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本文讨论了呼吸衰竭病人人工通气时的动脉氧合作用,以临床选择一个能使病人PaO_2达到正常的吸入氧浓度(FiO_2)开始,然后逐渐增加两或三个FiO_2浓度一直达到0.9。本文中以计算的肺循环末梢毛细血管与动脉血氧含量之间的差别(Cc′O_2-CaO_2)来评价氧转运中的损伤情况,提出了一些理由来说明这一指标正显示了静脉血混流的程度。在换气功能严重受损的病人(Cc′O_2-CaO_2大于1毫升/分升),起始增加吸入氧浓度可减少其损害的程度,而损害不那么严重的肺则无变化。这一观察是与通气/血流比例失调的假设相合的,我们未观察到增加氧浓度会有损于肺的氧合作用的效率。
This article discusses the arterial oxygenation during artificial ventilation in patients with respiratory failure, starting with the clinical choice of a concentration of inspired oxygen (FiO 2) that normalizes patient PaO 2 and then gradually increasing the concentration of two or three FiO 2s to 0.9. In this paper, we calculated the difference between peripheral blood capillaries and arterial oxygen content (Cc’O_2-CaO_2) in the pulmonary circulation to evaluate the damage during oxygen transport. Some reasons why this indicator is showing venous blood mixed degree. In patients with severe ventilatory impairment (Cc’O_2-CaO 2> 1 mL / dL), initially increasing the inhaled oxygen concentration may reduce the extent of the lesion, whereas the lesion less severe lungs do not change. This observation is consistent with the hypothesis of a ventilatory / blood flow imbalance, and we have not observed that increasing oxygen concentration can detract from lung oxygenation efficiency.