Bakker J, Schieveld S J, Brinkert W
Gelre ziekenhuizen, afd. Intensive Care, Apeldoorn.
Ned Tijdschr Geneeskd. 2000 Apr 15;144(16):737-41.
Adequate oxygen supply to the tissues is of vital importance to survive critical illness and trauma. Shock can be defined as an imbalance between oxygen demand and oxygen supply. Clinical features of shock, like hypotension, tachycardia, cold clammy skin et cetera, are poorly correlated with presence of tissue hypoxia. A high lactate level is an early sign of tissue hypoxia. In severely ill patients tissue hypoxia is the most important cause of increased lactate levels. Increased blood lactate levels are related to increased mortality. Optimizing oxygen supply by fluid resuscitation is the intervention of first choice.
为组织提供充足的氧气供应对于在危重病和创伤中存活至关重要。休克可定义为氧需求与氧供应之间的失衡。休克的临床特征,如低血压、心动过速、皮肤湿冷等,与组织缺氧的存在相关性较差。高乳酸水平是组织缺氧的早期迹象。在重症患者中,组织缺氧是乳酸水平升高的最重要原因。血乳酸水平升高与死亡率增加有关。通过液体复苏优化氧供应是首选的干预措施。