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Clinical Controversies Concerning Oxygen Transport Principles: More Apparent than Real?

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Yearbook of Intensive Care and Emergency Medicine 1993

Part of the book series: Yearbook of Intensive Care and Emergency Medicine 1993 ((YEARBOOK,volume 1993))

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Abstract

The measurement and manipulation of oxygen transport (DO2) variables is now a central part of the management of critically ill patients. The experimental and clinical literature abounds with publications on various aspects of this concept. However there have been controversies, sometimes fiercely contested, on several key issues that have been raised in the clinical field. At first sight, it may seem that different groups of investigators have produced contradictory results in areas which are vital to clinical practice. This has led to confusion and possibly on occasion to nihilism. There has also been some Variation in the findings and conclusions from some experimental studies. But, in contradistinction to the clinical discrepancies, in the orderly world of tightly controlled laboratory experiments, the differences have been easily resolved by considering the methods of the studies in question.

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References

  1. Pflüger E (1872) Über die Diffusion des Sauerstoffs, den Ort und die Gesetze der Oxydations-prozesse im tierischen Organismus. Pflügers Arch 6: 43

    Article  Google Scholar 

  2. Krogh A (1919) The number and distribution of capillaries in muscle with calculations of the oxygen pressure head necessary for supplying the tissue. J Physiol 52: 409–415

    PubMed  CAS  Google Scholar 

  3. Tenney SM (1974) A theoretical analysis of the relationship between venous blood and mean tissue oxygen pressures. Respir Physiol 20: 283–296

    Article  PubMed  CAS  Google Scholar 

  4. Hill AV (1928) The diffusion of oxygen and lactic acid through tissues. Proc Roy Soc Lond SB 104: 39–96

    Article  CAS  Google Scholar 

  5. Miller MJ (1982) Tissue oxygenation in clinical medicine: An historical review. Anesthesia and Analgesia 61: 527–535

    PubMed  CAS  Google Scholar 

  6. Barcroft J (1920) On anoxia. Lancet 2: 485

    Google Scholar 

  7. Nunn JF, Freeman J (1964) Problems of oxygenation and oxygen transport during hemorrhage. Anaesthesia 19: 206–216

    Article  PubMed  CAS  Google Scholar 

  8. Gessel RH, Krenger H, Graham G, Berthnal (1930) The regulation of respiration. Am J Physiol 94: 300–338

    Google Scholar 

  9. Cuthbertson DP (1932) Observations on the disturbance of metabolism produced by injury to the limbs. Quart J Med 1: 233–246

    CAS  Google Scholar 

  10. Cournand A, Riley RL, Bradley SE, et al. (1943) Studies of the circulation in clinical shock. Surgery 13: 964–995

    CAS  Google Scholar 

  11. Shoemaker WC, Montgomery ES, Kaplan E, Elwyn DH (1973) Physiologic patterns in surviving and nonsurviving shock patients. Arch Surg 106: 630–636

    Article  PubMed  CAS  Google Scholar 

  12. Shoemaker WC, Appel PL, Waxman K, Schwartz S, Chang P (1982) Clinical trial of survivors’ cardiorespiratory patterns as therapeutic goals in critically ill postoperative patients. Crit Care Med 10: 390–397

    Article  PubMed  CAS  Google Scholar 

  13. Shoemaker WC, Appel PL, Kram HB, Waxman K, Lee TS (1988) Prospective trial of supranormal values of survivors goals in high risk surgical patients. Chest 94: 1176–1186

    Article  PubMed  CAS  Google Scholar 

  14. Shoemaker WC, Czer LSC (1979) Evaluation of the biologic importance of various hemodynamic and oxygen transport variables: which variables should be monitored in postoperative shock? Crit Care Med 7: 424–431

    Article  PubMed  CAS  Google Scholar 

  15. Bland RD, Shoemaker WC (1985) Probability of survival as a prognostic and severity of illness score in critically ill surgical patients. Arch Surg 13: 91–95

    CAS  Google Scholar 

  16. Samsel PW, Schumacker PT (1992) Oxygen delivery and uptake: Insights from animal studies. In: Vincent JL (ed) Yearbook of Intensive Care and Emergency Medicine, Springer–Verlag, Berlin, Heidelberg, New York pp 271–280

