OXYGEN IN THE CLINICAL MANAGEMENT OF WOUNDS

过去25年来，在该中心的资助下进行的研究巩固了 观察1)在低氧条件下，伤口的许多过程 愈合不能正常进行，尤其是对感染的抵抗， 胶原合成、血管生成和炎症；2)这些 事实上，在超生理氧气条件下，过程的工作效率更高 浓度；以及3)低氧条件是受伤患者的常态 组织和创伤患者体内。这些观察不可避免地导致了 结论是，护理的最关键的方面之一 创伤患者是维持对伤者的氧气输送 纸巾。这需要在高PO2的情况下高流量的血液，但不是 氧气含量必然很高。医生对外周的估计 灌注通常是不准确的(通常高估)；因此，这 除非测量组织氧含量，否则目标无法实现。该计划的目的是 目前的建议是将组织血氧仪从一种研究工具转变为 临床监测，通过确定消除障碍的方法 灌流，并通过演示这些手段与氧分压的结合使用 在ICU环境中进行监测可以改善患者的预后。

The past 25 years of research under this Center grant have solidified the observations 1) that under hypoxic conditions, many processes of wound healing cannot proceed normally, particularly resistance to infection, collagen synthesis, angiogenesis, and inflammation; 2) that these processes, in fact, work more efficiently at supraphysiologic oxygen concentrations; and 3) that hypoxic conditions are the norm in injured tissue and in trauma patients. These observations lead inescapably to the conclusion that one of the most critical aspects of the care of traumatized patients is maintenance of oxygen delivery to injured tissues. This requires high flow of blood at high PO2 but not necessarily high oxygen content. Physician estimates of peripheral perfusion are usually inaccurate (usually overestimates); therefore, this goal cannot be achieved unless tissue oxygen is measured. The aim of the current proposal is to convert tissue oximetry from a research tool to a clinical monitor, by identifying means to remove obstacles to perfusion, and by demonstrating that use of these means combined with PO2 monitoring in the ICU setting leads to improved patient outcome.