Waxman K, Lazrove S, Shoemaker W C
Surg Gynecol Obstet. 1981 May;152(5):633-8.
Fifty-three high risk surgical patients were studied using invasive cardiorespiratory monitoring to gain physiologic perspective of the perioperative period. Multiple hemodynamic and oxygen transport variables were tracked through the preoperative, intraoperative and postoperative periods using frequent sequential measurements. Impairment of cardiac and pulmonary function was measured intraoperatively, but this was compensated by therapy, so that oxygen delivery was maintained. Nonetheless, there was a decrease in oxygen consumption intraoperatively due to decreased oxygen extraction. Postoperatively, there was an increase in cardiac output, oxygen delivery and oxygen consumption. It is postulated that the fall in oxygen consumption intraoperatively may result in a metabolic debt and that a hyperdynamic postoperative state represents the physiologic response necessary to repair the damage caused intraoperatively by relative cellular hypoxia.
对53例高危外科手术患者进行了研究，采用有创心肺监测以获取围手术期的生理学观点。通过频繁的连续测量，在术前、术中和术后阶段追踪多个血流动力学和氧输送变量。术中测量了心脏和肺功能的损害，但通过治疗得到了代偿，从而维持了氧输送。尽管如此，由于氧摄取减少，术中氧消耗仍有所下降。术后，心输出量、氧输送和氧消耗均增加。据推测，术中氧消耗的下降可能导致代谢亏欠，而术后高动力状态代表了修复术中相对细胞缺氧所造成损害所需的生理反应。
