Langeron O, Couture P, Mateo J, Riou B, Pansard J L, Coriat P
Department of Anesthesiology and Critical Care, Paris VI University, France.
Br J Anaesth. 1996 Jun;76(6):783-9. doi: 10.1093/bja/76.6.783.
The oxygen delivery (DO2) and consumption (VO2) relationship in brain-dead organ donors is unknown. Therefore, in a prospective study, we determined the DO2/VO2 relationship in 21 consecutive brain-dead patients. Patients were allocated to one of two groups, according to plasma lactate concentration: normal (group NL, n = 11) or high (> 2.5 mmol litre-1) (group HL, n = 10). VO2 was measured independently, using indirect calorimetry, under control conditions, during low DO2 challenge with PEEP administration, and high DO2 challenge with inflation of medical antishock trousers and volume expansion or blood transfusion, as required. Under control conditions, there were no significant differences between groups NL and HL in haemodynamic or oxygenation variables, both groups having a low VO2 (mean 114 (SD 21) ml min-1 m-2). In group HL there was a different DO2/VO2 relationship pattern, with a dependent VO2 only. The mean slope of the DO2/VO2 relationship was significantly higher in group HL than in group NL (0.12 (0.09) vs 0.04 (0.07), P < 0.05). We conclude that brain death was associated with a low VO2, and patients in group HL exhibited DO2/VO2 dependency which was not observed in patients in group NL.
脑死亡器官捐献者的氧输送（DO2）与氧消耗（VO2）之间的关系尚不清楚。因此，在一项前瞻性研究中，我们测定了21例连续脑死亡患者的DO2/VO2关系。根据血浆乳酸浓度，患者被分为两组之一：正常组（NL组，n = 11）或高乳酸组（> 2.5 mmol/L）（HL组，n = 10）。在控制条件下、给予呼气末正压（PEEP）进行低DO2刺激期间以及根据需要使用抗休克裤充气和容量扩充或输血进行高DO2刺激期间，使用间接热量测定法独立测量VO2。在控制条件下，NL组和HL组在血流动力学或氧合变量方面无显著差异，两组的VO2均较低（平均114（标准差21）ml·min-1·m-2）。在HL组中，DO2/VO2关系模式不同，仅存在依赖的VO2。HL组中DO2/VO2关系的平均斜率显著高于NL组（0.12（0.09）对0.04（0.07），P < 0.05）。我们得出结论，脑死亡与低VO2相关，HL组患者表现出DO2/VO2依赖性，而NL组患者未观察到这种情况。
