Hypoxaemia during open-airway apnoea: a computational modelling analysis
Hypoxaemia during open-airway apnoea: a computational modelling analysis
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DOI：
10.1111/j.1365-2044.2005.04228.x
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发表时间：
2005-08-01
期刊：
影响因子：
10.7
通讯作者：
Hardman, JG
中科院分区：
文献类型：
--
作者：
McNamara, MJ;Hardman, JG
开放式呼吸暂停期间的低氧血症，例如脑干死亡测试期间，可能导致器官损伤。环境氧含量对低氧血症程度的影响尚未确定。我们通过再现四项已发表临床研究的方法和结果，在此背景下验证了诺丁汉生理模拟器。然后，我们使用模拟器检查呼吸暂停期间不同环境氧分数（0.21 - 1.0）和分流分数（心输出量的1 - 30%）的影响。将环境氧分数从0.9增加到1.0，使所有分流分数下血红蛋白去饱和的时间增加一倍以上，并延长呼吸暂停时间，比环境氧分数从0.21增加到0.9时更长。当环境氧分数和分流分数较大时，在呼吸暂停期间动脉氧分压短暂升高。非常高的环境氧分数和通畅的气道可能延迟呼吸暂停期间的危险低氧血症。
Hypoxaemia during open-airway apnoea, e.g. during brainstem death testing, may cause organ damage. The effect of ambient oxygen fraction on the extent of hypoxaemia has not been established. We validated the Nottingham Physiology Simulator in this context by reproducing the methodologies and results of four published clinical studies. We then used the simulator to examine the effects of different ambient oxygen fractions (0.21-1.0) and shunt fractions (1-30% of cardiac output) during apnoea. Increasing ambient oxygen fraction from 0.9 to 1.0 more than doubled the time to haemoglobin desaturation at all shunt fractions, and extended apnoea longer than when the ambient oxygen fraction was increased from 0.21 to 0.9. When ambient oxygen fraction and shunt fraction were large, arterial oxygen tension transiently increased during apnoea. A very high ambient oxygen fraction and a patent airway are likely to delay dangerous hypoxaemia during apnoea.