Гипероксия в ОРИТ и что изменилось через 100 лет в тактике использования кислорода в медицине: обзор литературы
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Ключевые слова

кислород
гипоксия
гипероксия
активные формы кислорода

Как цитировать

Орлов ЮП, Говорова НВ, Лукач ВН, Кондратьев АИ, Какуля ЕН, Клементьев АВ, Байтугаева ГА, Глущенко АВ, Цилина СВ, Хиленко ИА Гипероксия в ОРИТ и что изменилось через 100 лет в тактике использования кислорода в медицине: обзор литературы. Вестник интенсивной терапии имени А.И. Салтанова. 2022;(2):80–94. doi:10.21320/1818-474X-2022-2-80-94.

Статистика

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Аннотация

АКТУАЛЬНОСТЬ. Кислород, открытый в XVIII в., является не только необходимым химическим элементом для нормального функционирования клеток и поддержания жизни, но и важным компонентом терапии широкого спектра критических состояний, протекающих с различными вариантами острой дыхательной недостаточности, лежащей в основе развития полиорганной недостаточности. Использование кислорода в медицине — это обязательный инструмент при различных критических ситуациях. ЦЕЛИ ИССЛЕДОВАНИЯ. Осветить в обзоре преимущественно токсические эффекты кислорода, а также существующие данные экспериментальных и фундаментальных исследований о потенцирующей роли гипероксии в процессах активации свободно-радикального окисления, приводящие к избыточному синтезу активных форм кислорода, которые, в свою очередь, являются ведущим фактором в патогенезе любого критического состояния, всегда сопряженного с гипоксией. МАТЕРИАЛЫ И МЕТОДЫ. В обзоре представлены данные экспериментальных исследований, метаанализов, рандомизированных клинических исследований, которые отражают вклад гипероксии в показатели смертности пациентов отделений реанимации и интенсивной терапии при широком спектре критических состояний. ВЫВОДЫ. Поддержание оксигенации тканей путем титрования концентраций кислорода до целевых уровней рО2 и SpO2 на фоне постоянного мониторинга параметров газообмена позволит избежать проявлений токсических эффектов кислорода (гипероксии) в условиях интенсивной терапии критических состояний.

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