Mink R B, Pollack M M
Department of Critical Care Medicine, Children's National Medical Center, Washington, DC 20010.
Crit Care Med. 1990 Oct;18(10):1087-91. doi: 10.1097/00003246-199010000-00007.
Treatment plans for pediatric septic shock advocate increasing oxygen consumption (VO2). Recent studies in septic shock indicate that improving oxygen delivery (DO2) by increasing blood flow will increase VO2. We prospectively examined the effect on VO2 of improving DO2 by increasing oxygen content (CO2) with blood transfusion in eight hemodynamically stable septic shock patients. Transfusion consisted of 8 to 10 ml/kg of packed RBC over 1 to 2 h. Hemodynamic and oxygen transport measurements were obtained before and after blood transfusion. Transfusion significantly (p less than .05) increased Hgb and Hct from 10.2 +/- 0.8 g/dl and 30 +/- 2% to 13.2 +/- 1.4 g/dl and 39 +/- 4%, respectively (mean +/- SD). DO2 significantly (p less than .05) increased after transfusion (599 +/- 65 to 818 +/- 189 ml/min.m2), but VO2 did not change (166 +/- 68 to 176 +/- 74 ml/min.m2; NS). In pediatric septic shock patients, increasing CO2 by blood transfusion may not increase VO2.
儿童感染性休克的治疗方案主张增加氧耗量（VO2）。近期关于感染性休克的研究表明，通过增加血流量来改善氧输送（DO2）会增加VO2。我们前瞻性地研究了对8例血流动力学稳定的感染性休克患儿输血增加氧含量（CO2）来改善DO2对VO2的影响。输血为在1至2小时内输注8至10ml/kg的浓缩红细胞。在输血前后进行血流动力学和氧输送测量。输血后血红蛋白（Hgb）和血细胞比容（Hct）显著（p<0.05）升高，分别从10.2±0.8g/dl和30±2%升至13.2±1.4g/dl和39±4%（均数±标准差）。输血后DO2显著（p<0.05）增加（从599±65增至818±189ml/min·m2），但VO2未改变（从166±68至176±74ml/min·m2；无显著性差异）。在儿童感染性休克患者中，输血增加CO2可能不会增加VO2。
