新生儿重症监护病房中的血红蛋白氧饱和度目标：隧道尽头有曙光吗？
Hemoglobin oxygen saturation targets in the neonatal intensive care unit: Is there a light at the end of the tunnel? .
作者信息
Vali Payam, Underwood Mark, Lakshminrusimha Satyan
机构信息
Department of Pediatrics, UC Davis School of Medicine, Sacramento, CA 95817, USA.
出版信息
Can J Physiol Pharmacol. 2019 Mar;97(3):174-182. doi: 10.1139/cjpp-2018-0376. Epub 2018 Oct 26.
Abstract
The optimal oxygenation target needed to prevent the extremes of hypoxia and oxygen toxicity in premature and sick newborns has been the subject of much research and debate. The advent of the pulse oximeter has allowed the continuous monitoring of oxyhemoglobin saturation and the delivery of oxygen with greater precision. Well-run, large clinical trials to determine the safest oxygen concentration have led to several revisions in guidelines for neonatal care. However, monitoring of oxyhemoglobin saturation has its limitations and does not provide a comprehensive assessment of tissue oxygenation. To identify optimal oxygen therapy, various other factors (partial pressure of arterial carbon dioxide, hemoglobin concentration, blood pH, and tissue metabolic demand) that influence perfusion and tissue oxygenation need to be considered.
摘要
预防早产和患病新生儿出现极端低氧血症和氧中毒所需的最佳氧合目标一直是众多研究和争论的主题。脉搏血氧仪的出现使得能够持续监测氧合血红蛋白饱和度，并更精确地输送氧气。精心开展的大型临床试验以确定最安全的氧浓度，导致新生儿护理指南进行了多次修订。然而，监测氧合血红蛋白饱和度有其局限性，无法全面评估组织氧合情况。为了确定最佳氧疗方案，需要考虑影响灌注和组织氧合的各种其他因素（动脉二氧化碳分压、血红蛋白浓度、血液pH值和组织代谢需求）。
相似文献
1
Hemoglobin oxygen saturation targets in the neonatal intensive care unit: Is there a light at the end of the tunnel? .新生儿重症监护病房中的血红蛋白氧饱和度目标：隧道尽头有曙光吗？
Can J Physiol Pharmacol. 2019 Mar;97(3):174-182. doi: 10.1139/cjpp-2018-0376. Epub 2018 Oct 26.
2
Supplemental CO improves oxygen saturation, oxygen tension and cerebral oxygenation in acutely hypoxic healthy subjects.补充 CO 可提高急性低氧健康受试者的血氧饱和度、氧分压和脑氧合。
Physiol Rep. 2020 Jul;8(14):e14513. doi: 10.14814/phy2.14513.
3
Agreement between arterial partial pressure of carbon dioxide and saturation of hemoglobin with oxygen values obtained by direct arterial blood measurements versus noninvasive methods in conscious healthy and ill foals.清醒健康和患病马驹中，通过直接动脉血测量获得的动脉二氧化碳分压与血红蛋白氧饱和度值之间的一致性，与无创方法的比较。
J Am Vet Med Assoc. 2011 Nov 15;239(10):1341-7. doi: 10.2460/javma.239.10.1341.
4
Retinal oximetry measures systemic hypoxia in central nervous system vessels in chronic obstructive pulmonary disease.视网膜血氧测定法可测量慢性阻塞性肺疾病患者中枢神经系统血管中的全身性缺氧情况。
PLoS One. 2017 Mar 22;12(3):e0174026. doi: 10.1371/journal.pone.0174026. eCollection 2017.
5
Pulse oximeter saturation target limits for preterm infants: a survey among European neonatal intensive care units.早产儿脉搏血氧饱和度目标限值：欧洲新生儿重症监护病房的一项调查
Eur J Pediatr. 2017 Jan;176(1):51-56. doi: 10.1007/s00431-016-2804-9. Epub 2016 Nov 16.
6
7
Pulse oximetry: an alternative method for the assessment of oxygenation in newborn infants.脉搏血氧饱和度测定法：评估新生儿氧合的一种替代方法。
Pediatrics. 1987 Apr;79(4):524-8.
8
9
10
Near-infrared spectroscopy in the detection of regional tissue oxygenation during hypoxic events in preterm infants undergoing critical care.近红外光谱技术在危重症护理的早产儿缺氧事件中检测局部组织氧合的应用
Pediatr Crit Care Med. 2006 Sep;7(5):449-54. doi: 10.1097/01.PCC.0000235248.70482.14.
引用本文的文献
1
Future perspectives of heart rate and oxygenation monitoring in the neonatal intensive care unit - a narrative review.新生儿重症监护病房中心率和氧合监测的未来展望——一篇叙述性综述
J Clin Monit Comput. 2025 Jun 27. doi: 10.1007/s10877-025-01310-1.
2
Oxygen Saturation Targeting in the Neonatal Intensive Care Unit.新生儿重症监护病房中的氧饱和度目标设定
J Clin Med. 2025 Jun 4;14(11):3975. doi: 10.3390/jcm14113975.
