新生儿常用氧疗方式的安全性评价

Safety assessment of oxygen delivery devices commonly used in neonates

目的评价改良鼻导管吸氧、头罩吸氧和暖箱内供氧三种新生儿常用氧疗方式的临床安全性.方法用测氧仪对不同吸氧方式及不同氧流量下患儿的实际吸入氧浓度进行测定,分析氧流量与氧浓度变化的关系.结果改良鼻导管和头罩吸氧时患儿实际吸入氧浓度与氧流量呈正相关,头罩吸氧时低流量(1 L/min)即可能对部分新生儿造成过高氧环境(>50%);暖箱内供氧在低流量下(1～3 L/min)各组之间实际吸入氧浓度无统计学差异.结论现有氧疗方式及常规不完全适用于新生儿,需密切监测实际吸入氧浓度,并应针对新生儿特点进行改进.

Objective To assess the safety of three commonly used oxygen delivery devices in neonates. Methods Using oxygen monitor to measure the actual inhaled oxygen concentration under modified nasal cannula, heedbox and incubator during oxygenation, and discuss the relationship between different flow settings and actual oxygen concentrations inhaled. Results The actual inhaled oxygen concentrations were positively related to the oxygen flows in modified nasal cannula group and headbox group. In headbox group, the concentration would be too high（ 〉50% ）for some infants even in a very low flow of oxygen（ 1 L/min）. In a low flow setting（ 1- 3 L/min）, the actual oxygen concentrations in incubator did not show a significant relation with the oxygen flows supplied. Conclusion The current oxygen delivery devices and guideline are not compatible with the neonatal settings. Modification of the guideline should be considered, and precautious monitoring of actual inhaled oxygen concentration is necessary to improve the safety of oxygen therapy in neonates.