Document Detail


Measurement of tissue perfusion by oxygen transport patterns in experimental shock and in high-risk surgical patients.
MedLine Citation:
PMID:  2289979     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Survivors of high-risk general (noncardiac) surgery were observed to have cardiac index (CI) values averaging 4.5 l/min.m2, oxygen delivery (DO2) of greater than 600 ml/min.m2, and oxygen consumption (VO2) of 170 ml/min.m2. In contrast, these values were relatively normal in patients who subsequently died. A very early predictive index based on these observations was found to predict outcome in 94% of high-risk patients. The hypotheses that increased DO2 and VO2 in the survivors represent compensatory physiologic responses and that these values were appropriate therapeutic goals were tested in prospective randomized clinical trials and found to reduce mortality and morbidity significantly. The optimal goals were more easily attained with colloids, red cells, dobutamine, and vasodilators, according to their capacity to improve tissue perfusion, as reflected by increased flow and oxygen transport. The extremely complex interactions between DO2 and VO2 are reviewed.
Authors:
W C Shoemaker; P L Appel; H B Kram
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Review    
Journal Detail:
Title:  Intensive care medicine     Volume:  16 Suppl 2     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  1990  
Date Detail:
Created Date:  1991-04-03     Completed Date:  1991-04-03     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  S135-44     Citation Subset:  IM    
Affiliation:
Department of Surgery, Martin Luther King, Jr. Hospital Charles R. Drew University, UCLA School of Medicine.
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MeSH Terms
Descriptor/Qualifier:
Animals
Cardiac Output
Disease Models, Animal
Dogs
Female
Humans
Male
Middle Aged
Oxygen / blood*
Oxygen Consumption*
Prospective Studies
Risk Factors
Shock / metabolism*,  physiopathology,  therapy
Surgical Procedures, Operative*
Chemical
Reg. No./Substance:
7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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