Spier S, Rivlin J, Hughes D, Levison H
Am Rev Respir Dis. 1984 May;129(5):712-8. doi: 10.1164/arrd.1984.129.5.712.
We determined the effect of nocturnal low-flow oxygen (NLFO) on arterial oxygen saturation (SaO2), transcutaneous PCO2 (TcPCO2), and sleep quality in 10 patients with cystic fibrosis (CF) and severe stable chronic obstructive pulmonary disease (COPD). The patients were studied on 2 nights, 1 with oxygen and 1 with air at 2 L/min. The NLFO had no effect upon sleep quality in our patients. The minimal SaO2 occurred during REM sleep and averaged 79.4%. With NLFO, this improved to 92.7%. The average maximal rise in TcPCO2 was 5.6 mmHg on falling asleep while breathing air; this increased a further 5.1 mmHg with NLFO. Two patients also had obstructive sleep apnea. Their SaO2 improved dramatically with NLFO, with no deterioration of ventilation. In 4 patients, ventilation was measured quantitatively. The only consistent changes during air were an increase in abdominal contribution to tidal volume and a drop in minute ventilation from Stage 3-4 to REM sleep of 26%, almost entirely caused by a drop in breathing frequency. The same changes occurred with NLFO. We conclude that NLFO is effective in alleviating the nocturnal hypoxemia of patients with CF with stable COPD and does not cause clinically important hypercapnia.
我们测定了夜间低流量吸氧（NLFO）对10例患有囊性纤维化（CF）和重度稳定期慢性阻塞性肺疾病（COPD）患者的动脉血氧饱和度（SaO2）、经皮二氧化碳分压（TcPCO2）及睡眠质量的影响。对这些患者进行了两个晚上的研究，一晚吸氧，一晚吸2L/min的空气。NLFO对我们的患者的睡眠质量没有影响。最低SaO2出现在快速眼动睡眠期，平均为79.4%。使用NLFO时，这一数值提高到了92.7%。呼吸空气入睡时，TcPCO2的平均最大上升幅度为5.6mmHg；使用NLFO时，这一数值又进一步上升了5.1mmHg。两名患者还患有阻塞性睡眠呼吸暂停。他们的SaO2在使用NLFO时显著改善，通气没有恶化。对4例患者进行了通气的定量测量。呼吸空气时唯一一致的变化是腹部对潮气量的贡献增加，以及从3-4期睡眠到快速眼动睡眠期分钟通气量下降26%，几乎完全是由呼吸频率下降所致。使用NLFO时也出现了同样的变化。我们得出结论，NLFO可有效缓解CF合并稳定期COPD患者的夜间低氧血症，且不会导致具有临床意义的高碳酸血症。