3
Oxygen saturation targets in neonatal care: A narrative review.新生儿护理中的氧饱和度目标：叙述性综述。
Early Hum Dev. 2024 Dec;199:106134. doi: 10.1016/j.earlhumdev.2024.106134. Epub 2024 Oct 28.
4
Pulse oximetry in pediatric care: Balancing advantages and limitations.儿科护理中的脉搏血氧饱和度测定：权衡利弊
World J Clin Pediatr. 2024 Sep 9;13(3):96950. doi: 10.5409/wjcp.v13.i3.96950.
5
What is your optimal target of oxygen during general anesthesia in pediatric patients?小儿患者全身麻醉期间的最佳氧目标是什么？
Anesth Pain Med (Seoul). 2024 Oct;19(Suppl 1):S5-S11. doi: 10.17085/apm.23103. Epub 2023 Oct 30.
6
Oxygen Targets in Neonatal Pulmonary Hypertension: Individualized, "Precision-Medicine" Approach.新生儿肺动脉高压的氧目标：个体化、“精准医学”方法。
Clin Perinatol. 2024 Mar;51(1):77-94. doi: 10.1016/j.clp.2023.12.003. Epub 2023 Dec 28.
7
Impact on cerebral hemodynamics of the use of volume guarantee combined with high frequency oscillatory ventilation in a neonatal animal respiratory distress model.在新生动物呼吸窘迫模型中，容量保证联合高频振荡通气对脑血流动力学的影响。
Eur J Pediatr. 2024 Jan;183(1):157-167. doi: 10.1007/s00431-023-05245-0. Epub 2023 Oct 18.
8
Response to first dose of inhaled albuterol in mechanically ventilated preterm infants.机械通气的早产儿对首剂吸入沙丁胺醇的反应。
J Perinatol. 2021 Jul;41(7):1704-1710. doi: 10.1038/s41372-021-01071-0. Epub 2021 May 25.
本文引用的文献
1
Association Between Oxygen Saturation Targeting and Death or Disability in Extremely Preterm Infants in the Neonatal Oxygenation Prospective Meta-analysis Collaboration.新生儿氧合前瞻性荟萃分析协作组：氧饱和度目标值与极早产儿死亡或残疾的相关性。
JAMA. 2018 Jun 5;319(21):2190-2201. doi: 10.1001/jama.2018.5725.
2
Optimizing Oxygen Saturation Targets in Extremely Preterm Infants.优化极早产儿的血氧饱和度目标
JAMA. 2018 Jun 5;319(21):2173-2174. doi: 10.1001/jama.2018.5724.
3
Lower versus higher oxygen concentrations titrated to target oxygen saturations during resuscitation of preterm infants at birth.出生时对早产儿进行复苏期间，将较低与较高氧浓度滴定至目标氧饱和度。
Cochrane Database Syst Rev. 2018 May 4;5(5):CD010239. doi: 10.1002/14651858.CD010239.pub2.
4
Oxygenation of the Immature Infant: A Commentary and Recommendations for Oxygen Saturation Targets and Alarm Limits.未成熟婴儿的氧合：关于氧饱和度目标和警报限值的评论与建议。
Neonatology. 2018;114(1):69-75. doi: 10.1159/000486751. Epub 2018 Apr 18.
5
Oxygen and preterm infant resuscitation: what else do we need to know?氧与早产儿复苏：我们还需要知道什么？
Curr Opin Pediatr. 2018 Apr;30(2):192-198. doi: 10.1097/MOP.0000000000000610.
6
Impact of the Neonatal Resuscitation Program-Recommended Low Oxygen Strategy on Outcomes of Infants Born Preterm.新生儿复苏计划推荐的低氧策略对早产婴儿结局的影响。
J Pediatr. 2017 Dec;191:35-41. doi: 10.1016/j.jpeds.2017.08.074.
7
Use of Oxyhemoglobin Saturation, Rather Than Oxygen Tension, as a Marker of Oxygenation in Cyanotic Patients.使用氧合血红蛋白饱和度而非氧张力作为发绀患者氧合标志物的研究。
JAMA Pediatr. 2017 Oct 1;171(10):1012-1014. doi: 10.1001/jamapediatrics.2017.2213.
8
Alarm Safety and Alarm Fatigue.警报安全与警报疲劳
Clin Perinatol. 2017 Sep;44(3):713-728. doi: 10.1016/j.clp.2017.05.005. Epub 2017 Jul 14.
9
The Fetus Can Teach Us: Oxygen and the Pulmonary Vasculature.胎儿能给我们的启示：氧气与肺血管系统
Children (Basel). 2017 Aug 3;4(8):67. doi: 10.3390/children4080067.
10
Oxygen and oxidative stress in the perinatal period.围产期的氧气与氧化应激
Redox Biol. 2017 Aug;12:674-681. doi: 10.1016/j.redox.2017.03.011. Epub 2017 Mar 12.
Zotero 插件