Oxygen consumption in the early postinjury period: use of continuous, on-line indirect calorimetry.
OBJECTIVE
To determine the patterns of oxygen consumption (Vo2) using indirect calorimetry (IC) for the first 24 hrs after serious blunt traumatic injury.


METHODS
Prospective, observational study.


METHODS
Surgical intensive care unit of a Level 1 trauma center.


METHODS
Sixty-six mechanically ventilated patients with blunt traumatic injury and Injury Severity Score >15.


METHODS
IC for 24 hrs postinjury. Patients were resuscitated to standard parameters of perfusion.


RESULTS
Mean patient age was 50.1+/-18.7 yrs with a mean Injury Severity Score 30.7+/-11.3). Mean Vo2 for all patients for the 24-hr study period was 168.5+/-29.5 mL/min/m2. The level of Vo2 was not related to Injury Severity Score, the number or combination of organ systems injured, or to the use of vasoactive agents. Patients >65 yrs of age had significantly lower Vo2 (P = .0038) compared with patients < or =50 yrs. Vo2 did not change over time after resuscitation to normal parameters of perfusion. Mean Vo2 was 156.5+/-63.2 mL/min/m2 in patients who developed multiple organ dysfunction, and 172.4+/-33.3 mL/min/m2 in those who did not develop multiple organ dysfunction (p = .16).


CONCLUSIONS
Seriously injured patients are hypermetabolic in the early postinjury period. The level of Vo2 is unrelated to injury severity or number of organ systems involved. Elderly patients can be expected to have lower levels of Vo2. Vo2 does not change significantly in response to resuscitation to normal parameters of perfusion. Vo2 measured by IC did not predict the development of multiple organ dysfunction.
Peerless
J R
JR
Department of Surgery, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Epstein
C D
CD
Martin
J E
JE
Pinchak
A C
AC
Malangoni
M A
MA
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002153:Calorimetry, Indirect / Q000379:methods*; D003422:Critical Care / Q000379:methods; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D009102:Multiple Organ Failure / Q000209:etiology; D009104:Multiple Trauma / Q000150:complications / Q000378:metabolism* / Q000628:therapy; D010101:Oxygen Consumption; D011446:Prospective Studies; D015203:Reproducibility of Results; D012121:Respiration, Artificial; D012151:Resuscitation; D012680:Sensitivity and Specificity; D013997:Time Factors; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000378:metabolism* / Q000628:therapy