Johnson J E, Peacock M D, Hayes J A, Morris M J, Anders G T, Blanton H M
Pulmonary Disease/Critical Care Service, Brooke Army Medical Center, Fort Sam Houston, TX 78234-6271, USA.
South Med J. 1995 Apr;88(4):443-9. doi: 10.1097/00007611-199504000-00012.
In order to determine the effect of breathing high fractional concentrations of oxygen on forced expiratory flow in individuals with chronic obstructive pulmonary disease (COPD), we studied 18 patients with moderately severe disease. The patients were studied breathing air, 100% oxygen, or a four-gas mixture in a randomized double-blind study design. The four-gas mixture (oxygen 21.0%, argon 48.6%, nitrogen 19.3%, and helium 11.1%) was calculated to have a density and viscosity similar to oxygen. During spirometric testing, breathing oxygen produced a detectable reduction in timed volumes by 1 minute that was sustained at 5 minutes (FEV1 reduction 4.9% at 1 minute and 6.3% at 5 minutes). Breathing the gas mixture for 5 minutes resulted in similar reductions in flow. We conclude that high concentrations of oxygen reduce forced expiratory flow in patients with airflow obstruction, an effect probably related to the increased density and viscosity relative to air. This reduction in forced expiratory flow may contribute to the deterioration seen when COPD patients with acute respiratory failure are treated with 100% oxygen.
为了确定吸入高分数浓度氧气对慢性阻塞性肺疾病（COPD）患者用力呼气流量的影响，我们研究了18例中度严重疾病患者。在一项随机双盲研究设计中，对这些患者进行了吸入空气、100%氧气或一种四气体混合物的研究。计算得出该四气体混合物（氧气21.0%、氩气48.6%、氮气19.3%和氦气11.1%）的密度和粘度与氧气相似。在肺量计测试期间，吸入氧气在1分钟时可检测到定时容积减少，并在5分钟时持续存在（第1分钟时第1秒用力呼气容积[FEV1]减少4.9%，第5分钟时减少6.3%）。吸入该气体混合物5分钟导致流量出现类似减少。我们得出结论，高浓度氧气会降低气流阻塞患者的用力呼气流量，这种影响可能与相对于空气而言密度和粘度增加有关。用力呼气流量的这种降低可能导致急性呼吸衰竭的COPD患者接受100%氧气治疗时出现病情恶化。
