Oxygen Delivery in Patients with Adult Respiratory Distress Syndrome Who Undergo Surgery. Correlation with Multiple-System Organ Failure

Cryer, J. G.; Richardson, J. David; Longmire-Cook, Sarah J.; Brown, Carly

doi:10.1097/00132586-199008000-00005

Cited by 2 publications

(2 citation statements)

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“…Clinical investigations in patients with sepsis support the concept of a pathologic supply dependence of oxygen uptake in this patient collective (outlined schematically in Fig. 6) [18,22,128,129]. Even though these results have been challenged for methodologic reasons (mathematical coupling of )02 and 1302 calculation), they are important for pathophysiologic considerations regarding therapy of sepsis patients, in particular under conditions of lactate formation.…”

Section: Fluid Balance and Oxygen Transportmentioning

confidence: 66%

Prevention and therapy of the adult respiratory distress syndrome

Temmesfeld-Wollbrück

Walmrath

Grimminger

et al. 1995

Lung

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The complex pathophysiology of adult respiratory distress syndrome (ARDS) makes preventive and therapeutic concepts difficult. Ample experimental evidence indicates that ARDS can be prevented by blocking systemic inflammatory agents. Clinically, only heparin, for inhibition of coagulation phenomena, is presently used among this array of approaches. Corticosteroids have not proven to be beneficial in ARDS. Alternative antiinflammatory agents are being proposed and are under current clinical investigation (e.g. indomethacin, acetylcysteine, alpha 1-proteinase inhibitor, antitumor necrosis factor, interleukin 1 receptor antagonist, platelet-activating factor antagonists). Symptomatic therapeutic strategies in early ARDS include selective pulmonary vasodilation (preferably by inhaled vasorelaxant agents) and optimal fluid balance. Transbronchial surfactant application, presently tested in pilot studies, may be available for ARDS patients in the near future and may have acute beneficial effects on gas exchange, pulmonary mechanics, and lung hemodynamics; its impact on survival cannot be predicted at the present time. Strong efforts should be taken to reduce secondary nosocomial pneumonia in ARDS patients and thus avoid the vicious circle of pneumonia, sepsis from lung infection, and perpetuation of multiple organ dysfunction syndrome. Optimal respirator therapy should be directed to ameliorate gas-exchange conditions acutely but at the same time should aim at minimizing potentially aggravating side effects of artificial ventilation (barotrauma, O2 toxicity). Several new techniques of mechanical ventilation and the concept of permissive hypercapnia address these aspects. Approaches with extracorporeal CO2 removal and oxygenation are being used in specialized centers.

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Section: Fluid Balance and Oxygen Transportmentioning

confidence: 66%

Prevention and therapy of the adult respiratory distress syndrome

Temmesfeld-Wollbrück

Walmrath

Grimminger

et al. 1995

Lung

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“…Multiple studies demonstrated the survivors of high stress situations induced by surgery, sepsis, trauma or cardiac insults achieved a higher cardiac index, oxygen delivery (DO2) and oxygen consumption (VO2) as compared to non-survivors (Heyland, 1996;, Bishop, 1993Edwards, 1989;Gilbert, 1986;Creamer, 1990;Hankein, 1991;Hayes, 1993;Kankein, 1987;Cryer, 1989). As a result of these findings, efforts were made to target these variables in an effort to improve outcomes of the critically ill.…”

Section: Therapeutic Targetsmentioning

confidence: 99%

Applied Physiology and the Hemodynamic Management of Septic Shock Utilizing the Physiologic Optimization Program

McGee¹,

Mailloux²

2012

Severe Sepsis and Septic Shock - Understanding a Serious Killer

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Oxygen Delivery in Patients with Adult Respiratory Distress Syndrome Who Undergo Surgery. Correlation with Multiple-System Organ Failure

Cited by 2 publications

References 0 publications

Prevention and therapy of the adult respiratory distress syndrome

Prevention and therapy of the adult respiratory distress syndrome

Applied Physiology and the Hemodynamic Management of Septic Shock Utilizing the Physiologic Optimization Program

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