CONTROLLED OXYGEN ADMINISTRATION IN ACUTE RESPIRATORY-FAILURE IN CHRONIC OBSTRUCTIVE PULMONARY-DISEASE - REAPPRAISAL
CONTROLLED OXYGEN ADMINISTRATION IN ACUTE RESPIRATORY-FAILURE IN CHRONIC OBSTRUCTIVE PULMONARY-DISEASE - REAPPRAISAL
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DOI：
10.1016/0002-9343(78)90740-4
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发表时间：
1978-01-01
影响因子：
5.9
通讯作者：
JOHNSON, RL
中科院分区：
文献类型：
--
作者：
BONE, RC;PIERCE, AK;JOHNSON, RL
在慢性阻塞性肺疾病（COPD）急性加重期间，控制性O2治疗可能会加重CO2潴留。在50例连续COPD和急性呼吸衰竭患者中，13例因CO2麻醉需要插管。通过对入院时动脉血氧分压（PaO2）和pH值的判别分析，将患者分为高风险和低风险CO2麻醉患者。然后，该图被用于预测73例接受受控O2治疗的COPD和急性呼吸衰竭患者的CO2麻醉。其中16名患者出现二氧化碳麻醉。13例（81%）被预测为该并发症的高风险。只有2例（4%）患者根据图表判断为CO2麻醉低风险，需要机械通气。利用氧分压（PO2）和二氧化碳分压（PCO2）图，将患者的呼吸反应与非卧床COPD患者的呼吸反应进行比较。低氧血症和酸中毒比高碳酸血症更能鉴别CO2麻醉。
Controlled O2 therapy may aggravate CO2 retention during acute exacerbations of chronic obstructive pulmonary disease (COPD). Of 50 consecutive patients with COPD and acute respiratory failure, 13 required intubation because of CO2 narcosis. With discriminant analysis of their arterial O2 tension (PaO2) and pH on admission, a diagram separated patients into those at high risk and those at low risk for CO2 narcosis. This diagram was then used to predict CO2 narcosis in 73 patients with COPD and acute respiratory failure who were treated with controlled O2. In 16 of these patients CO2 narcosis developed. Thirteen (81%) were predicted by the diagram to be at high risk for this complication. Only 2 (4%) patients judged by the diagram to be at low risk for CO2 narcosis required mechanical ventilation. Utilizing an O2 tension (PO2) and a CO2 tension (PCO2) diagram a patient''s ventilatory response was compared to that of ambulatory patients with COPD. Hypoxemia and acidosis are more discriminatory for CO2 narcosis than hypercapnia.