Oxygen therapy can be life-saving for patients with chronic obstructive pulmonary disease (COPD) and is the backbone of any acute COPD treatment strategy. Although largely considered to be a benign drug, many publications have highlighted the need to accurately adjust oxygen delivery to avoid both hypoxemia and the problem of hyperoxia-induced hypercapnia. Recent clinical data have shown that the deleterious effects of excess oxygen treatment can not only alter carbon dioxide levels (which has been known for more than 60 years) but can also lead to an increase in mortality. Nevertheless, despite the extensive literature, the risks associated with hyperoxia are often overlooked and published clinical recommendations are largely ignored. This failure in knowledge translation has become increasingly important not only because of the desire to reduce medical error, but in a society with limited health care resources, the economic burden of COPD is such that it cannot afford to make preventable medical mistakes. Recently, novel devices have been developed to automatically adjust oxygen flow rates to maintain stable oxygen saturations. These closed-loop oxygen delivery systems have the potential to reduce medical error, improve morbidity and mortality, and reduce health care costs. Preliminary data in this field are promising and will require a significant amount of research in the coming years to determine the precise indications for these systems. The importance of appropriate oxygen dosing and the current literature regarding novel oxygen delivery systems are reviewed.

译文

氧疗可以挽救慢性阻塞性肺疾病 (COPD) 患者的生命,并且是任何急性COPD治疗策略的支柱。尽管在很大程度上被认为是一种良性药物,但许多出版物都强调需要准确调整氧气输送以避免低氧血症和高氧诱导的高碳酸血症的问题。最近的临床数据表明,过量氧气治疗的有害影响不仅会改变二氧化碳水平 (已知已有60多年的历史),还会导致死亡率增加。然而,尽管有大量文献,但与高氧相关的风险经常被忽视,发表的临床建议在很大程度上被忽视。这种知识翻译的失败变得越来越重要,这不仅是因为希望减少医疗错误,而且在医疗资源有限的社会中,COPD的经济负担使它无法承受可预防的医疗错误。最近,已经开发了新颖的设备来自动调节氧气流速以保持稳定的氧气饱和度。这些闭环氧气输送系统具有减少医疗错误,提高发病率和死亡率以及降低医疗保健成本的潜力。该领域的初步数据很有希望,并且在未来几年中将需要大量研究以确定这些系统的确切指示。回顾了适当的氧气剂量的重要性以及有关新型氧气输送系统的当前文献。

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