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Supranormal oxygen delivery in critical illness
1Saint Louis University Health Services Center, MO, USA.
New Horizons (Baltimore, Md.)
|August 1, 1997
Summary
Limited evidence supports using the pulmonary artery catheter (PAC) to increase oxygen delivery in critically ill patients. More research is needed to determine if this strategy improves outcomes in high-risk surgery or sepsis.
Area of Science:
- Critical care medicine
- Hemodynamics
- Physiology
Background:
- The pulmonary artery catheter (PAC) is used to monitor hemodynamic parameters.
- Augmenting oxygen delivery to supranormal levels is a debated strategy in critical illness.
Purpose of the Study:
- To review literature on using PAC to achieve supranormal oxygen delivery in critical illness.
- To assess the evidence for improved outcomes with this intervention.
Main Methods:
- Literature search of English language articles (1988-1996).
- Selection of articles relevant to supranormal oxygen delivery in critically ill patients.
- Analysis of study methodologies and patient outcomes.
Main Results:
- Inadequate evidence exists to confirm improved outcomes with PAC-guided supranormal oxygen delivery.
- Evidence is insufficient for both pre-operative high-risk surgery and post-SIRS interventions.
Conclusions:
- Further research is required before recommending PAC-guided supranormal oxygen delivery.
- PAC-guided intervention is not currently recommended for SIRS-related organ dysfunction.
- Randomized controlled trials are needed to evaluate outcomes and survival benefits.