Vali Payam, Underwood Mark, Lakshminrusimha Satyan
Department of Pediatrics, UC Davis School of Medicine, Sacramento, CA 95817, USA.
Can J Physiol Pharmacol. 2019 Mar;97(3):174-182. doi: 10.1139/cjpp-2018-0376. Epub 2018 Oct 26.
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.
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）。
