Regional blood flow and oxygen transport in septic shock

E. Ruokonen, J. Takala, A. Kari, H. Saxen, J. Mertsola, E. J. Hansen

Research output: Contribution to journalArticle

276 Scopus citations

Abstract

Objective: To measure the blood flow distribution and regional oxygen transport in hyperdynamic septic shock during hypotension and after correction by vasopressor doses of dopamine or norepinephrine. Design: Prospective, randomized, controlled trial. Setting: Tertiary care center. Patients: Ten patients with hyperdynamic septic shock (ages ranging from 45.1 ± 16.6 yrs) and a control group of 11 postoperative cardiac surgery patients (ages ranging from 54.8 ± 7.9 yrs). Interventions: Systemic and regional hemodynamics and oxygen transport were measured in ten patients with hyperdynamic septic shock during hypotension and after vasopressor therapy (norepinephrine or dopamine). Oxygen consumption (V̇O2) was measured by indirect calorimetry and splanchnic and leg blood flow with indocyanine green infusion. Measurements and Main Results: Splanchnic blood flow and V̇O2 (p < .05) were increased in septic shock during hypotension and during vasopressor therapy. Both dopamine and norepinephrine increased systemic blood flow and V̇O2 independently of the arterial lactate level. Despite the relatively small changes in systemic oxygen transport, major regional changes occurred in oxygen delivery and V̇O2, and these changes were unpredictable from systemic changes. Conclusions: Regional changes in oxygen transport in septic shock cannot be predicted from the changes in the whole body. The increased oxygen demand in the splanchnic region is the main risk factor for splanchnic tissue hypoxia in septic shock.

Original languageEnglish (US)
Pages (from-to)1296-1303
Number of pages8
JournalCritical care medicine
Volume21
Issue number9
DOIs
StatePublished - 1993

Keywords

  • catecholamines
  • critical illness
  • dopamine
  • endotoxins
  • norepinephrine
  • oxygen consumption
  • regional blood flow
  • shock, septic/physiopathology/therapy
  • splanchnic circulation
  • tumor necrosis factor

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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    Ruokonen, E., Takala, J., Kari, A., Saxen, H., Mertsola, J., & Hansen, E. J. (1993). Regional blood flow and oxygen transport in septic shock. Critical care medicine, 21(9), 1296-1303. https://doi.org/10.1097/00003246-199309000-00011