Skip to main content
SpringerLink
Log in
Book cover

Anaesthesia, Pain, Intensive Care and Emergency Medicine - A.P.I.C.E. pp 691–696Cite as

Metabolic Disorders and Electrolyte Derangement during Hypoperfusion Syndrome

  • Conference paper

  • 221 Accesses

Abstract

Hypoperfusion could be defined as “a syndrome leading to widespread cellular hypoxia and vital organ dysfunction” [1], or “an inappropriate balance of substrate supply and demand at a cellular level” [2]; from a clinical point of view, whatever the cause, it is “a state in which reduction of effective tissue perfusion leads first to reversible, and then to irreversible cellular injury” [3]. Perhaps, after some intriguing insights about the subject, we should also include among the hypoperfusion syndromes any pathological O2 utilization at the cellular level, the so-called “dysoxia” [4, 5].

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Fink MP (1991) Shock: an overview. In: Rippe JM et al (eds) Intensive care medicine, Little, Brown, Boston

    Google Scholar 

  2. Cerra FB (1983) Shock. In: Burke JF (ed) Surgical physiology, Saunders, Philadelphia

    Google Scholar 

  3. Parrillo JE (1993) Pathogenetic mechanisms of septic shock. N Engl J Med 328: 1471–1473

    Article  PubMed  CAS  Google Scholar 

  4. Schlichtig R, Kramer D, Pinsky MR (1991) Flow redistribution during progressive hemorrhage is a determinant of critical O2 delivery. J Appl Physiol 70: 169–178

    PubMed  CAS  Google Scholar 

  5. Pinsky MR (1994) Beyond global oxygen supply-demand relations: in search of measures of dysoxia. Intensive Care Med 20: 1–3

    Article  PubMed  CAS  Google Scholar 

  6. Hochachka PW (1986) Defense strategies against hypoxia and hypothermia. Science 231(4735): 234–241

    Article  PubMed  CAS  Google Scholar 

  7. Schlichtig R, Pinsky MR (1991) Defining the hypoxic threshold. Crit Care Med 19: 147–149

    Article  PubMed  CAS  Google Scholar 

  8. Poole RC, Halestrap AP (1993) Transport of lactate and other monocarboxylates across mammalian plasma membranes. Am J Physiol 264: C761–C782

    PubMed  CAS  Google Scholar 

  9. Gutierrez G, Hurtado FJ et al (1993) Net uptake of lactate by rabbit hindlimb during hypoxia. Am Rev Respir Dis 148: 1204–1209

    PubMed  CAS  Google Scholar 

  10. Cohen RD (1988) Pathophysiology of lactic acidosis. In: Vincent JL (ed) Update in intensive care and emergency medicine. Springer, Berlin, pp 40–43

    Google Scholar 

  11. Connett RJ, Honig CR et al (1990) Defining hypoxia: a systems view of VO2, glycolysis, energetics, and intracellular PO2. J Appl Physiol 68: 833–842

    PubMed  CAS  Google Scholar 

  12. Gutierrez G, Wulf ME (1996) Lactic acidosis in sepsis: a commentary. Intensive Care Med 22: 6–15

    Article  PubMed  CAS  Google Scholar 

  13. Mizock BA (1987) Controversies in lactic acidosis: implications in critically ill patients. JAMA 258: 497–501

    Article  PubMed  CAS  Google Scholar 

  14. Vary TC, Siegel JH et al (1986) Effects of sepsis on activity of PDH complex in skeletal muscle and liver. Am J Physiol 250: E634–640

    PubMed  CAS  Google Scholar 

  15. Stacpoole PW, Harman EM et al (1983) Treatment of lactic acidosis with dichloroacetate. N Engl J Med 309: 390–396

    Article  PubMed  CAS  Google Scholar 

  16. Stacpoole PW, Wright EC et al (1992) A controlled clinical trial of DCA for treatment of lactic acidosis in adults. N Engl J Med 327: 1564–1569

    Article  PubMed  CAS  Google Scholar 

  17. Mira JP, Fabre JE et al (1994) Lack of oxygen supply dependency in patients with severe sepsis. Chest 106: 1524–1531

    Article  PubMed  CAS  Google Scholar 

  18. Astiz ME, Rackow EC, Kaufman B et al (1988) Relationship of oxygen delivery and mixed venous oxygenation to lactic acidosis in patients with sepsis and acute myocardial infarction. Crit Care Med 16: 655–658

    Article  PubMed  CAS  Google Scholar 

  19. Zhang H, Vincent JL (1993) Arteriovenous differences in PCO2 and pH are good indicators of critical hypoperfusion. Am Rev Respir Dis 148: 867–871

