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


15 Jan 2013

Lactate Levels as Predictors of the Relationship between Oxygen Delivery and Consumption in ARDS: Materials and Methods (1)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 of greater than 70 mm Hg, and radiographic evidence of diffuse bilateral pulmonary infiltrates. In addition, all patients included in the study were monitored by percutaneously placed pulmonary artery catheters and either femoral or radial artery catheters. To exclude patients with respiratory failure secondary to left ventricular dysfunction of hypervolemia, those with a pulmonary artery wedge pressure greater than 18 mm Hg were excluded from analysis. buy diabetes drugs
The interventions that we assessed included rapid intravenous fluid infusions, packed red blood cell transfusions, and the addition of PEEP. Because the MICUs participating in this study employ routine clinical protocols to evaluate patients receiving major therapeutic interventions, it was possible to record hemodynamic and systemic oxygen utilization data before (within 1 hour) and after (within 6 hours) the previously mentioned interventions. Accordingly, simultaneous measurements of Pa02, Pv02, SaOz, Sv02, Hb, and blood lactate levels and the mean of triplicate thermodilution determinations of cardiac output were obtained. The Cl, Ca02, Cv02, Vo2, and Do2 were calculated as follows:
Ca02 (ml/dl) = (1.39 x Hb X SaOJ + (0.0031 x PfciO*)
CvOa (ml/dl) = (1.39 x Hb x SvOJ + (0.0031 x PvO*)
Cl (L/min/m2) = cardiac output/body surface area
Do2 (ml/min/m2) = Cl X Ca02 x 10
Vo2 (ml/min/m2) = Cl x (Ca02 — CvOJ x 10

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