EFFECT OF BLOOD-TRANSFUSION ON OXYGEN-CONSUMPTION IN PEDIATRIC SEPTIC SHOCK

Treatment plans for pediatric septic shock advocate increasing oxygen consumption (V̇O2). Recent studies in septic shock indicate that improving oxygen delivery (ḊO2) by increasing blood flow will increase V̇O2. We prospectively examined the effect on V̇O2 of improving ḊO2 by increasing oxygen content (CO2) with blood transfusion in eight hemodynamically stable septic shock patients. Transfusion consisted of 8 to 10 ml/kg of packed RBC over 1 to 2 h. Hemodynamic and oxygen transport measurements were obtained before and after blood transfusion. Transfusion significantly (p < .05) increased Hgb and Hct from 10.2 ± 0.8 g/dl and 30 ± 2% to 13.2 ± 1.4 g/dl and 39 ± 4%, respectively (mean ± SD). ḊO2 significantly (p < .05) increased after transfusion (599 ± 65 to 818 ± 189 ml/min·m2), but V̇O2 did not change (166 ± 68 to 176 ± 74 ml/min·m2; NS). In pediatric septic shock patients, increasing CO2 by blood transfusion may not increase V̇O2.