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Fluid loading increases oxygen consumption in septic patients with lactic acidosis
The American Review of Respiratory Disease
|June 1, 1985
Summary
Fluid loading increased oxygen delivery in septic patients. High initial lactate levels predicted improved oxygen consumption, indicating which patients benefit from fluids.
Area of Science:
- Critical Care Medicine
- Physiology
Background:
- Sepsis often causes circulatory failure.
- Fluid loading is a common intervention.
Purpose of the Study:
- To determine if fluid loading increases systemic oxygen delivery (DO2) and consumption (VO2) in septic patients.
- To identify predictors of response to fluid loading.
Main Methods:
- Prospective evaluation of 20 sepsis patients with circulatory failure.
- Monitoring DO2 and VO2 changes after fluid loading.
- Analysis of lactate levels as a predictor.
Main Results:
- Fluid loading increased DO2 in 70% of patients.
- Patients with increased VO2 (Group A) had higher initial lactate levels (4.9 mmol/L) than those without (Group B, 1.9 mmol/L).
- Six patients (Group C) showed decreased DO2 due to hemodilution, with elevated lactate (5.1 mmol/L) and no VO2 change.
Conclusions:
- Lactic acidosis predicts increased VO2 in septic patients responding to fluid loading.
- Lactate levels can guide fluid therapy decisions in sepsis.