Kremzar B, Spec-Marn A, Tos L
Institut za anesteziologijo, OOUR Kirurska sluzba, Univerzitetni Klinicni center, Ljubljana.
Plucne Bolesti. 1990 Jul-Dec;42(3-4):213-7.
The patients with acute respiratory failure of different etiology are presented. The results of hemodynamic measurements together with those of oxygen transport and tissue oxygenation are given. The results reveal that in hypovolemic shock the transport system of oxygen and tissue oxygenation have been soon normalized by adequate therapy. However, more complicated is the condition of patients with sepsis and adult respiratory distress syndrome (ARDS) with disturbances in microcirculation. In them the oxygen uptake (VO2) is directly dependent upon the oxygen transport (DO2) i.e. much higher values of DO2 should be maintained by therapeutic measures than in conditions with intact microcirculation. According to their own experiences and data from the literature the authors consider that in patients with ARF in whom by the conventional methods the condition cannot be improved an invasive monitoring for following the hemodynamic measurements of oxygen transport and tissue oxygenation should be indicated for successful treatment.
本文介绍了不同病因的急性呼吸衰竭患者。给出了血流动力学测量结果以及氧运输和组织氧合的结果。结果显示,在低血容量性休克中,通过适当治疗,氧运输系统和组织氧合很快恢复正常。然而,脓毒症和伴有微循环障碍的成人呼吸窘迫综合征(ARDS)患者的情况更为复杂。在这些患者中,氧摄取量(VO2)直接依赖于氧运输量(DO2),即与微循环正常的情况相比,应通过治疗措施维持更高的DO2值。根据自身经验和文献数据,作者认为,对于采用传统方法病情无法改善的急性肾衰竭患者,为了成功治疗,应进行有创监测以跟踪氧运输和组织氧合的血流动力学测量。