慢性閉塞性肺疾患の悪化時の制御された酸素療法と二酸化炭素保持
Lancet (London, England)
|March 7, 2001
まとめ
慢性阻害性肺疾患 (COPD) の悪化を患っている患者は,制御された酸素療法中に二酸化炭素 (CO2) の保持のリスクが低い. 重度のハイパーキャプニアの患者でさえ,低流量酸素をよく耐えており,ほとんどの場合安全性を示しています.
科学分野:
- 肺内医学 肺内医学 肺内医学
- クリティカルケア・メディシン
背景:
- 慢性阻害性肺疾患 (COPD) が悪化した患者は,しばしば低酸素症を患い,酸素療法中にハイパーキャプニアのリスクがあります.
- この研究では,制御された酸素療法を受けたこのような患者で臨床的に有意な二酸化炭素 (CO2) 保持の発生率を調査しました.
研究 の 目的:
- 急性悪化時に制御された酸素療法を受けている低血圧性COPD患者の二酸化炭素 (CO2) 保持のリスクを定量化するために.
- この患者集団におけるCO2保持の臨床的意義を評価する.
主な方法:
- COPDの急性悪化とハイパーカプニック呼吸器不全を呈する24人の連続した患者を対象とした研究.
- 制御された酸素療法は,ベンチュリマスク (24-40%) を介して投与され,酸素飽和度を91-92%に維持しました.
主要な成果:
- 3人の患者 (12.5%) のみ,臨床的に有意なCO2保持 (PaCO2の上昇> 1kPaとして定義) が発生しました.
- この3人の患者は,当初より重度の頭痛症を発症し,低流量酸素 (24-28%) を必要とした.
結論:
- ハイパーカプニック呼吸器不全によるCOPD悪化における制御された酸素補給は,ハイパーカプニアを悪化させるリスクが低い.
- 厳密なモニタリングと制御された酸素供給は,特に重度の高頭蓋骨症の患者に重要である.
さらに関連する動画
関連する概念動画
Physiological Control of Respiration
Introduction
Breathing, a seemingly passive process, is regulated by the respiratory center in the brainstem. This center coordinates the involuntary control of respirations, which means it occurs without conscious effort, ensuring a smooth and uninterrupted pattern.
Regulation of Ventilation
The body maintains ventilation by monitoring levels of carbon dioxide (CO2), oxygen (O2), and hydrogen ion concentration (pH) in the arterial blood. Among these factors, the level of CO2 plays a crucial...
Breathing, a seemingly passive process, is regulated by the respiratory center in the brainstem. This center coordinates the involuntary control of respirations, which means it occurs without conscious effort, ensuring a smooth and uninterrupted pattern.
Regulation of Ventilation
The body maintains ventilation by monitoring levels of carbon dioxide (CO2), oxygen (O2), and hydrogen ion concentration (pH) in the arterial blood. Among these factors, the level of CO2 plays a crucial...
COPD: Management Using Bronchodilators and Corticosteroids
Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure
Oxygen therapy has emerged as a significant tool in enhancing the quality of life for patients suffering from pulmonary arterial hypertension (PAH). While this therapy has principally been studied on patients with significant hypoxemia, this therapeutic approach helps prevent potential organ damage and can be administered in the comfort of one's home.
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue, improving...
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue, improving...
Acute Respiratory Failure-III
Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without causing...
Acute Respiratory Failure-V
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Chronic Obstructive Pulmonary Disease-V: Management
Managing Chronic Obstructive Pulmonary Disease (COPD) involves a multifaceted approach to reduce symptoms, prevent exacerbations, improve overall health status, and slow disease progression. Key strategies include lifestyle modifications, pharmacotherapy, supportive therapies, and, in some cases, surgery. Here is an overview of the primary COPD management strategies:
Smoking Cessation
Smoking Cessation


