In: ARDS21 Jan 2013
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 and can lead to an increase in metabolic rate. Additionally, oxidative metabolism may be accelerated by factors that affect mitochondrial metabolism. Uncoupling of oxidative phosphorylation is observed in laboratory animals with chronic bacteremia and endotoxemia, a change that leads to higher resting Vo2 as well as a supply-dependent condition. buy prednisone
Our study supports the hypothesis that inadequate Vo2 relative to demand is characteristic of many patients with ARDS. The association of supply-dependent oxygen utilization and evidence of anaerobic metabolism suggests that these patients may benefit from therapeutic interventions directed at improving the balance between systemic oxygen supply and demand.
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