Does hepato-splanchnic VO2/DO2 dependency exist in critically ill septic patients?
Am J Respir Crit Care Med
; 157(4 Pt 1): 1219-25, 1998 Apr.
Article
de En
| MEDLINE
| ID: mdl-9563742
ABSTRACT
Since the gradient between the mixed venous and hepatic vein oxygen saturation (DSO2) is often increased in septic patients, we suspected these patients may have an imbalance between oxygen supply and demand in the hepato-splanchnic area. In 42 septic patients, hepato-splanchnic blood flow was determined by the indocyanine green clearance method with hepatic vein catheterization. The relationships between hepato-splanchnic oxygen delivery (DO2spla) and consumption (VO2spla) were analyzed during an increase in blood flow induced by a dobutamine infusion at doses up to 10 microg/kg x min. In 14 patients, positive end-expiratory pressure (PEEP) was also increased up to 20 cm H2O. The patients were separated according to their DSO2 (Group I DSO2 < 10%, n = 13; and Group II DSO2 > 10%, n = 29). Although DO2spla increased similarly in both groups, VO2spla only increased in Group II (from 45+/-22 to 59+/-39 ml/min x M2, p < 0.01). The slope of the VO2spla/DO2spla relationship was higher in Group II than in Group I (31.2+/-16.7 versus 10.4+/-5.1%, p < 0.001) and was similar during dobutamine and PEEP (21.9+/-14.2 versus 21.9+/-14.0%, p = NS). In conclusion, VO2spla increased only in septic patients with an increased DSO2 indicating splanchnic dysoxia. The similar slope observed with dobutamine and PEEP suggests that a thermogenic effect was unlikely.
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Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Oxygène
/
Consommation d'oxygène
/
Circulation splanchnique
/
Sepsie
/
Circulation hépatique
Limites:
Female
/
Humans
/
Male
/
Middle aged
Langue:
En
Journal:
Am J Respir Crit Care Med
Sujet du journal:
TERAPIA INTENSIVA
Année:
1998
Type de document:
Article
Pays d'affiliation:
Belgique