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首页> 外文期刊>COPD: Journal of Chronic Obstructive Pulmonary Disease >Time to steady state after changes in FIO2 in patients with COPD
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Time to steady state after changes in FIO2 in patients with COPD

机译：COPD患者FIO2改变后达到稳定状态的时间

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Background: International guidelines recommend that when changing FIO2 in patients with COPD receiving Long-Term Oxygen Therapy (LTOT), 30 minutes should be waited for steady state before measurement of arterial blood gasses. This study evaluates whether 30 minutes is really necessary, as a smaller duration might improve the logistics of care, potentially reducing the time spent by patients at the out-patient clinic. Methods: 12 patients with severe to very severe COPD according to the GOLD guidelines were included. Patients had a median FEV1% of 23% of the predicted value (range 15-64%), median FEV1/FVC 0.43 (range 0.26-0.63), and chronic respiratory failure necessitating LTOT, 1-4 liters/minute, minimum 16 hours/day. Following a FIO2 reduction (wash out), arterial blood gases were measured at 0, 1, 2, 4, 8, 12, 17, 22, 32 and 34 minutes. FIO2 was then increased to baseline levels (wash in) and blood gasses measured at 0, 1, 2, 4, 8, 12, 17, 22, 32, and 34 minutes. Data were analyzed to examine the dynamics of arterial PO2 and saturation (SO2) wash out and wash in by calculating the time constants, tau (?), and to evaluate the time required to reach values which might be considered clinically stable, defined as PO2 within 0.5 kPa and SO2 within 1% of equilibrium values. Results: For arterial PO2 values of time constants were about 3 minutes and similar for both wash out and wash in. A median of 5 minutes was required to reach clinically stable values of PO2 in both wash out and wash in, with 7-8 minutes sufficient in 75% of patients, and in the worst case 14 minutes. For SO2, values of the time constant were 4.5 and 1.4 minutes for wash out and wash in, respectively. The time required to reach clinically stable values was different in the two phases. For wash out the median time was 7.4 minutes, and in the worst case 15.6 minutes. For wash in the median time was 2.6 minutes and in worst case 6.8 minutes. No significant changes in PCO2 or pH were seen during FIO2 changes. Discussion/Conclusion: This study shows that oxygen equilibration relevant for clinical interpretation requires only 10 minutes following an increase and 16 minutes following a decrease in FIO2. over the range studied.
机译：背景：国际指南建议，在接受长期氧气疗法（LTOT）的COPD患者中更改FIO2时，应等待30分钟直至达到稳态，然后再测量动脉血气。这项研究评估了是否真的需要30分钟，因为更短的持续时间可能会改善护理的后勤状况，从而可能减少患者在门诊诊所所花费的时间。方法：根据GOLD指南，包括12例重度至极重度COPD患者。患者的中值FEV1％为预测值的23％（范围15-64％），中值FEV1 / FVC 0.43（范围0.26-0.63）和需要LTOT的慢性呼吸衰竭，需要1-4升/分钟，至少16小时/天。 FIO2降低（冲洗）后，在0、1、2、4、8、12、17、22、32和34分钟时测量动脉血气。然后将FIO2增加至基线水平（冲入），并在0、1、2、4、8、12、17、22、32和34分钟时测量血气。通过计算时间常数tau（？）来分析数据以检查动脉PO2和饱和度（SO2）冲洗和冲洗的动力学，并评估达到可能被认为是临床稳定的值（定义为PO2）所需的时间0.5 kPa以内，SO2平衡值的1％以内。结果：对于动脉PO2而言，时间常数约为3分钟，在冲洗和冲洗过程中相似，大约需要5分钟才能在7-8分钟内达到临床稳定的PO2在冲洗和冲洗过程中的平均值。在75％的患者中足够，最坏的情况是14分钟。对于SO2，洗出和洗入的时间常数分别为4.5分钟和1.4分钟。在两个阶段中，达到临床稳定值所需的时间有所不同。对于冲洗，中位时间为7.4分钟，在最坏的情况下为15.6分钟。清洗的中位时间为2.6分钟，最坏的情况为6.8分钟。在FIO2变化期间，未观察到PCO2或pH的显着变化。讨论/结论：这项研究表明，与FIO2升高相比，与临床解释相关的氧平衡仅需要10分钟，而在FIO2降低之后仅需要16分钟。在研究范围内。

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