[Changes on hemodynamics and oxygen delivery in patients with septic shock]

Since there are still some confusions in hemodynamics and changes of oxygen delivery (DO2) in septic shock which has a high mortality, the 40 septic shock patients were observed in hemodynamics and DO2 in general ICU of Peking Union Medical College Hospital. Both surviving group and nonsurviving group had their hyperdynaminc state in hemodynamics at the beginning of septic shock. In survivors, hemodynamics were back to normal range at the 4th day of septic shock. But nonsurvivors were still in the hyperdynamic state all way to the end stage. A critical level of DO2, which was found only in survivors, was 670 ml/min.m2. The oxygen supply dependency of oxygen consumption (VO2) was found in nonsurvivors even DO2 was highly increased. The oxygen extraction (O2 ext) in nonsurvivors was lower than in survivors when DO2 was lower than critical level. We think that maintaining hyperdynamic state in septic shock does not certainly improve survival rate. In the septic shock patients with pathologic oxygen supply dependency, DO2 is not able to be increased to meet tissue oxygen demand. The changes of O2 ext have a significance in prediction of outcome of septic shock. The current therapies for septic shock have remarkable limitation. So the new treatment methods of septic shock, not only to increases DO2, should be found out for improving the survival rate further.