Ronco J J, Montaner J S, Fenwick J C, Ruedy J, Russell J A
Department of Medicine, St. Pauls Hospital University of British Columbia, Vancouver, Canada.
Chest. 1990 Dec;98(6):1463-6. doi: 10.1378/chest.98.6.1463.
Oxygen consumption is pathologically dependent on oxygen delivery in ARDS and sepsis. We asked whether oxygen consumption is dependent on oxygen delivery in severe acute respiratory failure secondary to AIDS-related PCP. In five patients who had AIDS-related PCP, diffuse bilateral pulmonary infiltrates, no evidence of bacterial infection, and acute respiratory failure requiring mechanical ventilation with arterial oxygen tensions less than 75 mm Hg while breathing at least 50 percent oxygen, and PEEP greater than 10 cm H2O, we determined oxygen delivery and consumption by calculation from thermodilution cardiac output and arterial and mixed venous oxygen contents. Oxygen delivery was increased using transfusion of two units of packed red blood cells over one hour. Oxygen delivery increased 22 percent (638 +/- 204 to 778 +/- 201 ml/min.m2, p less than or equal to 0.006). Oxygen consumption increased 11 percent (134 +/- 34 to 149 +/- 29 ml/min.m2, p less than or equal to 0.02). The oxygen extraction ratio did not change. We conclude that similar to ARDS and sepsis, oxygen consumption may be pathologically dependent on oxygen delivery in patients who have severe acute respiratory failure secondary to AIDS-related PCP.
在急性呼吸窘迫综合征（ARDS）和脓毒症中，氧耗在病理上依赖于氧输送。我们探讨了在继发于艾滋病相关肺孢子菌肺炎（PCP）的严重急性呼吸衰竭患者中，氧耗是否依赖于氧输送。在5例患有艾滋病相关PCP、双侧弥漫性肺部浸润、无细菌感染证据、急性呼吸衰竭且需要机械通气（呼吸至少50%氧气时动脉血氧张力低于75 mmHg，呼气末正压大于10 cm H2O）的患者中，我们通过热稀释心输出量以及动脉血和混合静脉血氧含量计算来测定氧输送和氧耗。通过在1小时内输注2单位浓缩红细胞来增加氧输送。氧输送增加了22%（从638±204增至778±201 ml/min·m2，p≤0.006）。氧耗增加了11%（从134±34增至149±29 ml/min·m2，p≤0.02）。氧摄取率未改变。我们得出结论，与ARDS和脓毒症相似，在继发于艾滋病相关PCP的严重急性呼吸衰竭患者中，氧耗在病理上可能依赖于氧输送。
