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目的研究实际吸入氧浓度(inspired oxygen concentration,FiO_2)的变异大小及各种影响因素对其的影响程度。方法选择健康对照者及中.重度慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)急性加重期稳定后患者各8例,经双腔鼻导管吸氧,均按单纯常规吸氧与连接流量计测量呼吸参数两种情况下进行,随机调节给氧流量为1,2,3,4,5 L/min,气体平衡后随机模拟加快吸气速度、减慢吸气速度及平静呼吸等3种呼吸模式,采用旁流顺磁法测量氧浓度。结果单纯常规吸氧时,健康对照组的FiO_2影响因素影响程度大小的岭回归分析结果为给氧流量、吸气时间与呼吸周期时间比值(inspiratory time/respiratory cycle time,Ti/Ttot)及呼吸频率(respiratory frequency,RR)对FiO_2的影响程度较大。在COPD组,给氧流量及RR的影响程度较大。连接流量计测量呼吸参数后,在健康对照组,给氧流量、潮气量(tidal volume,V_T)、RR、吸气峰流速(peak inspirator flow,PIF)及平均吸气流速(mean inspiratory flow,MIF)对FiO_2的影响程度较大。COPD组的给氧流量、V_T、Ti/Ttot及PIF的影响程度较大。结论实际FiO_2受多种因素影响,其影响程度大小的分析结果显示,强影响因素:给氧流量;较强影响因素:V_T;中影响因素;RR、PIF及Ti/Ttot;弱影响因素:MIF、吸气时间(inspiratory time,Ti)及吸呼比(inspiratory time/expiratory time,I:E)。
Objective To study the variation of actual inspired oxygen concentration (FiO_2) and the influence of various influencing factors on it. Methods Eight healthy controls and 8 patients with stable chronic obstructive pulmonary disease (COPD) exacerbation were enrolled in this study. Oxygen inhalation was given via double-lumen nasal cannula, Measurement of respiratory parameters were carried out in two cases, and the oxygen flow rate was adjusted randomly to 1, 2, 3, 4, 5 L / min. Stochastic simulation after gas balance accelerated the inspiratory rate, slowed down the inspiratory rate and calm breathing Mode, using paramagnetic paramagnetic method to measure oxygen concentration. Results In the conventional oxygen inhalation alone, the ridge regression analysis of FiO_2 influencing factors of healthy control group showed the ratio of oxygen flow rate, inspiratory time / respiratory cycle time (Ti / Ttot) and respiratory rate (respiratory frequency, RR) on FiO_2 a greater extent. In the COPD group, oxygen flow and RR were greater. After connecting the flowmeter to measure the respiratory parameters, the oxygen flow rate, tidal volume (V_T), RR, peak inspirator flow (PIF) and mean inspiratory flow (MIF ) Has a greater impact on FiO_2. COPD group oxygen flow, V_T, Ti / Ttot and PIF greater impact. Conclusions The actual FiO_2 is influenced by many factors. The analysis of the influence of FiO_2 shows that the most influential factors are the oxygen flux, the stronger influencing factors, the influencing factors of V_T, the RR, PIF and Ti / Ttot, and the weak influencing factors of MIF , Inspiratory time (Ti) and inspiratory time / expiratory time (I: E).