Oxygen Targeting in Extremely Low Birth Weight Infants
Oxygen Targeting in Extremely Low Birth Weight Infants
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DOI：
10.1542/peds.2016-1576
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发表时间：
2016-08-01
期刊：
影响因子：
8
通讯作者：
Polin, Richard A.
中科院分区：
文献类型：
--
作者：
Cummings, James J.;Polin, Richard A.
补充氧气的使用在危重早产儿的护理中起着至关重要的作用，但无限制地使用氧气可能会导致意想不到的伤害，例如慢性肺病和早产儿视网膜病变。过度限制补充氧气的使用也可能产生不利影响。理想情况下，对组织和细胞氧输送的连续监测将使临床医生能够更好地调整补充氧气的使用，但这种监测目前在临床环境中并不可行。脉搏血氧测定法的引入通过提供相对简单且连续的动脉血氧饱和度估计为临床医生提供了极大的帮助，但脉搏血氧测定法具有一些实用、技术和生理方面的局限性。最近进行的随机临床试验比较了不同的脉搏血氧饱和度目标，以更好地指导补充氧气的使用实践。本临床报告讨论了脉搏血氧测定法用于评估氧合的优点和局限性，总结了氧饱和度目标的随机临床试验，并讨论了对实践的影响。
The use of supplemental oxygen plays a vital role in the care of the critically ill preterm infant, but the unrestricted use of oxygen can lead to unintended harms, such as chronic lung disease and retinopathy of prematurity. An overly restricted use of supplemental oxygen may have adverse effects as well. Ideally, continuous monitoring of tissue and cellular oxygen delivery would allow clinicians to better titrate the use of supplemental oxygen, but such monitoring is not currently feasible in the clinical setting. The introduction of pulse oximetry has greatly aided the clinician by providing a relatively easy and continuous estimate of arterial oxygen saturation, but pulse oximetry has several practical, technical, and physiologic limitations. Recent randomized clinical trials comparing different pulse oximetry targets have been conducted to better inform the practice of supplemental oxygen use. This clinical report discusses the benefits and limitations of pulse oximetry for assessing oxygenation, summarizes randomized clinical trials of oxygen saturation targeting, and addresses implications for practice.