Köhler Andrea, Zoll Felicitas M, Ploner Thomas, Hammer Alexander, Joannidis Michael, Tilg Herbert, Finkenstedt Armin, Hartig Frank
Division of Intensive Care and Emergency Medicine, Department of Internal Medicine I, Medical University Innsbruck, Innsbruck, Austria.
Front Physiol. 2022 Apr 26;13:885898. doi: 10.3389/fphys.2022.885898. eCollection 2022.
Application of high concentrations of oxygen to increase oxygen partial pressure (pO2) is the most important treatment for patients with carbon monoxide intoxication or divers with suspected decompression illness. The aim of this study was to evaluate the oxygenation performance of various non-invasive oxygen systems. The effect of different oxygen systems on arterial pO2, pCO2 and pH and their subjective comfort was evaluated in 30 healthy participants. Eight devices were included: nasal cannula, non-rebreather mask, AirLife Open mask, Flow-Safe II CPAP device, SuperNOVA nasal PAP device, all operated with 15 L/min constant flow oxygen; nasal high-flow (50 L/min flow, 1.0 FiO2), non-invasive positive pressure ventilation (NPPV, 12 PEEP, 4 ASB, 1.0 FiO2) and a standard diving regulator (operated with pure oxygen). Diving regulator, SuperNOVA, nasal high-flow and NPPV achieved mean arterial pO2 concentrations between 538 and 556 mm Hg within 5 minutes. The AirLife Open mask, the nasal cannula and the non-rebreather mask achieved concentrations of 348-451 mm Hg and the Flow-Safe II device 270 mm Hg. Except for the AirLife open mask, pCO2 decreased and pH increased with all devices. The highest pH values were observed with NPPV, diving regulator, Flow-Safe II and nasal high-flow but apparent hyperventilation was uncommon. The AirLife Open and the non-rebreather mask were the most comfortable, the SuperNOVA and the nasal cannula the most uncomfortable devices. A standard diving regulator and the SuperNOVA device were equally effective in providing highest physiologically possible pO2 as compared to nasal high-flow and NPPV.
应用高浓度氧气以增加氧分压（pO2）是一氧化碳中毒患者或疑似减压病潜水员最重要的治疗方法。本研究的目的是评估各种无创输氧系统的氧合性能。在30名健康参与者中评估了不同输氧系统对动脉pO2、pCO2和pH值的影响及其主观舒适度。纳入了八种设备：鼻导管、非重复呼吸面罩、AirLife开放式面罩、Flow-Safe II持续气道正压通气（CPAP）设备、SuperNOVA鼻持续气道正压通气设备，均以15升/分钟的恒定流速输氧；鼻高流量（50升/分钟流速，1.0吸入氧分数）、无创正压通气（NPPV，12厘米水柱呼气末正压，4辅助吸气，1.0吸入氧分数）以及标准潜水调节器（使用纯氧操作）。潜水调节器、SuperNOVA、鼻高流量和NPPV在5分钟内使平均动脉pO2浓度达到538至556毫米汞柱之间。AirLife开放式面罩、鼻导管和非重复呼吸面罩达到的浓度为348 - 451毫米汞柱，Flow-Safe II设备为270毫米汞柱。除了AirLife开放式面罩外，所有设备均使pCO2降低，pH值升高。NPPV、潜水调节器、Flow-Safe II和鼻高流量观察到最高的pH值，但明显的过度通气并不常见。AirLife开放式面罩和非重复呼吸面罩最舒适，SuperNOVA和鼻导管最不舒适。与鼻高流量和NPPV相比，标准潜水调节器和SuperNOVA设备在提供最高生理可能的pO2方面同样有效。
