Mohsenifar Z, Goldbach P, Tashkin D P, Campisi D J
Chest. 1983 Sep;84(3):267-71. doi: 10.1378/chest.84.3.267.
We evaluated the relationship between O2 delivery and oxygen consumption (VO2) in ten patients with the adult respiratory distress syndrome (ARDS) over the course of their illness (mean 7 +/- 5 days) while they were receiving positive mechanical ventilation with varying levels of positive end-expiratory pressure (PEEP). Mean values and standard deviations for O2 delivery and VO2 were 15.2 +/- 4.8 ml/min/kg and 4.1 +/- 1.2 ml/min/kg, respectively. In our ten patients, below an O2 delivery of 21 ml/min/kg, VO2 was linearly related to O2 delivery (VO2 = 0.32 X O2 delivery--0.53, n = 83, r = 0.76). However, at an O2 delivery rate higher than 21 ml/min/kg, there was no correlation between VO2 and O2 delivery. Mixed venous O2 content (CvO2) and arteriovenous oxygen content difference (C(a-v)O2) did not correlate with O2 delivery, nor was there a significant correlation between cardiac output (Qt) and mixed venous O2 tension (PvO2) or saturation (SvO2). We conclude that in patients with ARDS on mechanical ventilation with PEEP, VO2 and O2 delivery are linearly related except at high levels of O2 delivery. PvO2 and (C(a-v)O2) do not correlate with O2 delivery and are not sensitive indicators of tissue oxygenation in ARDS.
我们评估了10例成人呼吸窘迫综合征（ARDS）患者在疾病过程中（平均7±5天）接受不同呼气末正压（PEEP）水平的机械正压通气时，氧输送与氧耗量（VO2）之间的关系。氧输送和VO2的平均值及标准差分别为15.2±4.8 ml/min/kg和4.1±1.2 ml/min/kg。在我们的10例患者中，当氧输送低于21 ml/min/kg时，VO2与氧输送呈线性相关（VO2 = 0.32×氧输送 - 0.53，n = 83，r = 0.76）。然而，当氧输送速率高于21 ml/min/kg时，VO2与氧输送之间无相关性。混合静脉血氧含量（CvO2）和动静脉血氧含量差（C(a-v)O2）与氧输送无关，心输出量（Qt）与混合静脉血氧分压（PvO2）或血氧饱和度（SvO2）之间也无显著相关性。我们得出结论，对于接受PEEP机械通气的ARDS患者，除了在高氧输送水平外，VO2与氧输送呈线性相关。PvO2和（C(a-v)O2）与氧输送无关，且不是ARDS中组织氧合的敏感指标。
