Kaydu Ayhan, Orhun Günseli, Çakar Nahit
Department of Anesthesiology and Reanimation, Diyarbakır Selahaddi̇n Eyyubi State Hospital, Diyarbakır-Turkey.
Department of Anesthesiology and Reanimation, İstanbul University Faculty of Medicine, İstanbul-Turkey.
Ulus Travma Acil Cerrahi Derg. 2019 Jul;25(4):331-337. doi: 10.5505/tjtes.2018.51430.
Although there are studies demonstrating hyperoxia may be an independent risk factor for increased mortality and morbidity, this issue remains unclear. Our research then aimed to examine the relationship between arterial oxygen tension, arterial carbon dioxide tension, and in-hospital mortality of critically ill patients in intensive care unit (ICU).
After obtaining ethics committee approval, we analyzed a retrospective data of patients over the age of 18 who survived at least 24 hours in the ICU on mechanical ventilatory support between year 2008 and 2012. The demographic properties, mechanical ventilation, and blood gas parameters were studied. We defined hyperoxia group as PaO2 value of ≥120 mmHg and normoxemia group as PaO2 of 60-120 mmHg. Patients with PaCO2 value <30 mmHg were determined to have hypocapnia, those with 30-50 mmHg normocapnia, and those with >50 mmHg hypercapnia.
Between 2008 and 2012, a total of 7689 patients were admitted to the ICU. Of 450 patients meeting the inclusion criteria of the study, 263 (58.4%) were male and 187 (41.6%) were female. Normoxia was observed in 232 (51.5%) patients and hyperoxia in 218 (48.5%) patients. The mean PaO2 was 16.2 kPa (121.50 mmHg), and FiO2 was 60%. 254 (56%) of the patients had died during the five-year period. There was no statistically significant difference in mortality between PaO2 levels and PCO2 levels (p>0.05). According to the classification of PaO2 and FiO2, there was no statistically significant difference in mortality (p>0.05) among patients. In addition, no statistically significant difference was found between the survival rates according to PCO2 classification (p=0.602, p>0.05).
There was no significant association between mortality and oxygen and carbon dioxide of patients in ICU on mechanical ventilatory support.
尽管有研究表明高氧可能是死亡率和发病率增加的独立危险因素，但这个问题仍不明确。因此，我们的研究旨在探讨动脉血氧分压、动脉血二氧化碳分压与重症监护病房（ICU）重症患者院内死亡率之间的关系。
获得伦理委员会批准后，我们分析了2008年至2012年间在ICU接受机械通气支持至少24小时的18岁以上患者的回顾性数据。研究了人口统计学特征、机械通气情况和血气参数。我们将高氧组定义为动脉血氧分压（PaO2）值≥120 mmHg，将正常氧血症组定义为PaO2为60 - 120 mmHg。动脉血二氧化碳分压（PaCO2）值<30 mmHg的患者被判定为低碳酸血症，30 - 50 mmHg为正常碳酸血症，>50 mmHg为高碳酸血症。
2008年至2012年间，共有7689例患者入住ICU。在符合研究纳入标准的450例患者中，263例（58.4%）为男性，187例（41.6%）为女性。232例（51.5%）患者为正常氧血症，218例（48.5%）患者为高氧血症。平均PaO2为16.2 kPa（121.50 mmHg），吸入氧分数（FiO2）为60%。254例（56%）患者在五年期间死亡。PaO2水平和PaCO2水平之间的死亡率无统计学显著差异（p>0.05）。根据PaO2和FiO2分类，患者之间的死亡率无统计学显著差异（p>0.05）。此外，根据PaCO2分类的生存率之间也未发现统计学显著差异（p = 0.602，p>0.05）。
接受机械通气支持的ICU患者的死亡率与氧和二氧化碳之间无显著关联。
