ABSTRACT

Lowering oxygen deliver may cause irreversible damage to organs with great metabolic demands (i.e. Heart and brain). Increasing the systemic oxygen transport (i.e. exercise tachycardia) is an important mechanism to revert tissue hypoxia. Perhaps increasing oxygen delivery may improve the cellular oxygenation and the changes during exercise supports this hypothesis; but there are contradictory reports with increased mortality using supernormal oxygen transport. Failure to achieve regular oxygen delivers to cell in critical illness by increasing the oxygen transport is because of many other mechanisms as microvascular control and cell bioenergetics.

KEYWORDS

Oxygen transport, tissue hypoxia, oxygen deliver, oxygen consumption.

REFERENCES

1. Alia I, Esteban A, Gordo F, et al. A randomized and controlled trial of the effect of treatment aimed at maximizing oxygen delivery in patients with severe sepsis or septic shock. Chest 1999; 115: 453-461.

2. Bacher A, Mayer N, Rajek AM. Acute normovolaemic haemodilution does not aggravate gastric mucosal acidosis during cardiac surgery. Intensive Care Med 1998; 24: 313-321.

3. Bakker J, Gris P, Coffernils M, et al. Serial blood lactate levels can predict the development of multiple organ failure following septic shock. Am J Surg 1996; 171: 221-226.

4. Banner TE. Invasive cardiac output measurement technology. In: Civetta JM, Taylor RW, Kirby RR: Critical Care. 2nd Ed. Edit. Philadelphia, JB Lippincott, 1992: 271-282.

5. Barquist E, Kirton O, Windsor J, et al. The impact of antioxidant and splachnic-directed therapy on persistent uncorrected gastric mucosal pH in the critically injured trauma patient. J Trauma 1998; 44: 355-360.

6. Bernardin G, Pradier C, Tiger F, et al. Blood pressure and arterial lactate level are early indicators of short-term survival in human septic shock. Intensive Care Med 1996; 22: 17-25.

7. Bihari D, Smithies M, Gimson A, et al. The effects of vasodilation with prostacyclin on oxygen delivery and uptake in critically ill patients. N Engl J Med 1987; 317: 397-403.

8. Boyd O, Grounds M, Bennett M, et al. The dependency of oxygen consumption on oxygen delivery in postoperative patients is mimicked by variations in sedation. Chest 1992; 101: 1619-1624.

9. Bowton D, Scuderi P. Monitoring of mixed venous saturation. In: Tobin MJ. Principles and Practice of Intensive Care Monitoring. Edit McGraw-Hill 1998: 303-315.

10. Chittock DR, Ronco J, Russell JA. Monitoring of oxygen transport and oxygen consumption. In: Tobin MJ. Principles and Practice of Intensive Care Monitoring. Edit McGraw-Hill 1998: 317-343.

11. Choi PT, Yip G, Quiñonez L, et al. Crystalloid vs colloids in fluid resuscitation : A systematic review. Crit Care Med 1999; 27: 200-210.

12. Cochrane Injuries Group Albumin Reviewers: Human albumin administration in critically ill patients: Systematic review of randomized controlled trials. BMJ 1998; 317: 223-224, 235-240.

13. Elizalde JI, Hernández G, Llach J, et al. Gastric intramucosal acidosis in mechanically ventilated patients: Role of mucosal blood flow. Crit Care Med 1998; 26: 827-832.

14. Dantzker D. Transporte y utilización de oxígeno. En: Kvetan V, Dantzker D, editores. Cuidados intensivos cardiopulmonares. México; McGraw-Hill; 1999;735.

15. Doglio GR, Pusajo JF, Egurrola MA, et al. Gastric mucosal pH as a prognostic index of mortality in critically ill patients. Crit Care Med 1991; 19: 1037-1040.

16. Douzinas E, Tsidemiadou P, Pitaridis M, et al. The regional production of cytokines and lactate in sepsis-related multiple organ failure. Am J Respir Crit Care Med 1997: 155: 53-59.

17. Danek SJ, Lynch JP, Weg JG, et al. The dependence of oxygen uptake on oxygen delivery in the adult respiratory distress syndrome. Am Rev Respir Dis 1980; 122: 387-395.

18. Ernest D, Belzberg AS, Dodek PM, et al. Distribution of normal saline and 5% albumin infusion in septic patients. Crit Care Med 1999; 27: 46-50.

19. Wells H, Blajchman MA, Marshall J, et al. A multicenter, randomized controlled clinical trial of transfusion requirements in critical care. N Engl J Med 1999; 340: 409-417.

20. Tighe D, Moss R, Heywood G, et al. Goal-directed therapy with dopexamine, dobutamine, and volume expansion: Effects of systemic oxygen transport on hepatic ultrastructure in porcine sepsis. Crit Care Med 1995; 23: 1997-2007.

21. Kern JW, Shoemaker WC. Meta-analysis of hemodynamic optimization in high-risk patients. Crit Care Med 2002; 30: 1686-1692.

22. Stratton H, Feustel P, Newell J. Regression of calculated variables in the presence of shared measurement error. J Appl Physiol 1987; 62: 2083-2093.

23. Hottchkiss RS, Karl IE. Reevaluation of the role of cellular hypoxia and bioenergetic failure in sepsis. JAMA 1992; 267: 1503-1510.

24. Hébert PC, Szick S. The anemic patient in the intensive care unit. How much does the heart tolerate? Curr Opin Care 2000; 6: 372-380.

25. Aird WC. The hematologic system as a marker of organ dysfunction in sepsis. Mayo Clin Proc 2003; 78: 869-881.

26. Marik PE, Sibbald WJ. Effect of stored blood transfusion on oxygen delivery in patients with sepsis. JAMA 1993; 269:3024-3029.

27. Bishop MH, Shoemaker WC, Appel PL, et al. Prospective, randomized trial of survivor values of cardiac index, oxygen delivery, and oxygen consumption as resuscitation endpoints in severe trauma. J Trauma Injury Infect Crit Care 1995; 38: 780-787.

28. Velmahos GC, Demetriades D, Shoemaker WC, et al. Endpoints of resuscitation of critically injured patients: normal or supranormal? Ann Surg 2000; 232: 409-418.

29. Heyland DK, Cook DJ, King D, et al. Maximizing oxygen delivery in critically ill patients: A methodologic appraisal of the evidence. Crit Care Med 1996; 24: 517-524.

30. Kern JW, Shoemaker WC. Meta-analysis of hemodynamic optimization in high-risk patients. Crit Care Med 2002; 30: 1686-1692.