Boekstegers P, Weidenhöfer S, Pilz G, Werdan K
Klinikum Grosshadern, Universität München, Germany.
Infection. 1991 Sep-Oct;19(5):317-23. doi: 10.1007/BF01645355.
In 40 intensive care patients, tissue oxygen partial pressure distribution within skeletal muscle was measured in order to estimate peripheral oxygen availability. In septic patients with multiple organ failure (n = 20) mean skeletal muscle pO2 was abnormally high (48.8 +/- 8.5 mmHg, p less than 0.001) in contrast to patients with limited infection without sepsis (28.3 +/- 5.9 mmHg, n = 10). Mean muscle pO2 also discriminated between septic and cardiogenic shock (22.6 +/- 6.9 mmHg, p less than 0.001). The characteristic pattern of oxygen availability in septic patients--but not in patients with limited infection--was high skeletal muscle pO2 high whole body oxygen delivery and low whole body oxygen extraction, which was not influenced by the type of pathogenic agent of sepsis. In our patients in severe stage of sepsis, we did not observe local skeletal muscle hypoxia due to microcirculatory disorder. High mean skeletal muscle pO2 suggested reduced oxygen consumption within tissue rather than reduced oxygen transport to tissue in sepsis.
在40例重症监护患者中，测量了骨骼肌内的组织氧分压分布，以评估外周氧的可利用性。在多器官功能衰竭的脓毒症患者（n = 20）中，骨骼肌平均氧分压异常高（48.8±8.5 mmHg，p<0.001），相比之下，无脓毒症的局限性感染患者为（28.3±5.9 mmHg，n = 10）。平均肌肉氧分压也可区分脓毒症休克和心源性休克（22.6±6.9 mmHg，p<0.001）。脓毒症患者而非局限性感染患者的氧可利用性特征模式为：骨骼肌氧分压高、全身氧输送高和全身氧摄取低，这不受脓毒症病原体类型的影响。在我们处于脓毒症严重阶段的患者中，未观察到因微循环障碍导致的局部骨骼肌缺氧。骨骼肌平均氧分压高表明脓毒症时组织内氧消耗减少而非氧向组织的输送减少。
