The impact of inspired oxygen concentration on tissue oxygenation during progressive haemorrhage

Abstract

Hypoxaemia and hyperoxaemia both compromised haemodynamics and biochemical markers of organ perfusion during severe, progressive haemorrhage. This may carry implications for resuscitation practice.

Progressive hemorrhage: administer oxygen or early resuscitation?

“…As far as the first case is concerned, the impact of inspired oxygen concentration on tissue oxygenation (tPO 2 ) in the absence of resuscitation was the subject of a study from Dyson et al [8], published in this issue of the journal. The latter case is represented by hypoxemic resuscitation [9][10][11][12]; a process in which hypoxemia is applied during the first few minutes of resuscitation and, as shock reverses, it gradually turns to normoxemia.In the aforementioned study [8], tissue oxygenation improves at mild (less than 20%) blood volume losses similarly to normovolemia, in response to higher inspired oxygen admixtures. Adversely, at significant (more than 50%) blood volume losses, higher inspired oxygen admixtures lead to precipitous reduction of tissue oxygenation, similar to that of animals breathing in-room air.…”

“…In the aforementioned study [8], tissue oxygenation improves at mild (less than 20%) blood volume losses similarly to normovolemia, in response to higher inspired oxygen admixtures. Adversely, at significant (more than 50%) blood volume losses, higher inspired oxygen admixtures lead to precipitous reduction of tissue oxygenation, similar to that of animals breathing in-room air.…”

“…Likewise, a systemic review of animal studies [5] has also shown a lower risk of death in animals resuscitated to hypotensive levels than in animals resuscitated to normotensive levels (P \ 0.00001). The small volume resuscitation with fluids such as hypertonic saline [6] or albumin 25% [7] has similarly shown a higher survival rate compared with infusion of isotonic fluids.The approach of attempting to lessen reperfusion injury by adjusting the inspired O 2 may apply either before [8] or during [9-12] resuscitation. As far as the first case is concerned, the impact of inspired oxygen concentration on tissue oxygenation (tPO 2 ) in the absence of resuscitation was the subject of a study from Dyson et al [8], published in this issue of the journal.…”

“…The approach of attempting to lessen reperfusion injury by adjusting the inspired O 2 may apply either before [8] or during [9][10][11][12] resuscitation. As far as the first case is concerned, the impact of inspired oxygen concentration on tissue oxygenation (tPO 2 ) in the absence of resuscitation was the subject of a study from Dyson et al [8], published in this issue of the journal.…”

“…As far as the first case is concerned, the impact of inspired oxygen concentration on tissue oxygenation (tPO 2 ) in the absence of resuscitation was the subject of a study from Dyson et al [8], published in this issue of the journal. The latter case is represented by hypoxemic resuscitation [9][10][11][12]; a process in which hypoxemia is applied during the first few minutes of resuscitation and, as shock reverses, it gradually turns to normoxemia.…”