ID 原文 译文
1047 建议维持氧饱和度目标SpO293%-96%。若合并慢性II型呼吸衰竭,降低氧饱和度目标至SpO288%-92%;日常活动下SpO2频繁降至85%以下时,提高氧浓度至92%-95%,监测PaCO2水平。 The treatment goal of oxygen therapy is to maintain the oxygen saturation (SpO2) at 93%-96% for patients without chronic pulmonary disease and at 88%-92% for patients with chronic type II Respiratory failure. Specially, the oxygen concentration should be increased to 92%-95% for patients whose SpO2 drops below 85% frequently during daily activities.
1048 4)控制性氧疗 4) Control oxygen therapy
1049 PaO2 /FiO2 是比较准确的评价氧合功能指标。 PaO2/FiO2 is a sensitive and accurate indicator of oxygenation function.
1050 若病情进展、PaO2 /FiO2<300mmHg的患者,FiO2的稳定性、可监测性非常重要。 The stability and monitorability of FiO2 are very important for patients with disease progression and PaO2/FiO2 below 300 mmHg.
1051 推荐首选控制性氧疗。 Controlled oxygen therapy is the preferred treatment.
1052 静息状态下SpO2 <93%、PaO2 /FiO2 <300mmHg(1mmHg=0.133kPa)、呼吸频率>25次/min或影像学表现进展明显时,建议给予高流量吸氧(HFNC),患者佩戴外科口罩。 High-flow nasal cannula (HFNC) oxygen therapy is recommended for patients with the following conditions: SpO2< 93%; PaO2/FiO2< 300 mmHg (1 mmHg = 0.133 kPa); Respiratory rate > 25 times per min at bed; or remarkable progression on X-ray imaging. Patients should wear a surgical mask during HFNC treatment.
1053 对于PaO2/FiO2介于200-300mmHg且患者无明显胸闷气促主诉时,HFNC的气流量应从低水平开始,逐渐达到40-60L/min。 The air flow of HFNC oxygen therapy should star t at a low level and gradually increased up to 40-60 L/min when PaO2 is between 200-300 mmHg so that patients do not feel obvious chest tightness and shortness of breath.
1054 对于明显呼吸窘迫的患者,可直接给予60L/min的初始流量。 An initial flow of at least 60 L/min should be given immediately for patients with obvious respiratory distress.
1055 部分患者氧合指数较低(<100mmHg),但一般情况较好,对于这部分患者是否立即行气管插管,最重要的是关注原发病进展状况,综合评估患者全身状态、代偿能力及疾病发展趋势。 Tracheal intubation for patients is dependent on disease progression, systemic status and complication of patients for those with stable situation but with a low oxygenation index (<100 mmHg). Thus, detailed evaluations of the clinical condition of patients is very important before decision making.
1056 如果HFNC高流量(60L/min)高浓度吸入(>60%)1-2小时内患者氧合指数持续降低(<150mmHg)或呼吸窘迫症状明显加重或合并其他脏器功能不全,尽早气管插管。 Tracheal intubation should be per formed as early as possible for patients with an oxygenation index less than 150 mmHg, worsening symptoms of Respiratory distress or multiple organ dysfunction within 1-2 hours after high-flow (60 L/min) and high-concentration (> 60%) HFNC oxygen therapy.