    Google Scholar 

  17. Nelson DP, Samsel RW, Ward LDH, Schumacker PT (1988) Pathological supply dependence of systemic and intestinal oxygen uptake during endotoxemia in dogs. J Appl Physiol 64: 2410–2419

    PubMed  CAS  Google Scholar 

  18. Nelson DP, Beyer C, Samsel RW, Wood LDH and Schumacker PT (1987) Pathological supply dependence of O2 uptake during bacteremia in dogs. J Appl Physiol 63: 1487–1492

    PubMed  CAS  Google Scholar 

  19. Cain SM (1978) Effects of time and vasoconstrictor tone on O2 extraction during hypoxic hypoxia. J Appl Physiol 45: 219–224

    PubMed  CAS  Google Scholar 

  20. Simmons DH, Alpas A, Tashkin DP, Coulson A (1978) Hyperlactatemia due to arterial hypoxemia or reduced cardiac Output, or both. J Appl Physiol 45: 195–202

    PubMed  CAS  Google Scholar 

  21. Cain SM (1977) Oxygen delivery and uptake in dogs during anemic and hypoxic hypoxia. J Appl Physiol 42: 228–234

    PubMed  CAS  Google Scholar 

  22. Powers SR, Mannal R, Neclerio MS, et al. (1973) Physiologie consequences of Positive End- Expiratory Pressure ( PEEP) Ventilation. Am Surg 178: 265–271

    Google Scholar 

  23. Danek SJ, Lynch JP, Weg JG, Dantzker DR (1980) The dependence of oxygen uptake on oxygen delivery in the adult respiratory distress Syndrome. Am Rev Respir Dis 122: 387–395

    PubMed  CAS  Google Scholar 

  24. Annat G, Viale J-P, Percival C, Froment M, Motin J (1986) Oxygen delivery and uptake in the adult respiratory distress Syndrome. Am Rev Respir Dis 133: 999–1001

    PubMed  CAS  Google Scholar 

  25. Vermeij CG, Feenstra BWA, Bruining HA (1990) Oxygen delivery and oxygen uptake in post-operative and septic patients. Chest 98: 415–420

    Article  PubMed  CAS  Google Scholar 

  26. Westenskow DR, Cutler CA, Wallace WD (1984) Instrumentation for monitoring gas exchange and metabolic rate in critically ill patients. Crit Care Med 12: 183–187

    Article  PubMed  CAS  Google Scholar 

  27. Bill DB, Fölling A (1928) Studies in muscular exercise. J Physiol 66: 133–138

    Google Scholar 

  28. Hankeln KB, Gronemeyer R, Held A, Böhmert F (1991) Use of continuous noninvasive measurement of oxygen consumption in patients with adult respiratory distress Syndrome following shock of various etiologies. Crit Care Med 19: 642–649

    Article  PubMed  CAS  Google Scholar 

  29. Gutierrez G, Pohil RJ (1986) Oxygen consumption is linearly related to O2 supply in critically ill patients. J Crit Care 1: 45–53

    Article  Google Scholar 

  30. Clarke C, Edwards JD, Nightingale P, Mortimer AJ, Morris J (1991) Persistence of supply dependency of oxygen uptake at high levels of delivery in adult respiratory distress Syndrome. Crit Care Med 119: 497–502

    Article  Google Scholar 

  31. Cain SM, Curtis SE (1991) Experimental models of pathology oxygen supply dependency. Crit Care Med 19: 603–612

    Article  PubMed  CAS  Google Scholar 

  32. Edwards JD (1990) Practical application of oxygen transport principles. Crit Care Med 18: S45–S48

    Article  PubMed  CAS  Google Scholar 

  33. Dietrich KA, Conrad SA, Hebert CA, Levy GL, Romero MD (1990) Cardiovascular and metabolic response to red blood cell transfusion in critically ill volume-resuscitated nonsurgical patients. Crit Care Med 18: 940–944

    Article  PubMed  CAS  Google Scholar 

  34. Mink RB, Pollack MM (1990) Effect of blood transfusion on oxygen consumption in prediatric septic shock. Crit Care Med 18: 1087–1091

