Document Detail

Low oxygen extraction despite high oxygen delivery causes low oxygen consumption in patients with burns recovering slowly from operative hypothermia.
MedLine Citation:
PMID:  7604378     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Patients with burns who eventually succumbed to their injuries tended to recover more slowly from operative hypothermia than those who survived. Slower recovery was associated with a lower postoperative oxygen consumption (VO2). We have now investigated whether this was due to impairment of oxygen delivery or extraction. METHODS: This study was performed in 13 adult patients with severely burns. One hundred four measurements of VO2 by indirect calorimetry were made during recovery from 23 episodes of operative hypothermia in 11 patients. Sixty-six measurements of oxygen transport variables by balloon-tipped pulmonary artery catheter were made after 17 episodes of operative hypothermia in six patients. Body temperature was monitored in the urinary bladder. RESULTS: The rate of temperature rise (T) showed a strong positive correlation with VO2 measured both by indirect calorimetry (r = 0.91, p < 0.001) and by balloon-tipped pulmonary artery catheter (r = 0.83, p < 0.001). Oxygen delivery (DO2) was above normal in nearly all patients. Oxygen extraction was low in patients recovering slowly (T < 1.0 degree C/hr) and high in those recovering quickly (T > or = 1.0 degree C/hr). During fast recovery VO2 (373 +/- 77 ml.min-1.m-2; mean +/- SD) was approximately three times normal and was independent of DO2. In contrast, a strong linear relationship existed between VO2 and DO2 during slow recovery (r = 0.76, p < 0.001). CONCLUSIONS: Patients with burns with slow recovery from operative hypothermia exhibited impaired oxygen extraction and dependence of VO2 on DO2 over a wide range. This picture resembles that in patients with critical illness.
T Shiozaki; M Ohnishi; O Tasaki; A Hiraide; T Shimazu; T Yoshioka; T Sugimoto
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Surgery     Volume:  118     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  1995 Jul 
Date Detail:
Created Date:  1995-08-07     Completed Date:  1995-08-07     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  44-8     Citation Subset:  AIM; IM    
Department of Traumatology, Osaka University Medical School, Japan.
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MeSH Terms
Burns / mortality,  physiopathology,  surgery*
Debridement* / mortality
Follow-Up Studies
Middle Aged
Oxygen / blood*
Oxygen Consumption*
Regression Analysis
Skin Transplantation* / mortality
Reg. No./Substance:

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