Walsh Brian K, Smallwood Craig D
Division of Critical Care Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts and Harvard Medical School, Boston, Massachusetts.
Respir Care. 2017 Jun;62(6):645-661. doi: 10.4187/respcare.05245.
Oxygen is a colorless, odorless, tasteless gas that is utilized by the body for respiration. Oxygen has played a major role in respiratory care. Oxygen therapy is useful in treating hypoxemia but is often thought of as a benign therapy. After many years of study, we have learned a great deal of the benefits and potential risk of this powerful drug. Today oxygen gas is cheap, widely available, and easy to administer. Oxygen delivery devices vary in cost from a few cents for a simple nasal cannula to $25-$50 for some humidified systems. Undoubtedly, oxygen therapy is an important tool and has saved many lives and improved others. However, oxygen therapy risk, cost, and benefits should be considered in the same way as other drugs and titrated to a measured end point to avoid excessive or inadequate dosing. Withholding oxygen can have a detrimental effect, yet continuing to provide oxygen therapy when it is no longer indicated can prolong hospitalization and increase the cost of care. This comprehensive review begins with an assessment of need and a review of physiologic effects, potential toxicities, and common delivery devices, and it ends with advances in oxygen therapy with a focus on the pediatric patient.
氧气是一种无色、无味、无嗅的气体,身体利用它进行呼吸。氧气在呼吸护理中发挥了重要作用。氧疗对治疗低氧血症有用,但人们通常认为它是一种良性治疗方法。经过多年研究,我们已经了解了这种强效药物的诸多益处和潜在风险。如今,氧气价格便宜、广泛可得且易于施用。输氧设备的成本各不相同,简单的鼻导管只需几美分,而一些加湿系统则要25至50美元。毫无疑问,氧疗是一项重要工具,挽救了许多生命并改善了其他患者的状况。然而,氧疗的风险、成本和益处应与其他药物一样加以考虑,并滴定至一个可衡量的终点,以避免剂量过多或不足。不给予氧气会产生有害影响,但在不再需要时继续进行氧疗会延长住院时间并增加护理成本。这篇综述首先评估需求,并回顾生理效应、潜在毒性和常见的输氧设备,最后聚焦于儿科患者介绍氧疗的进展。