    Article  PubMed  CAS  Google Scholar 

  20. Idris AH, Staples ED et al (1994) Effect of ventilation on acid-base balance and oxygenation in low blood-flow states. Crit Care Med 22: 1827–1834

    PubMed  CAS  Google Scholar 

  21. Bircher NG (1992) Acidosis of cardiopulmonary resuscitation: carbon dioxide transport and anaerobios. Crit Care Med 20(9): 1203–1204

    Article  PubMed  CAS  Google Scholar 

  22. Cohen IL, Lumb PD (1991) Monitoring tissue oxygen perfusion: global or regional. Int Crit Care Dig 10(3): 56–59

    Google Scholar 

  23. Vexler ZS, Ayus JC et al (1994) Ischemic or hypoxic hypoxia exacerbates brain injury associated with metabolic encephalopathy in laboratory animals. J Clin Invest 93: 256–260

    Article  PubMed  CAS  Google Scholar 

  24. Shoemaker WC, Peitzman AB et al (1996) Resuscitation from severe hemorrhage. Crit Care Med 24[Suppl]: S12–S23

    Article  PubMed  CAS  Google Scholar 

  25. Benjamin E, Oropello JM et al (1994) Effects of acid-base correction on hemodynamics, oxygen dynamics, and resuscitability in severe canine hemorrhagic shock. Crit Care Med 22: 1616–1623

    PubMed  CAS  Google Scholar 

  26. Ronco JJ, Fenwick JC, Tweeddale MG et al (1993) Identification of the critical oxygen delivery for anaerobic metabolism in critically ill and nonseptic humans. JAMA 270: 1724–1729

    Article  PubMed  CAS  Google Scholar 

  27. Adrogue HJ, Rashad MN, Gorin AB et al (1989) Assessing acid-base status in circolatory failure. Differences between arterial and central venous blood. N Engl J Med 320: 1312–1318

    Article  PubMed  CAS  Google Scholar 

  28. Vincent JL, Dufaye P et al (1983) Serial lactate determinations during circulatory shock. Crit Care Med 11: 449–451

    Article  PubMed  CAS  Google Scholar 

  29. Friedman G, Berlot G et al (1995) Combined measurements of blood lactate levels and gastric intramucosal pH in patients with severe sepsis. Crit Care Med 23: 1184–1193

    Article  PubMed  CAS  Google Scholar 

  30. Iberti TJ, Leibowitz AB, Papadakos PJ et al (1990) Low sensitivity of the anion gap as a screen to detect hyperlactatemia in critically ill patients. Crit Care Med 18: 275–277

    Article  PubMed  CAS  Google Scholar 

  31. Van der Linden P, Rausin I et al (1995) Detection of tissue hypoxia by arterio-venous gradient for PCO2 and pH in anesthetized dogs during progressive hemorrhage. Anesth Analg 80: 269–275

    PubMed  Google Scholar 

  32. Mahutte CK, Jaffe MB et al (1991) Cardiac output from carbon dioxide production and arterial and venous oximetry. Crit Care Med 19: 1270–1277

    Article  PubMed  CAS  Google Scholar 

  33. Arieff AI (1993) Managing metabolic acidosis: update on the sodium bicarbonate controversy. J Crit Illness 8: 224–229

    Google Scholar 

  34. Steiner RW (1984) Interpreting the fractional excretion of sodium. Am J Med 77: 699–702

    Article  PubMed  CAS  Google Scholar 

  35. Laterre PF, Mallie JP (1993) The fractional excretion of chloride instead of sodium indicates hypovolemia: a comparative study of bedside assessment of true or effective intravascular depletion. Clin Intens Care 4: 112–115

    Google Scholar 

Download references

Authors
  1. F. Schiraldi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. R. Derosa
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F. Paladino
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Anaesthesiology and Intensive Care, Trieste University School of Medicine, Trieste, Italy

    Antonino Gullo M.D. (Head) (Head)

Rights and permissions

Reprints and permissions

Copyright information

© 1998 Springer-Verlag Italia, Milano

About this paper

Cite this paper

Schiraldi, F., Derosa, A.R., Paladino, F. (1998). Metabolic Disorders and Electrolyte Derangement during Hypoperfusion Syndrome. In: Gullo, A. (eds) Anaesthesia, Pain, Intensive Care and Emergency Medicine - A.P.I.C.E.. Springer, Milano. https://doi.org/10.1007/978-88-470-2278-2_75

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-2278-2_75

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0007-0

  • Online ISBN: 978-88-470-2278-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation