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Circulation

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Multiple Organ Failure

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Abstract

The circulation is perhaps not always thought of as an individual organ and, indeed, is not a compact, well defined structure as are many other organs, such as the heart, liver, kidney, and brain. Instead, it is composed of some 60,000 miles of vessels of various size, capacity, and function. Together these vessels form a unique organ that provides the body with the means of transporting oxygen, nutrients, and waste products around the body. The circulation thus functions to maintain an appropriate environment in all tissues for optimal cellular activity and survival; and efficient and effective circulatory function is essential for normal body function. In fact, the circulation could perhaps be considered the most important organ in the development of multiple organ failure, as its function is vital for the normal function of all other organs; if the circulation fails, everything fails. This chapter discusses the various causes of circulatory failure and the available therapeutic interventions used to treat it.

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References

  1. Vincent JL, Preiser JC, Friedman G, et al: Endothelial cell function in the critically ill. In: Reinhart K, Eyrich K, Sprung C (eds) Sepsis: Current Perspectives in Pathophysiology and Therapy. Heidelberg, Springer, 1994; 174–180.

    Google Scholar 

  2. Vincent JL, Dufaye P, Berre J, et al: Serial lactate determinations during circulatory shock. Grit Care Med 1983; 11: 449–451.

    Article  CAS  Google Scholar 

  3. Manilas P, Jankowski S, Zhang H, et al: Correlation of serial blood lactate levels to organ failure and mortality after trauma. Am J Emerg Med 1995; 13: 619–622.

    Article  Google Scholar 

  4. Bakker J, Gris P, Coffernils M, et al: Serial blood lactate levels can predict the development of multiple organ failure following septic shock. Am J Surg 1996; 171: 221–226.

    Article  PubMed  CAS  Google Scholar 

  5. Cain SM, Adams RP: Appearance of excess lactate in anesthetized dogs during anemic and hypoxic hypoxia. Am J Physiol 1965; 209: 604–608.

    PubMed  CAS  Google Scholar 

  6. Bakker J, Vincent JL: The oxygen supply dependency phenomenon is associated with increased blood lactate levels. J Crit Care 1991; 6: 152–159.

    Article  Google Scholar 

  7. Ronco JJ, Fenwick JC, Tweeddale MG, et al: Identification of the critical oxygen delivery for anaerobic metabolism in critically ill septic and nonseptic humans. JAMA 1993; 270: 1724–1730.

    Article  PubMed  CAS  Google Scholar 

  8. Nelson DP, Samsel RW, Wood LD, et al: Pathological supply dependency of systemic and intestinal O2 uptake during endotox-emia. J Appl Physiol 1988; 64: 2410–2419.

    PubMed  CAS  Google Scholar 

  9. Zhang H, Vincent JL: Oxygen extraction is altered by endotoxin during tamponade-induced stagnant hypoxia in the dog. Circ Shock 1993; 40: 168–176.

    PubMed  CAS  Google Scholar 

  10. Phang PT, Cunningham KF, Ronco JJ, et al: Mathematical coupling explains dependence of oxygen consumption on oxygen delivery in ARDS. Am J Respir Crit Care Med 1994; 150: 318–323.

    Article  PubMed  CAS  Google Scholar 

  11. Vincent JL, De Backer D: Oxygen uptake/oxygen supply dependency: fact or fiction? Acta Anaesthesiol Scand Suppl 1995; 107: 229–237.

    Article  PubMed  CAS  Google Scholar 

  12. Hankeln KB, Gronemeyer R, Held A, et al: Use of continuous noninvasive measurement of oxygen consumption in patients with adult respiratory distress syndrome following shock of various etiologies. Crit Care Med 1991; 19: 642–649.

    Article  PubMed  CAS  Google Scholar 

  13. De Backer D, Moraine JJ, Berre J, et al: Effects of dobutamine on oxygen consumption in septic patients: direct vs indirect determinations. Am Rev Respir Grit Care Med 1994; 150: 95–100.

    Article  Google Scholar 

  14. Vincent JL, Roman A, De Backer D, et al: Oxygen uptake/supply dependency: effects of short-term dobutamine infusion. Am Rev Respir Dis 1990; 142: 2–8.

    Article  PubMed  CAS  Google Scholar 

  15. Kruse JA, Haupt MT, Puri VK, et al: Lactate levels as predictors of the relationship between oxygen delivery and consumption in ARDS. Chest 1990; 98: 959–962.

    Article  PubMed  CAS  Google Scholar 

  16. Silance PG, Simon C, Vincent JL: The relation between cardiac index and oxygen extraction in acutely ill patients. Chest 1994; 105: 1190–1197.

