Vallet Benoit
Department of Anesthesiology and Intensive Care Medicine, University Hospital of Lille, Lille, France.
Crit Care. 2002 Aug;6(4):282-3. doi: 10.1186/cc1508. Epub 2002 May 31.
Part of Stephan Jakob's exhaustive review paper in the present issue of deals with the notion that intestinal cellular energetics are deranged in sepsis, in terms not only of inadequate tissue perfusion but also of impaired mitochondrial respiration and/or coupling (i.e. organ dysfunction in sepsis may occur as a result of 'cytopathic hypoxia'). This suggests that efforts to improve outcome in septic patients by manipulating systemic oxygen delivery and regional blood flow are doomed to failure. That suggestion remains largely speculative, and experimental and clinical results presented here consistently demonstrate that there is still a place for treatment of abnormal perfusion in the context of early severe sepsis and septic shock.
本期斯蒂芬·雅各布详尽的综述文章的一部分探讨了这样一种观点,即脓毒症时肠道细胞能量代谢紊乱,不仅表现为组织灌注不足,还表现为线粒体呼吸和/或偶联受损(即脓毒症中的器官功能障碍可能是“细胞病性缺氧”的结果)。这表明,通过操纵全身氧输送和局部血流来改善脓毒症患者预后的努力注定会失败。这一观点在很大程度上仍属推测,而本文给出的实验和临床结果一致表明,在早期严重脓毒症和脓毒性休克的情况下,治疗异常灌注仍有意义。