The effect of low flow oxygen therapy on the chemical control of ventilation in patients with hypoxemic COPD.
The effect of low flow oxygen therapy on the chemical control of ventilation in patients with hypoxemic COPD.
复制标题
低流量氧疗对低氧慢性阻塞性肺病患者通气化学控制的影响。
DOI：
10.1164/arrd.1980.122.6.833
复制
发表时间：
2015
期刊：
影响因子：
--
通讯作者：
N. Anthonisen
中科院分区：
文献类型：
--
作者：
J. Fleetham;C. Bradley;M. Kryger;N. Anthonisen
为了确定低氧性慢性阻塞性肺疾病（COPD）患者的低氧反应降低是否可以通过纠正低氧血症而逆转，我们测量了30例此类患者对CO2和缺氧的通气和P0.1反应。然后将这些患者随机分配到24小时连续吸氧组或12小时夜间吸氧组。所有患者在氧气治疗6个月后，以及13例患者在氧气治疗1年后，对二氧化碳和缺氧的反应进行了重新测量。两种氧疗方案后钝性缺氧反应均未增加，6个月后12小时夜间供氧进一步降低。低氧血症COPD患者的低氧反应降低，随着低氧血症的缓解似乎是不可逆转的。24小时氧疗6个月后，患者对CO2的反应下降，PaCO2显著升高。就缺氧或CO2的初始反应而言，氧疗后PaCO2的变化是不可预测的。24小时供氧治疗6个月后，动脉氧饱和度为95%时静息呼吸时的分钟通气量（VE）和平均吸气流量下降，表明中枢通气驱动减少。
To determine whether the decreased hypoxic responses present in patients with hypoxemic chronic obstructive pulmonary disease (COPD) were reversible with correction of their hypoxemia, we measured ventilatory and P0.1 responses to CO2 and hypoxia in 30 such patients. These patients were then randomly allocated to either 24-h continuous oxygen or 12-h nocturnal oxygen therapy. Responses to CO2 and hypoxia were then remeasured in all patients after 6 months of oxygen therapy, and in 13 patients after 1 yr of oxygen therapy. The blunt hypoxic responses showed no increase after either regimen of oxygen therapy and were further reduced after 6 months of 12-h nocturnal oxygen. The decreased hypoxic response in patients with hypoxemic COPD appears nonreversible with the relief of the hypoxemia. Responses to CO2 were depressed after 6 months of 24-h oxygen therapy and associated with a significant increase in PaCO2. The change in PaCO2 after oxygen therapy was nonpredictable in terms of the initial responses to hypoxia or CO2. Minute ventilation (VE) and mean inspiratory flow during resting breathing at an arterial O2 saturation of 95% decreased after 6 months of 24-h oxygen therapy, indicating a reduction in central ventilatory drive.