Oxygen consumption and resting metabolic rate in sepsis, sepsis syndrome, and septic shock - PubMed (original) (raw)
Oxygen consumption and resting metabolic rate in sepsis, sepsis syndrome, and septic shock
G Kreymann et al. Crit Care Med. 1993 Jul.
Abstract
Objective: To test the hypothesis that variations in oxygen consumption (VO2) and resting metabolic rate reflect the severity of bacterial infections and reflect the development of sepsis syndrome and septic shock.
Design: Observational study with sequential measurements of VO2 and resting metabolic rate by expiratory gas analysis.
Setting: Medical intensive care unit.
Patients: Thirty patients, treated primarily for presumed bacterial infection, were examined on 118 treatment days.
Interventions: None.
Measurements and main results: VO2 and resting metabolic rate were measured by expiratory gas analysis. For mechanically ventilated patients, a measurement system was developed, based on a paramagnetic oxygen sensor, an infrared CO2 sensor, and digital signal averaging. Measurements in spontaneously breathing patients were performed with a metabolic monitor. Patients were assigned by clinical criteria to the following groups: sepsis, sepsis syndrome, and septic shock. The lowest VO2 value of each patient in each stage was evaluated. Mean VO2 in 15 patients with sepsis was 180 +/- 19 (SD) mL/min/m2, in 11 patients with sepsis syndrome 156 +/- 22 mL/min/m2, and in eight patients with septic shock 120 +/- 27 mL/min/m2 (p < .001). Mean resting metabolic rate in sepsis was +55 +/- 14%, in sepsis syndrome +24 +/- 12%, and in septic shock +2 +/- 24% (p < .001). Mean oxygen delivery (DO2) was 501 +/- 116 mL/min/m2 in sepsis, 515 +/- 186 mL/min/m2 in sepsis syndrome, and 404 +/- 96 mL/min/m2 in septic shock. Oxygen extraction (VO2/DO2) was highest in sepsis (0.39 vs. 0.33 in sepsis syndrome and 0.29 in septic shock). During recovery from sepsis syndrome or septic shock, a significant increase in resting metabolic rate to +61 +/- 22% was measured in nine patients.
Conclusions: In sepsis syndrome, VO2 and resting metabolic rate are enhanced by 30% compared with normal basal metabolism, but they are markedly reduced compared with uncomplicated sepsis. The higher VO2 in uncomplicated sepsis is flow independent. The noninvasive measurement of VO2 and resting metabolic rate by expiratory gas analysis therefore can be used as a quantitative staging and monitoring parameter for the development of sepsis syndrome and septic shock.
Similar articles
- Oxygen transport patterns in patients with sepsis syndrome or septic shock: influence of treatment and relationship to outcome.
Hayes MA, Timmins AC, Yau EH, Palazzo M, Watson D, Hinds CJ. Hayes MA, et al. Crit Care Med. 1997 Jun;25(6):926-36. doi: 10.1097/00003246-199706000-00007. Crit Care Med. 1997. PMID: 9201043 Clinical Trial. - Sequence of physiologic patterns in surgical septic shock.
Shoemaker WC, Appel PL, Kram HB, Bishop MH, Abraham E. Shoemaker WC, et al. Crit Care Med. 1993 Dec;21(12):1876-89. doi: 10.1097/00003246-199312000-00015. Crit Care Med. 1993. PMID: 8252893 - Different dosages of dobutamine in septic shock patients: determining oxygen consumption with a metabolic monitor integrated in a ventilator.
Schaffartzik W, Sanft C, Schaefer JH, Spies C. Schaffartzik W, et al. Intensive Care Med. 2000 Dec;26(12):1740-6. doi: 10.1007/s001340000635. Intensive Care Med. 2000. PMID: 11271080 Clinical Trial. - Oxygen consumption in septic shock: collective review.
Houtchens BA, Westenskow DR. Houtchens BA, et al. Circ Shock. 1984;13(4):361-84. Circ Shock. 1984. PMID: 6383653 Review. - [Is infection and septic shock caused by a global oxygen deficiency? An overview in 2 parts. 1: Infection and correlation between DO2 and VO2].
Ensinger H, Georgieff M. Ensinger H, et al. Anasthesiol Intensivmed Notfallmed Schmerzther. 1996 Apr;31(3):132-42. doi: 10.1055/s-2007-995889. Anasthesiol Intensivmed Notfallmed Schmerzther. 1996. PMID: 8672614 Review. German.
Cited by
- Sepsis-induced cardiomyopathy.
Romero-Bermejo FJ, Ruiz-Bailen M, Gil-Cebrian J, Huertos-Ranchal MJ. Romero-Bermejo FJ, et al. Curr Cardiol Rev. 2011 Aug;7(3):163-83. doi: 10.2174/157340311798220494. Curr Cardiol Rev. 2011. PMID: 22758615 Free PMC article. Review. - Effects of prolonged endotoxemia on liver, skeletal muscle and kidney mitochondrial function.
Porta F, Takala J, Weikert C, Bracht H, Kolarova A, Lauterburg BH, Borotto E, Jakob SM. Porta F, et al. Crit Care. 2006;10(4):R118. doi: 10.1186/cc5013. Crit Care. 2006. PMID: 16895596 Free PMC article. - Evaluation of Factors Associated with Hypermetabolism and Hypometabolism in Critically Ill AKI Patients.
Góes CR, Balbi AL, Ponce D. Góes CR, et al. Nutrients. 2018 Apr 19;10(4):505. doi: 10.3390/nu10040505. Nutrients. 2018. PMID: 29671764 Free PMC article. - Calcium Signaling in Interstitial Cells: Focus on Telocytes.
Radu BM, Banciu A, Banciu DD, Radu M, Cretoiu D, Cretoiu SM. Radu BM, et al. Int J Mol Sci. 2017 Feb 13;18(2):397. doi: 10.3390/ijms18020397. Int J Mol Sci. 2017. PMID: 28208829 Free PMC article. Review. - Disease progression in hemodynamically stable patients presenting to the emergency department with sepsis.
Glickman SW, Cairns CB, Otero RM, Woods CW, Tsalik EL, Langley RJ, van Velkinburgh JC, Park LP, Glickman LT, Fowler VG Jr, Kingsmore SF, Rivers EP. Glickman SW, et al. Acad Emerg Med. 2010 Apr;17(4):383-90. doi: 10.1111/j.1553-2712.2010.00664.x. Acad Emerg Med. 2010. PMID: 20370777 Free PMC article.
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical