Lactate Levels as Predictors of the Relationship between Oxygen Delivery and Consumption in ARDS (1)

In: ARDS

13 Jan 2013

Lactate Levels as Predictors of the Relationship between Oxygen Delivery and Consumption in ARDS (1)Abiphasic relationship between systemic Vo2 and Do2 has been observed in laboratory animals with progressive anemia, hypoxic hypoxia, hypovolemia, and oleic acid pulmonary edema. This relationship is characterized by the transition from a supply-independent to a supply-dependent Vo2 response when Do2 is decreased. Oxygen consumption is constant when Do2 is above a critical or threshold level; however, as Do2 is decreased below a critical level, corresponding decreases in Vo2 are observed. flovent inhaler
This characteristic transition from a supply-independent to a supply-dependent state has not consistently been observed in clinical studies of critically ill patients; for example, in several studies, patients with ARDS appear to exhibit a supply-dependent Vo2 response at all levels of Do2. Clinical investigations of patients with sepsis have also identified subsets of patients who exhibit a supply-dependent relationship; however, other studies of patients with sepsis in which blood lactate levels were measured found contrasting patterns of oxygen utilization when groups with and without elevated lactate concentrations were separately analyzed. Thus, a dependency of Vo2 on changes in Do2 appears to characterize patients with lactic acidosis, while an independent relationship is observed in patients without lactic acidosis. One interpretation of these observations in patients with sepsis is that an oxygen debt, reflected by elevated lactate levels, characterizes patients who exhibit a supply-dependent condition.


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