Oxygen delivery and outcome.
Perioperative haemodynamic optimization of high-risk surgical patients seems to be associated with a reduction in morbidity and mortality. There is, however, no evidence to support the use of treatment directed at achieving survivor values of oxygen delivery and consumption in critically ill patients after admission to intensive care. Mitochondrial dysfunction may be responsible for the inability of patients dying of sepsis to increase oxygen consumption and thus may explain why therapies directed at reducing mortality through increasing oxygen delivery have not been successful. In response to the recent controversy surrounding the risks versus benefits of pulmonary artery catheterization, current research is focusing on the development and evaluation of noninvasive methods to assess the adequacy of resuscitation.
Hayes
M A
MA
Department of Anaesthesia and Intensive Care, Chelsea and Westminster Hospital, 369 Fulham Road, London, SW10 9NH, UK.