THE DEPENDENCY OF OXYGEN-CONSUMPTION ON OXYGEN DELIVERY IN CRITICALLY ILL POSTOPERATIVE-PATIENTS IS MIMICKED BY VARIATIONS IN SEDATION

被引:35
作者
BOYD, O
GROUNDS, M
BENNETT, D
机构
[1] General Intensive Care, St George's Hospital, London
关键词
D O I
10.1378/chest.101.6.1619
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
The finding of a dependence of oxygen consumption on oxygen delivery in critically ill patients has encouraged interventions to increase oxygen delivery index (DO2I) to overcome tissue hypoxia. In individuals other factors may influence oxygen consumption index (VO2I) and DO2I and may cause an apparently dependent relationship. We studied the effects of sedation and temperature on the VO2I/DO2I relationship in 13 perioperative patients. Pooled data showed significant correlations between VO2I and DO2I (r>0.6,p<0.05) but also between VO2I and sedation score (r>0.7,p<0.05), but not VO2I and temperature (r<0.5). When VO2I was standardized for the effects of sedation score (SS), the relationship between VO2I and DO2I was lost (r<0.5). Seven of 13 patients had significant (p<0.05) correlations between VO2I and SS and six of 13 between VO2I and DO2I; when standardized for the effect of varying sedation, no relationships were significant. When interpreting oxygen transport data from critically ill patients, the effects of sedation but not temperature must be taken into account; otherwise a false impression of a dependent relationship between VO2I and DO2I may cause unnecessary treatment.
引用
收藏
页码:1619 / 1624
页数:6
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共 34 条
[21]  
RODRIGUEZ JL, 1983, CRIT CARE MED, V11, P490
[22]   MORPHINE AND POSTOPERATIVE REWARMING IN CRITICALLY ILL PATIENTS [J].
RODRIGUEZ, JL ;
WEISSMAN, C ;
DAMASK, MC ;
ASKANAZI, J ;
HYMAN, AI ;
KINNEY, JM .
CIRCULATION, 1983, 68 (06) :1238-1246
[23]   OXYGEN-CONSUMPTION IS INDEPENDENT OF CHANGES IN OXYGEN DELIVERY IN SEVERE ADULT RESPIRATORY-DISTRESS SYNDROME [J].
RONCO, JJ ;
PHANG, PT ;
WALLEY, KR ;
WIGGS, B ;
FENWICK, JC ;
RUSSELL, JA .
AMERICAN REVIEW OF RESPIRATORY DISEASE, 1991, 143 (06) :1267-1273
[24]  
ROUBY JJ, 1981, CIRCULATION, V64, P530
[25]   CRITICAL-LEVEL OF OXYGEN DELIVERY IN ANESTHETIZED MAN [J].
SHIBUTANI, K ;
KOMATSU, T ;
KUBAL, K ;
SANCHALA, V ;
KUMAR, V ;
BIZZARRI, DV .
CRITICAL CARE MEDICINE, 1983, 11 (08) :640-643
[26]   PROSPECTIVE TRIAL OF SUPRANORMAL VALUES OF SURVIVORS AS THERAPEUTIC GOALS IN HIGH-RISK SURGICAL PATIENTS [J].
SHOEMAKER, WC ;
APPEL, PL ;
KRAM, HB ;
WAXMAN, K ;
LEE, TS .
CHEST, 1988, 94 (06) :1176-1186
[27]   OXYGEN-TRANSPORT MEASUREMENTS TO EVALUATE TISSUE PERFUSION AND TITRATE THERAPY - DOBUTAMINE AND DOPAMINE EFFECTS [J].
SHOEMAKER, WC ;
APPEL, PL ;
KRAM, HB .
CRITICAL CARE MEDICINE, 1991, 19 (05) :672-688
[28]   24-HOUR ENERGY-EXPENDITURE IN CRITICALLY ILL PATIENTS [J].
SWINAMER, DL ;
PHANG, PT ;
JONES, RL ;
GRACE, M ;
KING, EG .
CRITICAL CARE MEDICINE, 1987, 15 (07) :637-643
[29]  
TUCHSCHMIDT J, 1991, CRIT CARE MED, V19, pS66
[30]   INDEPENDENT OXYGEN-UPTAKE AND OXYGEN DELIVERY IN SEPTIC AND POSTOPERATIVE-PATIENTS [J].
VERMEIJ, CG ;
FEENSTRA, BW ;
ADRICHEM, WJ ;
BRUINING, HA .
CHEST, 1991, 99 (06) :1438-1443