    Article  PubMed  CAS  Google Scholar 

  35. Lucking SE, Williams TM, Chaten FC, Metx RI, Mickeil JJ (1990) Dependence of oxygen consumption on oxygen delivery in children with hyperdynamic septic shock and low oxygen extraction. Crit Care Med 18: 1316–1319

    Article  PubMed  CAS  Google Scholar 

  36. Steffes CP, Bender JS, Levison MA (1991) Blood transfusion and oxygen consumption in surgical sepsis. Crit Care Med 19: 512–517

    Article  PubMed  CAS  Google Scholar 

  37. Fenwick JC, Dodek PM, Ronco JJ, Phang PT, Wiggs B, Russell JA (1990) Increased concentrations of plasma lactate predict pathologic dependence of oxygen consumption on oxygen delivery in patients with adult respiratory distress Syndrome. J Crit Care 5: 81–86

    Article  Google Scholar 

  38. da Luz PL, Cavanilles, Michaels S, Weil MH, Shubin H (1975) Oxygen delivery, anoxic metabolism and hemoglobin-oxygen affinity (P50) in patients with acute myocardial infaretion and shock. Am J Cardiol 36: 148–154

    Article  PubMed  Google Scholar 

  39. Yang SC, Puri VK, Raheja R (1986) Oxygen delivery and consumption and P50 in patients with acute myocardial infaretion. Circulation 73: 1183–1185

    Article  PubMed  CAS  Google Scholar 

  40. Creamer JE, Edwards JD, Nightingale P (1990) Hemodynamic and oxygen transport variables in cardiogenic shock secondary to acute myocardial infaretion, and response to treatment. Am J Cardiol 65: 1297–1300

    Article  PubMed  CAS  Google Scholar 

  41. Stürm JA, Lewis FR, Trentz O, Oestern H-J, Hempelman G, Tscherne H (1979) Cardiopulmonary parameters and prognosis after severe multiple trauma. J Trauma 19: 305–316

    Article  PubMed  Google Scholar 

  42. Edwards JD, Redmond AD, Nightingale P, Wolkins RG (1988) Oxygen consumption following trauma: A reappraisal in severely injured patients requiring mechanical Ventilation. Br J Surg 75: 690–692

    Google Scholar 

  43. Rady MY, Edwards JD, Nightingale P (1992) Early cardiorespiratory findings after severe blunt thoracic trauma and their relation to outcome. Br J Surg 79: 65–68

    Article  PubMed  CAS  Google Scholar 

  44. Shoemaker WC, Appel P, Czer LSC, et al. (1980) Pathogenesis of respiratory failure ( ARDS) after hemorrhage and trauma. Crit Care Med 8: 504–512

    Google Scholar 

  45. Moore FA, Haenel JB, Moor EC, Whitehill TA (1992) Commensurate oxygen consumption in response to maximal oxygen availability predicts post-injury multiple organ failure. J Trauma 33: 58–67

    Article  PubMed  CAS  Google Scholar 

  46. Schwartz S, Frantz RA, Shoemaker WC (1981) Sequential hemodynamic and oxygen transport responses in hypovolemia, anemia and hypoxia. Am J Physiol 241: H864 - H871

    PubMed  CAS  Google Scholar 

  47. Rady MY, Little RA, Edwards JD, Kirkman E, Faithfull S (1991) The effect of nociceptive Stimulation on the changes in hemodynamics and oxygen transport induces by hemorrhage in anesthetized pigs. J Trauma 31: 617–621

    Article  PubMed  CAS  Google Scholar 

  48. Rashkin MC, Bosken C, Baughman RP (1985) Oxygen delivery in critically ill patients relationship to blood lactate and survival. Chest 85: 580–584

    Article  Google Scholar 

  49. Komatsu T, Shibutani K, Okamoto K, et al. (1987) Critical level of oxygen delivery after cardiopulmonary bypass. Crit Care Med 15: 194–197

    Article  PubMed  CAS  Google Scholar 

  50. Mohsenifar L, Goldbach P, Tashkin DP, Campisi DJ (1983) Relationship between O2 delivery and O2 consumption in the adult respiratory distress Syndrome. Chest 84: 267–270

