高氧对心脏骤停后、脓毒症、创伤性脑损伤或中风患者的有害影响：个体化氧疗在重症患者中的重要性
Harmful Effects of Hyperoxia in Postcardiac Arrest, Sepsis, Traumatic Brain Injury, or Stroke: The Importance of Individualized Oxygen Therapy in Critically Ill Patients.
作者信息
Vincent Jean-Louis, Taccone Fabio Silvio, He Xinrong
机构信息
Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, 1070 Brussels, Belgium.
Department of Intensive Care, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.
出版信息
Can Respir J. 2017;2017:2834956. doi: 10.1155/2017/2834956. Epub 2017 Jan 26.
Abstract
The beneficial effects of oxygen are widely known, but the potentially harmful effects of high oxygenation concentrations in blood and tissues have been less widely discussed. Providing supplementary oxygen can increase oxygen delivery in hypoxaemic patients, thus supporting cell function and metabolism and limiting organ dysfunction, but, in patients who are not hypoxaemic, supplemental oxygen will increase oxygen concentrations into nonphysiological hyperoxaemic ranges and may be associated with harmful effects. Here, we discuss the potentially harmful effects of hyperoxaemia in various groups of critically ill patients, including postcardiac arrest, traumatic brain injury or stroke, and sepsis. In all these groups, there is evidence that hyperoxia can be harmful and that oxygen prescription should be individualized according to repeated assessment of ongoing oxygen requirements.
摘要
氧气的有益作用广为人知，但血液和组织中高氧浓度的潜在有害作用却较少被广泛讨论。提供补充氧气可增加低氧血症患者的氧输送，从而支持细胞功能和代谢并限制器官功能障碍，但是，在非低氧血症患者中，补充氧气会使氧浓度升高至非生理性的高氧范围，并可能产生有害影响。在此，我们讨论高氧血症在各类危重症患者群体中的潜在有害作用，包括心脏骤停后、创伤性脑损伤或中风以及脓毒症患者。在所有这些患者群体中，有证据表明高氧可能有害，并且应根据对持续氧需求的反复评估来个体化开具氧疗处方。
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