Beyond the lung: oxygen delivery and tissue oxygenation

Central Venous-to-Arterial Carbon Dioxide Partial Pressure Difference in Patients Undergoing Cardiac Surgery is Not Related to Postoperative Outcomes

“…This type of composite score has been used previously in studies evaluating the association between hemodynamic optimization and postoperative morbidity and mortality. 2,3,28 In the present study, incidence of complications seemed high, but they were close to those usually reported in the cardiac surgical area. 1,2,28,29 Most of these complications were related to arrhythmia, which are demonstrated to occur in up to 40% of cardiac surgical patients.…”

Pre‐operative fasting in adults and children: clinical practice and guidelines

“…Patients would often arrive in the anaesthetic room in a state of dehydration, exacerbated by other factors such as bowel preparation. The measurement of cardiac output and oxygen delivery allowed recognition of the detrimental effects of dehydration . From this concept arose modern individualised fluid therapy and stroke volume optimisation leading to improved outcomes, particularly in critically ill patients undergoing surgery.…”

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“…Hence, there is a consistent body of information suggesting that during CPB an unrecognized pattern of critically decreased peripheral oxygen supply may occur and that, as a result of this condition of circulatory failure, lactate production appears. As a matter of fact, the concept of critical Do 2 is based on the assumption that when a patient is perfused below the critical value, the oxygen consumption (Vo 2 ) becomes dependent on the Do 2 [14-16] and energy production is partially supplied by anaerobic glycolysis. As a result, lactate production increases and HL takes its course [17,18].…”