高级检索
当前位置: 首页 > 详情页

Should Hyperoxia Be Avoided During Sepsis? An Experimental Study in Ovine Peritonitis

文献详情

资源类型:
机构: [1]Univ Libre Bruxelles, Dept Intens Care, Erasme Univ Hosp, Brussels, Belgium; [2]Sun Yat Sen Univ, Dept Intens Care, Canc Ctr, Guangzhou, Guangdong, Peoples R China; [3]Univ Verona, AOUI Univ Hosp Integrated Trust Verona, Anesthesia & Intens Care B, Dept Surg Dent Pediat & Gynecol, Verona, Italy
出处:
ISSN:

关键词: hemodynamics hyperoxia lactate-to-pyruvate ratio septic shock

摘要:
Objectives: Optimizing oxygen delivery is an important part of the hemodynamic resuscitation of septic shock, but concerns have been raised over the potentially deleterious effects of hyperoxia. We evaluated the impact of hyperoxia on hemodynamics, the microcirculation, and cerebral and renal metabolism in an ovine model of septic shock. Design: Randomized animal study. Setting: University hospital animal research laboratory. Subjects: Fourteen adult female sheep. Interventions: After induction of fecal peritonitis, sheep were randomized to ventilation with an Fio(2) of 100% (n = 7) or an Fio(2) adjusted to maintain Pao(2) between 90 and 120 mm Hg (n = 7, control). All animals were fluid resuscitated and observed until death. Measurements and Main Results: In addition to hemodynamic measurements, we assessed the sublingual microcirculation, renal and cerebral microdialysis and microvascular perfusion, and brain tissue oxygen pressure. Hyperoxic animals initially had a higher mean arterial pressure than control animals. After onset of shock, hyperoxia blunted the decrease in stroke volume index observed in the control group. Hyperoxia was associated with a higher sub-lingual microcirculatory flow over time, with higher cerebral perfusion and brain tissue oxygen pressure and with a lower cerebral lactate-to-pyruvate ratio than in control animals. Hyperoxia was also associated with preserved renal microvascular perfusion, lower renal lactate-to-pyruvate ratio, and higher Pao(2)/Fio(2) ratio. Conclusions: In this acute peritonitis model, hyperoxia induced during resuscitation provided better hemodynamics and peripheral microvascular flow and better preserved cerebral metabolism, renal function, and gas exchange. These observations are reassuring with recent concerns about excessive oxygen therapy in acute diseases.

语种:
被引次数:
WOS:
PubmedID:
中科院(CAS)分区:
出版当年[2017]版:
大类 | 1 区 医学
小类 | 2 区 危重病医学
最新[2023]版:
大类 | 1 区 医学
小类 | 2 区 危重病医学
第一作者:
第一作者机构: [1]Univ Libre Bruxelles, Dept Intens Care, Erasme Univ Hosp, Brussels, Belgium; [2]Sun Yat Sen Univ, Dept Intens Care, Canc Ctr, Guangzhou, Guangdong, Peoples R China;
通讯作者:
通讯机构: [1]Univ Libre Bruxelles, Dept Intens Care, Erasme Univ Hosp, Brussels, Belgium;
推荐引用方式(GB/T 7714):
APA:
MLA:

资源点击量:43389 今日访问量:0 总访问量:3120 更新日期:2024-09-01 建议使用谷歌、火狐浏览器 常见问题

版权所有©2020 四川省肿瘤医院 技术支持:重庆聚合科技有限公司 地址:成都市人民南路四段55号