Relationship of mortality to increasing oxygen delivery in patients >or=to50 years of age

Abstract

Patients 50 to 75 yrs of age receiving a DO2 of > or =600 mL/min/m2 demonstrated a statistically significant (p=.01) improved survival rate over patients in the control group. Patients >75 yrs of age demonstrated no benefit from attempts to increase DO2 to >600 mL/min/m2, and they may have been overtreated as reflected by the lower O2ER values in this age group. Treating to an O2ER that reflects a balance between oxygen consumption and DO2 may be an alternative goal that allows individual titration.

Association of physical examination with pulmonary artery catheter parameters in acute lung injury *

“…This association has been reported previously (20,21), and a low SvO 2 has been associated with a greater inflammatory response and increased mortality (22). Therapy directed at increasing SvO 2 to normal levels may improve survival (23). Using ScvO 2 as a surrogate for SvO 2 is appealing because it does not require placement of a PAC.…”

Quantitative resuscitation in sepsis

“…This value is questionable given that the baseline mortality rates of the included studies were somewhat variable, as demonstrated in Table 1. [13][14][15][16][17] The implications of this study are in keeping with the Canadian Association of Emergency Physicians Sepsis Guidelines 18 recommendation for a quantitative resuscitation strategy. The implications are also consistent with the Surviving Sepsis Campaign 2008 Guidelines, 5 which specifically recommend early goal-directed therapy upon recognition of severe sepsis or septic shock, with the option to substitute mixed venous oxygen saturation in place of central venous oxygen saturation as the end point.…”

Prophylactic hemofiltration in severely traumatized patients: effects on post-traumatic organ dysfunction syndrome

“…The latter factors, which contribute to tissue hypoxia, may be aggravated by directly impaired oxygen utilization due to a decreased mitochondrial redox state induced, for example, by cytokines or activated complement factors [1,3]. Hence, the OER is usually reduced in critically ill patients with a hyperdynamic circulatory state and there still may be a hidden oxygen debt in spite of increased DO 2 [1,22,23,24].…”