Gunawardena K A, Patel B, Campbell I A, MacDonald J B, Smith A P
Br Med J (Clin Res Ed). 1984 Jan 28;288(6413):272-4. doi: 10.1136/bmj.288.6413.272.
Changes in blood gas tensions occurring when 100% oxygen or air was used as the driving gas for nebulised salbutamol were studied in 23 patients with severe airways obstruction. The patients fell into three groups: nine had chronic bronchitis and emphysema with carbon dioxide retention, seven had emphysema and chronic bronchitis without carbon dioxide retention, and seven had severe asthma (no carbon dioxide retention). When oxygen was used as the driving gas patients who retained carbon dioxide showed a mean rise of 1.03 kPa (7.7 mm Hg) in their pressure of carbon dioxide (Pco2) after 15 minutes (p less than 0.001) but the Pco2 returned to baseline values within 20 minutes of stopping the nebuliser. The other two groups showed no rise in Pco2 with oxygen. When air was used as the driving gas none of the groups became significantly more hypoxic. Although it is safe to use oxygen as the driving gas for nebulisers in patients with obstructive airways disease with normal Pco2, caution should be exercised in those who already have carbon dioxide retention.
在23例严重气道阻塞患者中，研究了将100%氧气或空气用作雾化沙丁胺醇驱动气体时血气张力的变化。患者分为三组：9例患有慢性支气管炎和肺气肿且伴有二氧化碳潴留，7例患有肺气肿和慢性支气管炎但无二氧化碳潴留，7例患有重度哮喘（无二氧化碳潴留）。当使用氧气作为驱动气体时，有二氧化碳潴留的患者在15分钟后二氧化碳分压（Pco2）平均升高1.03 kPa（7.7 mmHg）（p<0.001），但在停止雾化后20分钟内Pco2恢复到基线值。其他两组使用氧气时Pco2未升高。当使用空气作为驱动气体时，所有组均未出现明显的低氧血症加重。虽然对于Pco2正常的阻塞性气道疾病患者，使用氧气作为雾化器的驱动气体是安全的，但对于已经存在二氧化碳潴留的患者应谨慎使用。
