Edwards J D
Intensive Care Unit, University Hospital of South Manchester, West Didsbury, UK.
Crit Care Med. 1991 May;19(5):658-63. doi: 10.1097/00003246-199105000-00012.
To review clinical studies of oxygen transport in cardiogenic and septic shock.
Descriptive and prospective studies.
University hospital multi disciplinary ICU.
Critically ill cardiogenic and septic shock patients greater than 18 and less than 80 yrs of age.
The responses to volume loading with colloid or crystalloid and infusion of catecholamines are documented with baseline hemodynamic and oxygen transport measurements before and after administration of catecholamines.
Nineteen patients in cardiogenic shock were studied. In three patients, invasive systemic mean arterial pressure was greater than 80 mm Hg and cardiac index was greater than 2.0 L/min.m2. In all patients, there were increases in oxygen extraction ratio that averaged 48 +/- 18 (SD) %. However, in 30 septic shock patients, extraction ratio was 24 +/- 2%. In both groups, the response to therapy was an increase in mixed venous oxygen saturation from 54 +/- 16% to 69 +/- 8% in cardiogenic patients (p less than .001) and from 75 +/- 2% to 80 +/- 1% in septic shock (p less than .01).
There are widely differing oxygen transport patterns in cardiogenic and septic shock that may have implications for therapy.
回顾心源性休克和脓毒性休克中氧输送的临床研究。
描述性和前瞻性研究。
大学医院多学科重症监护病房。
年龄大于18岁且小于80岁的重症心源性休克和脓毒性休克患者。
在给予儿茶酚胺之前和之后，通过基线血流动力学和氧输送测量记录对胶体或晶体液容量负荷以及儿茶酚胺输注的反应。
对19例心源性休克患者进行了研究。3例患者的有创全身平均动脉压大于80mmHg，心脏指数大于2.0L/min·m²。所有患者的氧摄取率均增加，平均为48±18（标准差）%。然而，在30例脓毒性休克患者中，氧摄取率为24±2%。两组患者对治疗的反应是，心源性休克患者的混合静脉血氧饱和度从54±16%升至69±8%（p<0.001），脓毒性休克患者从75±2%升至80±1%（p<0.01）。
心源性休克和脓毒性休克的氧输送模式差异很大，这可能对治疗有影响。