    Article  PubMed  CAS  Google Scholar 

  51. Haupt MT, Gilbert EM Carlson RW (1985) Fluid loading increases oxygen consumption in septic patients with lactic acidosis. Am Rev Respir Dis 131: 912–916

    PubMed  CAS  Google Scholar 

  52. Gilbert EM, Haupt MT, Manadanas RY, Hauringa AJ, Carlson RW (1986) The effect of fluid loading, blood transfusion and catecholamine infusion on oxygen delivery and consumption in patients with sepsis. Am Rev Respir Dis 134: 873–878

    PubMed  CAS  Google Scholar 

  53. Shelly MP, Nightingale P, Mortimer AJ Edwards JD (1990) Initial oxygen transport patterns in survivors and non-survivors of shock. Intensive Care Med 16: 91 (Abstract)

    Article  Google Scholar 

  54. Edwards JD (1990) Practical applications of oxygen transport. Intensive Care Med 16: S133

    Article  Google Scholar 

  55. Barlett RH, Dechert RE (1990) Oxygen kinetics: Pitfalls in clinical research. J Crit Care 5: 77–80

    Google Scholar 

  56. Weissman C, Kemper M, Damask MC, Askanazi J, Hyman AI, Kinney JM (1984) Effect of routine intensive care interactions on metabolic rate. Chest 86: 815–818

    Article  PubMed  CAS  Google Scholar 

  57. McConachie I, Edwards JD, Nightingale P, Mortimer AJ (1990) The relationship between central temperature and oxygen consumption in critically ill patients. Intensive Care Med 16: 56 (Abstract)

    Google Scholar 

  58. Ashbaugh DG, Bigelow DB, Petty TL, Levine BE (1967) Acute respiratory distress in adults. Lancet 1: 319–323

    Article  Google Scholar 

  59. Petty TL, Fowler AA (1982) Another look at ARDS. Chest 82: 98–104

    Article  PubMed  CAS  Google Scholar 

  60. Bell RC, Coalson JJ, Smith JD, Johanson WG (1983) Multiple organ system failure and infection in adult respiratory distress Syndrome. Ann Intern Med 99: 293–298

    PubMed  CAS  Google Scholar 

  61. Kariman K, Burns SR (1985) Regulation of tissue oxygen extraction is disturbed in adult respiratory distress Syndrome. Am Rev Respir Dis 132: 109–111

    PubMed  CAS  Google Scholar 

  62. Shoemaker WC, Appel PL (1985) Pathophysiology of adult respiratory distress Syndrome after sepsis and surgical Operations. Crit Care Med 13: 166–172

    Article  PubMed  CAS  Google Scholar 

  63. Montgomery AB, Stager MA, Carrico J, Hudson LD (1985) Causes of mortality in patients with the adult respiratory distress Syndrome. Am Rev Respir Dis 132: 485–489

    PubMed  CAS  Google Scholar 

  64. Smith PEM, Gordon IJ (1986) An index to predict outcome in adult respiratory distress Syndrome. Intensive Care Med 12: 86–89

    Article  PubMed  CAS  Google Scholar 

  65. Jacobs S, Chang RWS, Lee B (1991) Prognosis in the adult respiratory distress Syndrome: Comparison of a ventilatory index with Riyadh Intensive Care Programme. Clin Intensive Care 2: 81–85

    Google Scholar 

  66. Suchtya MR, Clemmer TP, Elliott CG, Orme JF, Weaver LK (1992) The adult respiratory distress Syndrome; A report of survival and modifying factors. Chest 101: 1074–1079

    Google Scholar 

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© 1993 Springer-Verlag Berlin Heidelberg

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Edwards, J.D. (1993). Clinical Controversies Concerning Oxygen Transport Principles: More Apparent than Real?. In: Vincent, JL. (eds) Yearbook of Intensive Care and Emergency Medicine 1993. Yearbook of Intensive Care and Emergency Medicine 1993, vol 1993. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-84904-6_35

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  • DOI: https://doi.org/10.1007/978-3-642-84904-6_35

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-56463-8

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