Fayazi Azadeh R, Sesia Matteo, Anand Kanwaljeet J S
Department of Pediatrics, Division of Critical Care Medicine, Stanford University School of Medicine, Palo Alto, California, United States.
Department of Data Sciences and Operations, USC Marshall School of Business, Los Angeles, California, United States.
J Pediatr Intensive Care. 2021 Dec 23;13(2):184-191. doi: 10.1055/s-0041-1740586. eCollection 2024 Jun.
Supratherapeutic oxygen levels consistently cause oxygen toxicity in the lungs and other organs. The prevalence and severity of hyperoxemia among pediatric intensive care unit (PICU) patients remain unknown. This was the first study to examine the prevalence and duration of hyperoxemia in PICU patients receiving oxygen therapy. This is a retrospective chart review. This was performed in a setting of 36-bed PICU in a quaternary-care children's hospital. All the patients were children aged <18 years, admitted to the PICU for ≥24 hours, receiving oxygen therapy for ≥12 hours who had at least one arterial blood gas during this time. There was no intervention. Of 5,251 patients admitted to the PICU, 614 were included in the study. On average, these patients received oxygen therapy for 91% of their time in the PICU and remained hyperoxemic, as measured by pulse oximetry, for 65% of their time on oxygen therapy. Patients on oxygen therapy remained hyperoxemic for a median of 38 hours per patient and only 1.1% of patients did not experience any hyperoxemia. Most of the time (87.5%) patients received oxygen therapy through a fraction of inspired oxygen (FiO )-adjustable device. Mean FiO on noninvasive support was 0.56 and on invasive support was 0.37. Mean partial pressure of oxygen (PaO ) on oxygen therapy was 108.7 torr and 3,037 (42.1%) of PaO measurements were >100 torr. Despite relatively low FiO , PICU patients receiving oxygen therapy are commonly exposed to prolonged hyperoxemia, which may contribute to ongoing organ injury.
超治疗剂量的氧水平持续会导致肺部和其他器官的氧中毒。儿科重症监护病房（PICU）患者中高氧血症的患病率和严重程度尚不清楚。这是第一项研究PICU接受氧疗患者高氧血症的患病率和持续时间的研究。这是一项回顾性病历审查。研究在一家四级儿童专科医院的36张床位的PICU中进行。所有患者均为18岁以下儿童，入住PICU≥24小时，接受氧疗≥12小时，在此期间至少进行过一次动脉血气分析。未进行干预。在入住PICU的5251例患者中，614例纳入研究。平均而言，这些患者在PICU期间91%的时间接受氧疗，通过脉搏血氧饱和度测定，在接受氧疗期间65%的时间处于高氧状态。接受氧疗的患者平均每位患者高氧状态持续38小时，只有1.1%的患者未出现任何高氧血症。大多数时候（87.5%）患者通过可调节吸入氧分数（FiO₂）的设备接受氧疗。无创支持时的平均FiO₂为0.56，有创支持时为0.37。氧疗时的平均氧分压（PaO₂）为108.7 torr，3037次（42.1%）PaO₂测量值>100 torr。尽管FiO₂相对较低，但接受氧疗的PICU患者通常会长期处于高氧状态，这可能会导致持续的器官损伤。
