[Management of oxygen delivery and consumption during sepsis]
Publisher DOI
PubMed ID
20461314
Abstract
Maintaining an adequate tissue oxygen delivery (DO(2)) and consumption (VO(2)) is crucial in the treatment of septic patients. A fall in V0(2) is associated with a higher mortality. The early recognition of shock or tissue hypo perfusion impacts on patient prognosis. In occasions, hypovolemia or important regional oxygen debts are not recognized, since macro homodynamic variables have been compensated. In this situation, the use of metabolic hypo perfusion markers such as lactate, central venous oxygen saturation and gastric goniometry, can be helpful. However, interpretation of these markers should be cautious and always considering the overall clinical status of the patient. In the initial stages of sepsis, the dependency of V0(2) on DO(2) predominates as histopathological mechanism of multiple organic failure. In late stages, other factors predominate as determinants of multiple organic failure and mortality, such as hyper or hypo immune response, microcirculatory alterations and cytopathic hypoxia.
Date Issued
2010
Publication Type
Article
Subject(s)
Author(s)
Regueira, Tomas Emilio | |
Andresen, Max |
Journal
Revista médica de Chile
Publisher
Sociedad Médica de Santiago
ISSN
0034-9887
Access(Rights)
metadata.only