Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về y học đề tài: The International Sepsis Forum’s frontiers in sepsis: high cardiac output should not be maintained in severe sepsis. | Critical Care August 2003 Vol 7 No 4 Sharma and Dellinger Commentary The International Sepsis Forum s frontiers in sepsis high cardiac output should not be maintained in severe sepsis Vinay K Sharma1 and R Phillip Dellinger2 Attending Physician Pulmonary and Critical Care Division Graduate Hospital Philadelphia Pennsylvania USA 2Chief Critical Care Section Cooper Health System Camden New Jersey USA Correspondence Vinay Sharma vinayks@ Published online 3 July 2003 Critical Care 2003 7 272-275 DOI cc2350 This article is online at http content 7 4 272 2003 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Abstract Abnormal oxygen utilisation is one of the features of septic shock. Some studies have observed that patients that survive septic shock tend to have higher cardiac output and oxygen delivery compared to those that do not. It has been proposed that higher than normal or supra-normal levels of cardiac output and oxygen deliver should be the goal in the management of septic shock. However randomised controlled trials have not been able to validate that such a goal provides a mortality or morbidity advantage. In this commentary we discuss the various reasons put forward by the proponents of this strategy and review the available evidence. Keywords cardiac output oxygen consumption oxygen delivery septic shock Introduction Septic shock is a syndrome characterized by abnormal oxygen utilization. It has been suggested that maintaining cardiac output CO above normal in patients with septic shock should increase oxygen delivery Do2 and oxygen consumption VO2 decrease any oxygen debt present and potentially improve survival. However the tissue extraction of needed oxygen is maintained even at very low levels of DO2. Furthermore Vo2 increases with increasing Do2 only up to a point. Thereafter subsequent increases in Do2 do not result in any further increase in Vo2 Fig. 1 . Attempts to increase the Do2 beyond this point are more .
