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- Role of Oxygen Debt in the Development of Organ Failure Sepsis, and Death in High-Risk Surgical Patients (14)

Many factors affect circulatory function and metabolism, such as age, trauma, sepsis, stress, nutrition, metabolic diseases such as diabetes, medications, anesthetic agents, drug abuse, hypovolemia, and other associated illnesses. These and many other influences may be operative and may limit circulatory compensations. Notwithstanding, it is the amount of the Vo2 debt that is related to organ failure and outcome. Moreover, oxygen debt is the earliest circulatory event observed with lethal and nonlethal organ failure.
In summary, data of the present study confirm previous concepts of inadequate tissue perfusion as an early mechanism responsible for postoperative shock. Data of the present study are consistent with tissue oxygen tension measurements using transcuta-neous, conjunctival, and subcutaneous oxygen sensors. These studies point to tissue hypoxia as thfc primary underlying physiologic event that produces organ failure and death. The increased cardiac output, Do2, and Vo2 may be physiologic compensations to the underlying tissue hypoxia. The practical clinical implication for physicians at the bedside is to augment the bodys natural compensations by further increasing Do2 to supranormal values. Specific criteria to evaluate and titrate the adequacy of therapy in the wide range of associated clinical circumstances require further documentation.

September 1, 2013 Oxygen
Tags: anesthesia cardiac output organ failure oxygen