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成人危重患者中不同人群氧疗目标的合理选择

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氧疗是成人危重症患者治疗中最常见的干预措施之一.适量的氧有助于纠正低氧血症和组织缺氧,同时恢复细胞功能并维持体内代谢平衡;但过量的氧可导致活性氧的产生,对细胞结构和功能造成氧化损伤并激活细胞的死亡途径.在危重症患者中,低氧血症和高氧血症均与临床不良结局相关,因此,确定合理的氧疗目标范围至关重要.目前,在成人危重症患者中针对不同患者人群氧疗目标的探索一直备受研究者的广泛关注,尽管已进行大量的相关研究,为临床氧疗策略提供了一定参考,但仍存在争议,期待未来有更多基于最佳氧合目标的研究成果为临床建立确切获益的氧疗策略提供更加可靠的证据参考.
Optimal oxygen therapy targets among critically ill adult patients
Oxygen therapy is one of the most common interventions in the treatment of adult critically ill patients.Appropriate oxygen contributes to correcting hypoxemia and tissue hypoxia,restoring cellular function and maintaining metabolic balance at the same time;however,excessive oxygen may enhance the production of reactive oxygen species,which can lead to oxidative damage to cellular components and function,ultimately resulting in cell death.Both hypoxemia and hyperoxemia are associated with adverse clinical outcomes in critically ill patients.Therefore,it is imperative to establish optimal oxygenation targets.At present,the exploration of oxygen therapy targets for different patient populations in critically ill adult patients has received widespread attention from researchers.Although a large number of related studies have been conducted,providing some reference for clinical oxygen therapy strategies,there is still controversy.It is expected that more research results based on the optimal oxygen therapy target will provide more reliable evidence reference for establishing precise and beneficial oxygen therapy strategies in clinical practice in the future.

oxygen therapyconservative oxygen therapyliberal oxygen therapyhypoxemiahyperoxemia

李欣雨、谭伟

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中国医科大学附属第一医院呼吸与危重症医学科,辽宁沈阳 110001

氧疗 保守性氧疗 自由性氧疗 低氧血症 高氧血症

2024

中国实用内科杂志
中国医师协会,中国实用医学杂志社

中国实用内科杂志

CSTPCD北大核心
影响因子:1.618
ISSN:1005-2194
年,卷(期):2024.44(12)