medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2024-477medsovet-8667Research ArticleХРОНИЧЕСКИЕ ЗАБОЛЕВАНИЯ ЛЕГКИХCHRONIC PULMONARY DISEASESДлительная кислородотерапия при хронической дыхательной недостаточностиLong-term oxygen treatment in chronic respiratory failurehttps://orcid.org/0000-0002-4726-4906НуралиеваГ. С.NuralievaG. S.

Нуралиева Галиа Сериковна - к.м.н., доцент кафедры пульмонологии, ПМГМУ им. И.М. Сеченова (Сеченовский Университет); научный сотрудник лаборатории интенсивной терапии и дыхательной недостаточности, НИИ пульмонологии ФМБА.

119048, Москва, ул. Трубецкая, д. 8, стр. 2; 115682, Москва, Ореховый бульвар, д. 28

Galiya S. Nuralieva - Cand. Sci. (Med.), Associate Professor, Department of Pulmonology, Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University); Researcher, Laboratory of Intensive Therapy and Respiratory Failure, Research Institute for Pulmonology of the Federal Medical Biological Agency.

8, Bldg. 2, Trubetskaya St., Moscow, 119991; 8, Orekhovy Boulevard, Moscow, 115682

galia32@yandex.ruhttps://orcid.org/0000-0002-1314-0091ШмидтА. Е.ShmidtA. E.

Шмидт Анна Евгеньевна - ассистент кафедры пульмонологии.

119048, Москва, ул. Трубецкая, д. 8, стр. 2

Anna E. Shmidt - Assistant, Department of Pulmonology, Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University).

8, Bldg. 2, Trubetskaya St., Moscow, 119991

a_e_schmidt@mail.ruhttps://orcid.org/0000-0002-2070-3497АвдеевИ. С.AvdeevI. S.

Авдеев Иван Сергеевич - студент института клинической медицины.

119048, Москва, ул. Трубецкая, д. 8, стр. 2

Ivan S. Avdeev - Student, Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University).

8, Bldg. 2, Trubetskaya St., Moscow, 119991

ivan.avdeev@list.ruhttps://orcid.org/0000-0002-9509-0867НеклюдоваГ. В.NekludovaG. V.

Неклюдова Галина Васильевна - д.м.н., профессор кафедры пульмонологии, ПМГМУ им. И.М. Сеченова (Сеченовский Университет); ведущий научный сотрудник лаборатории функциональных и ультразвуковых методов исследования, НИИ пульмонологии ФМБА.

119048, Москва, ул. Трубецкая, д. 8, стр. 2; 115682, Москва, Ореховый бульвар, д. 28

Galina V. Nekludova - Dr. Sci. (Med.), Professor, Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University); Research Institute for Pulmonology of the Federal Medical Biological Agency.

8, Bldg. 2, Trubetskaya St., Moscow, 119991; 8, Orekhovy Boulevard, Moscow, 115682

nekludova_gala@mail.ruПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет); Научно-исследовательский институт пульмонологии Федерального медико-биологического агентстваРоссияSechenov First Moscow State Medical University (Sechenov University); Research Institute for Pulmonology of the Federal Medical Biological AgencyRussian FederationПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian Federation2024081120240209299Copyright © Нуралиева Г.С., Шмидт А.Е., Авдеев И.С., Неклюдова Г.В., 20242024Нуралиева Г.С., Шмидт А.Е., Авдеев И.С., Неклюдова Г.В.Nuralieva G.S., Shmidt A.E., Avdeev I.S., Nekludova G.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/8667

Хроническая дыхательная недостаточность (ХДН) является ведущей причиной летальности пациентов с бронхолегочными заболеваниями. Одним из ключевых методов лечения ХДН является длительная кислородотерапия (ДКТ). Основная цель ДКТ заключается в улучшении качества жизни, повышении физической работоспособности, снижении частоты обострений и летальности пациентов. Рекомендуется применять кислородотерапию не менее 15-16 ч в день, а при отсутствии эффекта увеличить это время до 24 ч. Показания к ДКТ уже долгое время остаются неизменными. Решение вопроса о назначении ДКТ должно основываться на трехкратных результатах газового состава артериальной крови, причем оценка параметров газообмена может быть произведена только после стабилизации состояния (3-4 нед. после обострения). Также стоит учитывать возможность наличия у пациентов гиперкапнии и вероятность усугубления состояния пациента за счет кислород-индуцированной гиперкапнии и респираторного ацидоза. Несмотря на наличие многочисленных исследований, касающихся применения ДКТ, большинство из них было проведено на пациентах с ХОБЛ, что создает необходимость в более глубоком изучении эффективности данного метода у пациентов с другими заболеваниями. Применение длительной кислородотерапии оказывает положительное влияние на качество жизни, физическую работоспособность, частоту обострений, госпитализаций и выживаемость пациентов. Существуют различные способы доставки кислорода, что позволяет использовать ДКТ не только в состоянии покоя, но и при передвижении пациента на большие расстояния. Важно отметить, что помимо назначения ДКТ пациентам необходимо изменить образ жизни, а именно отказаться от курения, и получать адекватную лекарственную терапию основного заболевания.

Chronic respiratory failure (CRF) is the leading cause of mortality in patients with pulmonary diseases. One of the key treatments for CRF is long-term oxygen therapy (LTOT). The main purpose of LTOT is to improve the quality of life, increase physical performance, reduce the frequency of exacerbations and mortality of patients. It is recommended to use oxygen therapy for at least 15-16 hours a day, and if there is no effect, increase this time to 24 hours. Indications for LTOT have remained unchanged for a long time. The decision on the appointment of LTOT should be based on three-fold results of the gas composition of arterial blood, and the assessment of gas exchange parameters can be made only after stabilization of the condition (3-4 weeks after exacerbation). It is also worth considering the possibility of hypercapnia in patients and the likelihood of aggravation of the patient's condition due to oxygen-induced hypercapnia and respiratory acidosis. Despite the existence of numerous studies concerning the use of LTOT, most of them have been conducted on patients with COPD, which creates the need for a deeper study of the effectiveness of this method in patients with other diseases. The use of long-term oxygen therapy has a positive effect on the quality of life, physical performance, the frequency of exacerbations, hospitalizations and patient survival. There are various methods of oxygen delivery, which allows the use of LTOT not only at rest, but also when moving the patient over long distances. It is important to note that in addition to prescribing LTOT, patients need to change their lifestyle, stop smoking, and receive adequate drug therapy for the underlying disease.

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The authors declare that there are no conflicts of interest present.