高氧血症对重症患者的危害及管理措施

Harm and management measures of hyperoxemia to intensive care patients

重症患者发生高氧血症的现象十分普遍,高氧血症会对患者造成不同程度的病理生理性危害,是患者病死率升高、住院时间延长和预后差的主要原因之一。因此,实施规范化氧疗尤为重要。本文从高氧血症对心脑血管的影响、高氧肺损伤以及高氧血症与呼吸机相关性肺炎(VAP)和急性肾损伤(AKI)的关联等方面综述了高氧血症对重症患者的危害,从规范临床氧疗、氧疗范围相关研究及提高监测水平等方面提出相关管理措施,为今后规范临床用氧流程,减少高氧血症的发生,制定合理的防治措施提供参考依据和研究方向。

Hyperoxia is very common in critical patients,which causes varying degrees of pathophysiological damage.Hyperoxia is one of the main reasons for increasing mortality,prolonged hospital stay and poor prognosis of critical patients.Therefore,it is critical to carry out the standardized oxygen therapy.In this paper,we discussed the harmful effects of hyperoxemia to critically ill patients by reviewing the effect of hyperoxemia on cardiovascular and cerebrovascular,hyperoxia-induced lung injury,and the association of hyperoxemia with ventilator-associated pneumonia(VAP)and acute renal kidney injury(AKI).Meanwhile,we provided some management suggestions about standardized clinical oxygen therapy,oxygen therapy related research and clinical management of oxygen therapy,aimed at providing reference and research direction for standardizing clinical oxygenation process,reducing the occurrence of hyperoxemia,and making reasonable method for hyperoxemia prevention.