Pływaczewski R, Sliwiński P, Pałasiewicz G, Kamiński D, Zieliński J
Kliniki Chorób Pluc, Instytutu Gruźlicy i Chorób Pluc w Warszawie.
Pneumonol Alergol Pol. 1997;65(7-8):494-9.
In COPD patients undergoing LTOT recent ATS and ERS guidelines suggest increase of oxygen flow by I L/min. to avoid severe desaturations during sleep. The aim of this study was to investigate frequency of overnight desaturations in COPD patients qualified for LTOT. We studied 101 consecutive COPD patients qualified for LTOT. Their functional characteristics were as follows: FVC = 2.24 +/- 0.78 L, FEVI = 0.88 +/- 0.39 L, PaO2 = 50 +/- 5 mmHg, PaCO2 = 48 +/- 8 mmHg. Overnight pulse oximetry was performed twice, while breathing air and on supplemental oxygen assuring satisfactory oxygenation (PaO2/O2 at rest when awake = 65 +/- 7 mmHg). We distinguished three groups of patients according to mean overnight arterial blood saturation breathing supplemental oxygen (mean SaO2/O2). First group - 40 patients (39.6%) had mean SaO2/O2 > 93% and time spent in saturation below 90% (T90/O2) = 4.5 +/- 6.7% of the recording time. Second group - 30 patients (29.7%) had mean SaO2/O2 between 90% and 92% and T90/O2 = 32.7 +/- 15.3%. Third group - 31 patients (30.6%) had mean SaO2/O2 < 90% and T90/O2 = 81.8 +/- 16.2% of the recording time. Comparison of ventilatory variables and daytime blood gases in these groups revealed statistically significant elevation of PaCO2 in group 3 (54 +/- 9 mmHg) compared to group 1 and 2 (45 +/- 6 mmHg and 47 +/- 7 mmHg respectively). FVCI, PaO2 and age were similar in all groups. We conclude that around 1/3 of COPD patients qualified for LTOT need increased oxygen flow during sleep. Such need should to be confirmed by the overnight pulse oximetry.
在接受长期家庭氧疗（LTOT）的慢性阻塞性肺疾病（COPD）患者中，近期美国胸科学会（ATS）和欧洲呼吸学会（ERS）的指南建议将氧流量增加1升/分钟，以避免睡眠期间出现严重的血氧饱和度下降。本研究的目的是调查符合LTOT条件的COPD患者夜间血氧饱和度下降的频率。我们研究了101例连续符合LTOT条件的COPD患者。他们的功能特征如下：用力肺活量（FVC）=2.24±0.78升，第一秒用力呼气容积（FEV1）=0.88±0.39升，动脉血氧分压（PaO2）=50±5毫米汞柱，动脉血二氧化碳分压（PaCO2）=48±8毫米汞柱。在呼吸空气和补充氧气以确保满意的氧合（清醒时静息状态下的PaO2/氧流量=65±7毫米汞柱）时，进行了两次夜间脉搏血氧饱和度测定。根据补充氧气时夜间平均动脉血氧饱和度（平均SaO2/氧流量），我们将患者分为三组。第一组 - 40例患者（39.6%）的平均SaO2/氧流量>93%，血氧饱和度低于90%的时间（T90/氧流量）占记录时间的4.5±6.7%。第二组 - 30例患者（29.7%）的平均SaO2/氧流量在90%至92%之间，T90/氧流量=32.7±15.3%。第三组 - 31例患者（30.6%）的平均SaO2/氧流量<90%，T9
