机械通气患者的氧管理：一项多中心前瞻性观察研究。
Oxygen management in mechanically ventilated patients: A multicenter prospective observational study.
机构信息
Department of Anesthesiology, Kobe University Hospital, Hyogo, Japan.
Department of Critical Care Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan.
出版信息
J Crit Care. 2018 Aug;46:1-5. doi: 10.1016/j.jcrc.2018.03.024. Epub 2018 Mar 21.
PURPOSE
To observe arterial oxygen in relation to fraction of inspired oxygen (FO) during mechanical ventilation (MV).
MATERIALS AND METHODS
In this multicenter prospective observational study, we included adult patients required MV for >48h during the period from March to May 2015. We obtained FO, PaO and SaO from commencement of MV until the 7th day of MV in the ICU.
RESULTS
We included 454 patients from 28 ICUs in this study. The median APACHE II score was 22. Median values of FO, PaO and SaO were 0.40, 96mmHg and 98%. After day two, patients spent most of their time with a FO between 0.3 and 0.49 with median PaO of approximately 90mmHg and SaO of 97%. PaO was ≥100mmHg during 47.2% of the study period and was ≥130mmHg during 18.4% of the study period. FO was more likely decreased when PaO was ≥130mmHg or SaO was ≥99% with a FO of 0.5 or greater. When FO was <0.5, however, FO was less likely decreased regardless of the value of PaO and SaO.
CONCLUSIONS
In our multicenter prospective study, we found that hyperoxemia was common and that hyperoxemia was not corrected.
目的
观察机械通气（MV）期间动脉血氧与吸入氧分数（FO）的关系。
材料和方法
在这项多中心前瞻性观察研究中，我们纳入了 2015 年 3 月至 5 月期间需要 MV 超过 48 小时的成年患者。我们在 ICU 中从 MV 开始到第 7 天获得了 FO、PaO 和 SaO。
结果
我们纳入了来自 28 个 ICU 的 454 名患者。APACHE II 评分中位数为 22。FO、PaO 和 SaO 的中位数分别为 0.40、96mmHg 和 98%。第 2 天以后，患者大部分时间的 FO 在 0.3 到 0.49 之间，中位数 PaO 约为 90mmHg，SaO 为 97%。在研究期间的 47.2%有 PaO≥100mmHg，在研究期间的 18.4%有 PaO≥130mmHg。当 PaO≥130mmHg 或 SaO≥99%且 FO 为 0.5 或更高时，FO 更有可能降低。然而，当 FO<0.5 时，无论 PaO 和 SaO 的值如何，FO 降低的可能性都较小。
结论
在我们的多中心前瞻性研究中，我们发现高氧血症很常见，且并未得到纠正。
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