Hemodynamic effects of supplemental oxygen administration in congestive heart failure
Hemodynamic effects of supplemental oxygen administration in congestive heart failure
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DOI：
10.1016/0735-1097(95)00474-2
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发表时间：
1996-02-01
影响因子：
24
通讯作者：
Sinoway, LI
中科院分区：
文献类型：
--
作者：
Haque, WA;Boehmer, J;Sinoway, LI
目标.本研究旨在确定氧疗对心力衰竭患者血流动力学的影响。高剂量氧对正常人的血流动力学有不利影响，但氧是心力衰竭的常用治疗方法。氧是否改变心力衰竭的血流动力学变量尚不清楚。我们研究了10例纽约心脏协会功能分级为III和IV级的充血性心力衰竭患者，他们吸入室内空气和100%氧气20分钟。测量的变量包括心输出量、每搏输出量、肺毛细血管楔压、全身和肺血管阻力、平均动脉压和心率。还研究了分级氧气浓度（室内空气，分别为24%、40%和100%氧气; n = 7）。在五个独立的患者，肌肉交感神经活动和通气量进行了测量，在100%的氧气。100%的氧气减少了心输出量（从3.7 +/- 0.3到3.1 +/- 0.4升/分钟[平均值+/- SE]，p < 0.01）和每搏输出量（从46 +/- 4至38 +/- 5 ml/次/min，p < 0.01）和肺毛细血管楔压增加（从25 +/- 2到29 +/- 3 mm Hg，p < 0.05）和全身血管阻力（从1，628 +/- 154到2，203 +/- 199达因）。s/cm（5），p < 0.01）。分级供氧导致心输出量（单因素方差分析，p < 0.0001）和每搏输出量（p < 0.017）进行性下降，全身血管阻力增加（p < 0.005）。100%的氧气并没有改变交感神经活动或通气。在心力衰竭中，氧对心输出量、每搏输出量、肺毛细血管楔压和全身血管阻力具有不利影响。这些变化与交感神经活动和通气无关。
Objectives. This study sought to determine the hemodynamic effects of oxygen therapy in heart failure.Background. High dose oxygen has detrimental hemodynamic effects in normal subjects, yet oxygen is a common therapy for heart failure. Whether oxygen alters hemodynamic variables in heart failure is unknown.Methods. We studied 10 patients with New York Heart Association functional class III and IV congestive heart failure who inhaled room air and 100% oxygen for 20 min. Variables measured included cardiac output, stroke volume, pulmonary capillary wedge pressure, systemic and pulmonary vascular resistance, mean arterial pressure and heart rate. Graded oxygen concentrations were also studied (room air, 24%, 40% and 100% oxygen, respectively; n = 7). In five separate patients, muscle sympathetic nerve activity and ventilation were measured during 100% oxygen.Results. The 100% oxygen reduced cardiac output (from 3.7 +/- 0.3 to 3.1 +/- 0.4 liters/min [mean +/- SE], p < 0.01) and stroke volume (from 46 +/- 4 to 38 +/- 5 ml/beat per min, p < 0.01) and increased pulmonary capillary wedge pressure (from 25 +/- 2 to 29 +/- 3 mm Hg, p < 0.05) and systemic vascular resistance (from 1,628 +/- 154 to 2,203 +/- 199 dynes . s/cm(5), p < 0.01). Graded oxygen led to a progressive decline in cardiac output (one-way analysis of variance, p < 0.0001) and stroke volume (p < 0.017) and an increase in systemic vascular resistance (p < 0.005). The 100% oxygen did not alter sympathetic activity or ventilation.Conclusions. In heart failure, oxygen has a detrimental effect on cardiac output, stroke volume, pulmonary capillary wedge pressure and systemic vascular resistance. These changes are independent of sympathetic activity and ventilation.