 l.min-1. After 30 min, the conserving device (OX) was at least as efficient as the pharyngeal catheter (PC) and did significantly better than the nasal prongs (NP), the mean increments in PaO2 and arterial oxygen saturation (SaO2) being, respectively, 1.1 kPa (8.1 mmHg) and 1.3% higher with OX than with NP. Twenty patients did not reach the target level of 8.6 kPa (65 mmHg) PaO2 with the nasal prongs, but the reservoir cannula allowed nine of these "refractory" patients to hit this therapeutic goal, a result indicating a clear trend towards improved immediate oxygen response. Although initially designed to spare gas, we suggest that a reservoir cannula could serve another purpose, namely to optimize oxygenation in patients treated by an oxygen concentrator. Indeed, since the oxygen flow rate cannot be reliably increased over 3 l.min-1 with the available oxygen concentrators, the reservoir device could be more effective in some selected patients whose hypoxaemia cannot be adequately corrected by standard nasal prongs.
在36例严重低氧血症患者（动脉血氧分压（PaO₂）低于7.3 kPa或55 mmHg）中，这些患者均为长期氧疗的候选对象，我们以2 l.min⁻¹的预设流速比较了三种输氧系统的有效性，这三种系统分别是标准鼻导管、一种所谓的氧保存储器装置（“Oxymizer Pendant”）和作为对照的咽导管。30分钟后，保存装置（OX）至少与咽导管（PC）一样有效，且明显优于鼻导管（NP），OX组的PaO₂和动脉血氧饱和度（SaO₂）的平均增加值分别比NP组高1.1 kPa（8.1 mmHg）和1.3%。20例患者使用鼻导管时未达到8.6 kPa（65 mmHg）的PaO₂目标水平，但储氧套管使其中9例“难治性”患者达到了这一治疗目标，这一结果表明在即时氧反应方面有明显的改善趋势。尽管储氧套管最初设计的目的是节省气体，但我们认为它还可以用于另一个目的，即在使用制氧机治疗的患者中优化氧合。事实上，由于现有的制氧机无法将氧气流速可靠地提高到超过3 l.min⁻¹，储氧装置对于一些低氧血症无法通过标准鼻导管充分纠正的特定患者可能更有效。
