Monitoring oxygen delivery in the critically ill.
An accurate assessment of regional tissue oxygen delivery (DO(2)) may help the intensivist to attenuate end-organ damage in critically ill patients. Transport of oxygen from the ambient air to the mitochondria occurs by convection and diffusion, and is tightly regulated by neural and humoral factors. This article reviews the basic principles of DO(2) and the abnormal oxygen supply-demand relationship seen in patients with shock. It also discusses approaches to monitoring DO(2), including clinical symptoms/signs, acid-base status, and gas exchange, which provide global assessment, as well as gastric tonometry, which may reflect regional DO(2). Some new experimental methods, such as near-infrared spectroscopy and positron emission tomography, are still in development but may in the future provide useful clinical devices for quantifying the adequacy of regional tissue oxygenation in critically ill patients.
Duke Scholars
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DOI
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Related Subject Headings
- Tissue Distribution
- Respiratory System
- Pulmonary Gas Exchange
- Oxygen Consumption
- Oxygen
- Hypoxia
- Humans
- Critical Illness
- Acid-Base Equilibrium
- 3202 Clinical sciences
Citation
Published In
DOI
ISSN
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- Tissue Distribution
- Respiratory System
- Pulmonary Gas Exchange
- Oxygen Consumption
- Oxygen
- Hypoxia
- Humans
- Critical Illness
- Acid-Base Equilibrium
- 3202 Clinical sciences