常用氧疗方式下新生儿实际吸入氧浓度测定及其临床参考价值OA
Measurement of actual inspired oxygen concentration under common oxygen therapy modalities in neonates and its clinical reference value
目的 在使用空氧混合仪设定吸入氧浓度(FiO2)的条件下,测量不同普通氧疗方式及氧流量对应的新生儿实际吸入FiO2,明确设定值与实际吸入值之间的差异,为临床合理实施氧疗提供参考.方法 采用婴儿模型模拟新生儿氧疗,在箱式吸氧和头罩吸氧条件下,分别设置不同氧流量(箱式:1～9 L/min;头罩:5～9 L/min)及设定FiO2(30％、50％、70％、100％).在供氧条件稳定后,于模型口鼻处测量实际吸入FiO2.结果 箱式吸氧条件下,实际FiO2随氧流量和设定氧浓度增加而升高,但整体明显低于设定值.头罩吸氧条件下,实际FiO2整体高于箱式吸氧,在部分设定条件下呈平台趋势.FiO2偏差分析显示,箱式吸氧在各设定条件下均存在较大偏差,而头罩吸氧偏差相对较小.以FiO2≥30％为参考阈值,箱式吸氧在设定氧浓度为50％、70％、100％时分别需氧流量≥8、5、3 L/min方可达到;头罩吸氧在设定氧浓度为50％、70％、100％时,氧流量5 L/min即可达到.结论 在普通氧疗条件下,即使使用空氧混合仪设定FiO2,不同供氧方式和氧流量仍可导致新生儿实际吸入FiO2与设定值存在明显差异.明确普通氧疗方式下实际FiO2的变化特征,有助于临床在氧疗过程中更准确评估氧暴露水平,合理调节氧流量,降低过度氧疗或供氧不足的风险.
Objective To measure the actual inspired oxygen concentration(FiO2)delivered to neonates under different conventional oxygen therapy modalities and oxygen flow rates when FiO2 was preset using an air-oxygen blender,and to clarify the discrepancy between preset and actual inspired FiO2 values,thereby providing a reference for the rational clinical application of oxygen therapy.Methods A neonatal oxygen therapy simulation was conducted using an infant model.Under oxygen box and head hood oxygen therapy conditions,different oxygen flow rates(oxygen box:1-9 L/min;head hood:5-9 L/min)and preset FiO2 levels(30％,50％,70％,and 100％)were applied.After stabilization of oxygen delivery,the actual inspired FiO2 at the model's nose and mouth was measured.Results Under oxygen box therapy,the actual FiO2 increased with increasing oxygen flow rate and preset oxygen concentration,but remained consist-ently lower than the preset values.Under head hood oxygen therapy,the actual FiO2 was generally higher than that under oxygen box therapy and demonstrated a plateau trend under certain preset conditions.FiO2 deviation analysis showed sub-stantial discrepancies between preset and actual FiO2 values under oxygen box therapy across all settings,whereas devia-tions under head hood oxygen therapy were relatively smaller.Using FiO2 ≥30％as the reference threshold,oxygen box therapy required oxygen flow rates of ≥8,≥5,and ≥3 L/min to achieve this target at preset FiO2 levels of 50％,70％,and 100％,respectively.In contrast,head hood oxygen therapy achieved FiO2 ≥30％at an oxygen flow rate of 5 L/min under all three preset oxygen concentrations(50％,70％,and 100％).Conclusion Under conventional oxygen therapy conditions,even when FiO2 is preset using an air-oxygen blender,different oxygen delivery modalities and oxygen flow rates can result in significant discrepancies between the preset and actual inspired FiO2 in neonates.Understanding the characteristics of actual FiO2 changes under conventional oxygen therapy may help clinicians more accurately assess oxygen exposure,optimize oxygen flow adjustments,and reduce the risks of hyperoxia or insufficient oxygen delivery during neo-natal oxygen therapy.
杨艺佩;黄九龙;王潜;石文静
上海交通大学医学院附属上海市第六人民医院新生儿科(上海 200233)上海交通大学医学院附属上海市第六人民医院新生儿科(上海 200233)上海交通大学医学院附属上海市第六人民医院新生儿科(上海 200233)上海交通大学医学院附属上海市第六人民医院新生儿科(上海 200233)
医药卫生
氧疗吸入氧浓度箱式吸氧头罩吸氧早产儿空氧混合仪
oxygen therapyfraction of inspired oxygenincubator oxygen deliveryhood oxygen deliverypre-term infantsair-oxygen blender
《广东医学》 2026 (6)
833-837,5
国家自然科学基金青年科学基金项目(82101809)上海市第六人民医院医疗集团科研课题(X-3477)
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