Edwards J D
Intensive Care Unit, University Hospital of South Manchester, UK.
Crit Care Med. 1990 Jan;18(1 Pt 2):S45-8.
Management of shock is generally guided by hemodynamic data, but the true aim of therapy should be optimizing oxygen delivery (DO2) and consumption (VO2). Available data do not support the hypothesis that there is a single critical threshold of DO2 below which tissue hypoxia occurs; thus, DO2 and VO2 should be addressed for each patient. Interventions that raise BP, such as infused catecholamines, may actually decrease DO2, as can mechanical ventilation with PEEP. Therefore, the clinician should avoid responding solely to hemodynamic data and should direct interventions toward delivering the optimum amount of oxygen to the patient's tissues.
休克的管理通常以血流动力学数据为指导，但治疗的真正目标应该是优化氧输送（DO2）和氧消耗（VO2）。现有数据并不支持存在一个单一的DO2临界阈值，低于该阈值就会发生组织缺氧的假设；因此，应针对每位患者处理DO2和VO2。提高血压的干预措施，如输注儿茶酚胺，实际上可能会降低DO2，使用呼气末正压（PEEP）的机械通气也可能如此。因此，临床医生应避免仅根据血流动力学数据做出反应，而应将干预措施直接指向为患者组织输送最佳量的氧气。
