高氧液对危重患者氧合和血液流变学指标的影响

Effect of intravenous infusion of hyperoxic liquid on oxygenation and haemo-rheology parameters in critically ill patients

目的观察静脉输注高氧液对危重患者氧合和血液流变学指标的影响,从而评价其临床应用价值.方法 2004-08～12浙江省9家医院急诊科或ICU伴有低氧血症的危重患者,在常规给氧措施的基础上以60滴/min的速度经静脉输注高氧液,观察输注前和输注1、2 h的血压、心率、呼吸频率、动脉血气和血液流变学指标的变化.结果高氧液输注后患者脉搏氧饱和度和动脉血氧分压明显上升,3个时点的中位数值分别为94%、96%、97%和67.0、80.0、84.7 mmHg(均P<0.001);心率和呼吸频率减慢(均P<0.001),对血压影响不大;全血黏度降低(P<0.05);未见明显不良反应.结论高氧液可作为其他氧疗措施的补充手段,适用于有低氧血症危重患者的救治.

Objective To observe effect of intravenous infusion of hyperoxic liquid on oxygenation and haemo-rheology parameters in critically ill patients,then to evaluate its clinical value.Methods Prospective,self-control and multi-centers's study were done.From August to December 2004,critically ill patients with hypoxemia were included in 9 hospitals in Zhejiang Province.Routine delivery of oxygen was administrated on them,then hyperoxic liquid was intravenously infused at the rate of 60 drops per minute.Blood pressure,heart rate,respiratory rate,arterial blood gas and haemo-rheology parameters were recorded before infusion,1 h and 2 h after infusion.Results 166 patients were enrolled in this study,122 males and 44 females,with an average age of (68±20)years.Pulse oximetry and partial pressure of arterial oxygen were markedly increased after infusion of hyperoxic liquid.Their median values at three time points were 94%,96%,97% and 67.0,80.0,84.7 mmHg respectively(P<0.001).Heart and respiratory rates were decreased (P<0.001),and there were no changes in blood pressure.Total blood viscosity was decreased after 2 -hours infusion.Adverse reactions were not found in all the patients.Conclusion Intravenous infusion of hyperoxic solution could be used as a complementary alternative to treat critically ill patients with hypoxemia besides routine delivery of oxygen.