    Article  PubMed  CAS  Google Scholar 

  17. Weil MH, Shubin H: The “VIP” approach to the bedside management of shock. JAMA 1969; 207: 337–340.

    Article  PubMed  CAS  Google Scholar 

  18. Haupt MT, Rackow EG: Colloid osmotic pressure and fluid resuscitation with hetastarch, albumin and saline solutions. Crit Care Med 1982; 10: 159–163.

    Article  PubMed  CAS  Google Scholar 

  19. Hebert PC, Wells G, Blajchman MA, et al: A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. N Engl J Med 1999; 340: 409–417.

    Article  PubMed  CAS  Google Scholar 

  20. Marik PE, Sibbald WJ: Effect of stored-blood transfusion on oxygen delivery in patients with sepsis. JAMA 1993; 269: 3024–3029.

    Article  PubMed  CAS  Google Scholar 

  21. Bersten AD, Holt AW: Vasoactive drags and the importance of renal perfusion pressure. New Horiz 1995; 3: 650–661.

    PubMed  CAS  Google Scholar 

  22. Richer M, Robert S, Lebel M: Renal hemodynamics during norepinephrine and low-dose dopamine infusion in man. Crit Care Med 1996; 24: 1150–1156.

    Article  PubMed  CAS  Google Scholar 

  23. Carcoana OV, Hines RL: Is renal dose dopamine protective or therapeutic? Yes. Crit Care Clin 1996; 12: 677–685.

    Article  PubMed  CAS  Google Scholar 

  24. Duke GJ, Bersten AD: Dopamine and renal salvage in the critically ill patient. Anaesth Intensive Care 1992; 20: 277–287.

    PubMed  CAS  Google Scholar 

  25. Thompson BT, Cockrill BA: Renal-dose dopamine: a siren song? Lancet 1994; 344: 7–8.

    Article  PubMed  CAS  Google Scholar 

  26. Maynard ND, Bihari DJ, Dalton RN, et al: Increasing splanchnic blood flow in the critically ill. Chest 1995; 108: 1648–1654.

    Article  PubMed  CAS  Google Scholar 

  27. Olson D, Pohlman A, Hall JB: Administration of low-dose dopamine to nonoliguric patients with sepsis syndrome does not raise gastric intramucosal pH nor improve creatinine clearance. Am J Respir Crit Care Med 1996; 154: 1664–1670.

    Article  PubMed  CAS  Google Scholar 

  28. Cottee DB, Saul WP: Is renal dose dopamine protective or therapeutic? No. Crit Care Clin 1996; 12: 687–695.

    Article  PubMed  CAS  Google Scholar 

  29. Chertow GM, Sayegh MH, Allgren RL, et al: Is the administration of dopamine associated with adverse or favorable outcomes in acute renal failure. Am J Med 1996; 101: 49–53.

    Article  PubMed  CAS  Google Scholar 

  30. Juste RN, Moran L, Hooper J, et al: Dopamine clearance in critically ill patients. Intensive Care Med 1998; 24: 1217–1220.

    Article  PubMed  CAS  Google Scholar 

  31. Devins SS, Miller A, Herndon BL, et al: Effects of dopamine on T-lymphocyte proliferative responses and serum prolactin concentrations in critically ill patients. Grit Care Med 1992; 20: 1644–1649.

    Article  CAS  Google Scholar 

  32. Bailey AR, Burchett KR: Effect of low-dose dopamine on serum concentrations of prolactin in critically ill patients. Br J Anaesth 1997; 78: 97–99.

    Article  PubMed  CAS  Google Scholar 

  33. Giraud GD, MacCannell KL: Decreased nutrient blood flow during dopamine and epinephrine induced intestinal vasodilation. J Pharmacol Exp Ther 1984; 230: 214–220.

    PubMed  CAS  Google Scholar 

  34. Martin C, Papazian L, Perrin G, et al: Norepinephrine or dopamine for the treatment of hyperdynamic septic shock? Chest 1993; 103: 1826–1831.

    Article  PubMed  CAS  Google Scholar 

  35. Marik PE, Mohedin J: The contrasting effects of dopamine and norepinephrine on systemic and splanchnic oxygen utilization in hyperdynamic sepsis. JAMA 1994; 272: 1354–1357.

    Article  PubMed  CAS  Google Scholar 

  36. Desjars P, Pinaud M, Bugnon D, et al: Norepinephrine therapy has no deleterious renal effects in human septic shock. Grit Care Med 1989; 17: 426–429.

    Article  CAS  Google Scholar 

  37. Marin G, Eon B, Saux P, et al: Renal effects of norepinephrine used to treat septic shock patients. Grit Gare Med 1990; 18: 282–285.

    Article  CAS  Google Scholar 

  38. Vincent JL, Roman A, Kahn RJ: Dobutamine administration in septic shock: addition to a standard protocol. Crit Care Med 1990; 18: 689–693.

