Factors which increase metabolic demands for oxygen may also precipitate an anaerobic condition and thus lead to supply dependency over a wide range of Do2, including supranormal Do2 levels. These factors may include fever, rigors, seizures, and increased work of breathing. Elevated levels of endogenous and exogenous catecholamines are frequently present in critically ill patients […]
Our findings are consistent with investigations of patients with systemic sepsis. Many patients with ARDS have sepsis as well. The similarity in patterns of systemic oxygen utilization in sepsis and ARDS may also be attributed to similar systemic pathophysiology in both conditions, pathophysiology that may be a characteristic of severe systemic inflammation. asthma inhalers
In several studies of patients with ARDS, a much greater proportion of patients exhibited supply-dependent behavior when compared to the proportion in our study; for example, more than 90 percent of the patients studied by Danek et al and by Powers et al exhibited changes in Vo2 that corresponded to changes in Do2; in our […]
The results of this study confirm that a supply-dependent Vo2 response is characteristic of patients with ARDS and elevated blood lactate concentrations, whereas patients without hyperlactatemia appear to be supply independent with respect to tissue oxygenation. These findings suggest that the pattern of oxygen utilization in ARDS may be biphasic and support the hypothesis that […]
Descriptive features of patients with normal aqd with elevated lactate levels are shown in Table 1. The alveolar-arterial oxygen tension gradient and mortality were significantly higher in the elevated lactate group. A higher proportion of patients in the increased lactate group exhibited a change in Vo2 in the same direction as the change in Do2, […]
Arterial and mixed venous oxygen tensions were measured using standard automated blood gas instrumentation. Hemoglobin concentrations and oxyhemoglobin saturations were measured spectro-photometrically using an automated spectrophotometric oximeter (CO-oximeter). Blood lactate concentrations were determined on iced arterial blood specimens using spectrophotometric or ampe-rometric enzyme assays.
Data from 58 patients from the MICUs of Mount Carmel Mercy Hospital (n = 10), Detroit Receiving Hospital (n = 36), and Harper Hospital (n = 12) were retrospectively reviewed. All patients met criteria for ARDS, including a compatible underlying clinical disorder, an inspired oxygen fraction requirement of at least 0.4 to maintain a Pa02 […]
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