PMID: 9539067Apr 16, 1998Paper

Oxygen supply dependency can characterize septic shock

Intensive Care Medicine
G FriedmanJ L Vincent

Abstract

To demonstrate that oxygen consumption (VO2) can be dependent on oxygen delivery (DO2) during hemodynamic instability and independent of DO2 following stabilization. We retrospectively reviewed hemodynamic and blood gas data collected from ten patients in whom DO2 was acutely altered during an episode of septic shock (phase A) and after recovery from this episode (phase B). General intensive care unit of a university hospital. 10 critically ill adult patients (aged 55 +/- 19 years). DO2 was altered by fluid challenge, administration of vasoactive agents, or application of positive end-expiratory pressure. In phase A, changes in VO2 (121 +/- 32 vs 165 +/- 36 ml/min.m2; p < 0.001) paralleled changes in DO2 (415 +/- 153 vs 607 +/- 217 ml/min.m2; p < 0.001), but oxygen extraction (O2ER) remained stable (31.9 +/- 11.2 vs. 30.2 +/- 8.9%; NS). In phase B, changes in DO2 (412 +/- 118 vs 526 +/- 152 ml/min.m2; p < 0.001) were associated with opposite changes in O2ER (36.1 +/- 4.2 vs 28.9 +/- 4.9%; p < 0.001), and VO2 was unchanged (147 +/- 35 vs 149 +/- 33 ml/min.m2; NS). The mean VO2/DO2 slope was greater in phase A than in phase B (0.26 +/- 0.09 vs. 0.08 +/- 0.08; p < 0.004). Blood lactate levels were higher in phase A than in phase B...Continue Reading

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Citations

Jul 10, 2007·Intensive Care Medicine·Jan Bakker, Tim C Jansen
Apr 16, 1998·Intensive Care Medicine·G FriedmanJ L Vincent
May 15, 2013·Annals of Intensive Care·Jan BakkerTim C Jansen
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