    Article  PubMed  CAS  Google Scholar 

  39. Vincent JL, Reuse G, Kahn RJ: Administration of dopexamine, a new adrenergic agent, in cardiorespiratory failure. Chest 1989; 96: 1233–1236.

    Article  PubMed  CAS  Google Scholar 

  40. Silva E, De Backer D, Creteur J, et al: Effects of vasoactive drugs on gastric intramucosal pH. Crit Gare Med 1998; 26: 1749–1758.

    Article  CAS  Google Scholar 

  41. De Boelpaepe G, Vincent JL, Contempre B, et al: Combination of norepinephrine and amrinone in the treatment of endotoxin shock. J Crit Care 1989; 4: 202–207.

    Article  Google Scholar 

  42. Shoemaker WC, Appel PL, Kram HB, et al: Prospective trial of supranormal values of survivors as therapeutic goals in high-risk surgical patients. Chest 1988; 94: 1176–1186.

    Article  PubMed  CAS  Google Scholar 

  43. Fleming A, Bishop M, Shoemaker W, et al: Prospective trial of supranormal values as goals of resuscitation in severe trauma. Arch Surg 1992; 127: 1175–1179.

    Article  PubMed  CAS  Google Scholar 

  44. Bishop MH, Shoemaker WC, Appel PL, et al: Prospective, randomized trial of survivor values of cardiac index, oxygen delivery, and oxygen consumption as resuscitation endpoints in severe trauma. J Trauma 1995; 38: 780–787.

    Article  PubMed  CAS  Google Scholar 

  45. Yu M, Burchell S, Hasaniya NWMA, et al: Relationship of mortality to increasing oxygen delivery in patients >50 years of age: a prospective randomized trial. Crit Care Med 1998; 26: 1011–1019.

    Article  PubMed  CAS  Google Scholar 

  46. Hayes MA, Timmins AG, Yau EH, et al: Elevation of systemic oxygen delivery in the treatment of critically ill patients. N Engl J Med 1994; 330: 1717–1722.

    Article  PubMed  CAS  Google Scholar 

  47. Gattinoni L, Brazzi L, Pelosi P, et al: A trial of goal-oriented hemodynamic therapy in critically ill patients. N Engl J Med 1995; 333: 1025–1032.

    Article  PubMed  CAS  Google Scholar 

  48. Vary TC: Sepsis-induced alterations in pyruvate dehydrogenase complex activity in rat skeletal muscle: effects on plasma lactate. Shock 1996; 6: 89–94.

    Article  PubMed  CAS  Google Scholar 

  49. Bakker J, Coffernils M, Leon M, et al: Blood lactate levels are superior to oxygen derived variables in predicting outcome in human septic shock. Chest 1991; 99: 956–962.

    Article  PubMed  CAS  Google Scholar 

  50. Friedman G, Berlot G, Kahn RJ, et al: Combined measurements of blood lactate concentrations and gastric intramucosal pH in patients with severe sepsis. Grit Care Med 1995; 23: 1184–1193.

    Article  CAS  Google Scholar 

  51. Marecaux G, Pinsky MR, Dupont E, et al: Blood lactate levels are better prognostic indicators than TNF and IL-6 levels in patients with septic shock. Intensive Care Med 1996; 22: 404–408.

    Article  PubMed  CAS  Google Scholar 

  52. Vincent JL, Creteur J: Gastric mucosal pH (pHi) is definitely obsolete: please tell us more about gastric mucosal PGO2 (PgCO2). Grit Care Med 1998; 26: 1479–1481.

    Article  CAS  Google Scholar 

  53. Friedman G, Vincent JL: Has the mortality of septic shock changed with time? Crit Care Med 1998; 26: 2078–2086.

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. Jean-Louis Vincent
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Editor information

Editors and Affiliations

  1. Department of Surgery, St. Louis University Hospital, St. Louis, Missouri, 63110, USA

    Arthur E. Baue MD (Professor Emeritus) (Professor Emeritus)

  2. Department of Surgery, Klinikum Grosshadern, University of Munich, Munich, D-81377, Germany

    Eugen Faist MD (Professor) (Professor)

  3. Department of Surgery, School of Medicine, University of New Mexico, Albuquerque, New Mexico, 87131, USA

    Donald E. Fry MD (Professor and Chairman) (Professor and Chairman)

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© 2000 Springer Science+Business Media New York

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Vincent, JL. (2000). Circulation. In: Baue, A.E., Faist, E., Fry, D.E. (eds) Multiple Organ Failure. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-1222-5_34

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  • DOI: https://doi.org/10.1007/978-1-4612-1222-5_34

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-7049-2

  • Online ISBN: 978-1-4612-1222-5

  • eBook Packages: Springer Book Archive

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