The dependency of oxygen consumption on oxygen delivery in critically ill postoperative patients is mimicked by variations in sedation.
The finding of a dependence of oxygen consumption on oxygen delivery in critically ill patients has encouraged interventions to increase oxygen delivery index (DO2I) to overcome tissue hypoxia. In individuals other factors may influence oxygen consumption index (VO2I) and DO2I and may cause an apparently dependent relationship. We studied the effects of sedation and temperature on the VO2I/DO2I relationship in 13 perioperative patients. Pooled data showed significant correlations between VO2I and DO2I (r greater than 0.6, p less than 0.05) but also between VO2I and sedation score (r greater than 0.7, p less than 0.05), but not VO2I and temperature (r less than 0.5). When VO2I was standardized for the effects of sedation score (SS), the relationship between VO2I and DO2I was lost (r less than 0.5). Seven of 13 patients had significant (p less than 0.05) correlations between VO2I and SS and six of 13 between VO2I and DO2I; when standardized for the effect of varying sedation, no relationships were significant. When interpreting oxygen transport data from critically ill patients, the effects of sedation but not temperature must be taken into account; otherwise a false impression of a dependent relationship between VO2I and DO2I may cause unnecessary treatment.
Boyd
O
O
General Intensive Care, St George's Hospital, London, England.
Grounds
M
M
Bennett
D
D
D001692:Biological Transport / Q000187:drug effects / Q000502:physiology; D001831:Body Temperature / Q000187:drug effects / Q000502:physiology; D016638:Critical Illness / Q000453:epidemiology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D007432:Intraoperative Period; D010101:Oxygen Consumption / Q000187:drug effects / Q000502:physiology*; D011184:Postoperative Period; D011446:Prospective Studies; D012044:Regression Analysis
D006993:Hypnotics and Sedatives