Oxygen delivery in the pediatric surgical patient
Related Experiment Videos
1Section of Pediatric Surgery, UMMC, Women's Hospital, Ann Arbor 48107.
Insights
Maintaining oxygen delivery (DO2) is crucial for critically ill patients. This review examines the relationship between oxygen delivery and consumption, particularly in sepsis and ARDS.
Area of Science:
- Critical care medicine
- Physiology
Background:
- Oxygen delivery (DO2) is vital for critically ill patients.
- Therapeutic goals aim to maintain tissue perfusion and oxygenation.
- A biphasic relationship exists between oxygen consumption (VO2) and DO2 in normal physiology.
Purpose of the Study:
- To review the relationship between oxygen delivery and consumption.
- To discuss the potential existence of this relationship in sepsis and ARDS.
Main Methods:
- Literature review on oxygen delivery and consumption.
- Analysis of physiological relationships in critical illness.
Main Results:
- In healthy subjects, VO2 is stable until DO2 falls below a critical threshold.
- Mixed venous oxygen saturation monitors DO2 adequacy.
- Controversy exists regarding this relationship in sepsis and ARDS.
Conclusions:
- The DO2/VO2 relationship is complex in critical illness.
- Further research is needed to clarify these relationships in sepsis and ARDS.
Abstract:
Support of oxygen delivery (DO2) is central to the care of the critically ill. Whether through interventions designed to correct deviations in cardiac output, oxygenation, or hemoglobin content, the overall therapeutic goal is to maintain perfusion and oxygen delivery to the tissues. In normal animals and humans, there is a biphasic relationship between oxygen consumption (VO2) and delivery in which VO2 remains stable as long as sufficient oxygen is delivered. If oxygen delivery is reduced below a critical value (DO2 crit), then oxygen consumption decreases. The mixed venous oxygen saturation serves as an excellent monitor of the adequacy of oxygen delivery in relation to oxygen consumption. As discussed in this review, controversy exists as to whether such VO2/DO2 relationships exist in patients with sepsis or the adult respiratory distress syndrome.