title: Monitoring oxygen transport and tissue oxygenation.
abstract: OBJECTIVE
  To review recent publications in the field of oxygen delivery and tissue oxygenation. With few exceptions, we restricted our selection to clinical studies published in the English literature.
  
  
  RESULTS
  No major breakthroughs have occurred in the past decade in the diagnosis or treatment of tissue hypoxia. There is renewed interest in goal-directed resuscitation when applied early in the course of treatment. Monitoring metabolic markers of tissue hypoxia continues to hold great clinical interest, in particular, tissue PCO2, near infrared spectroscopy, base deficit and blood lactate concentration. Technical issues, however, seem to restrict the widespread use of many of these techniques.
  
  
  CONCLUSIONS
  There is an urgent need to develop methods to accurately and rapidly identify patients with tissue hypoxia. Perhaps the combination of gastric tonometry, near-infrared spectroscopy, urinary PO2 and continuous measures of mixed (or central) venous O2 saturation may provide the answer. An even more formidable task is that of developing effective therapy to correct tissue hypoxia while avoiding harm to the patient.
authors.affiliation: Pulmonary and Critical Care Medicine Division, The George Washington University Medical Center, Washington, DC 20037, USA. ggutierrez@mfa.gwu.edu
authors.forename: Guillermo
authors.initials: G
authors.lastname: Gutierrez
authors.forename: Marian E
authors.initials: ME
authors.lastname: Wulf-Gutierrez
authors.forename: H David
authors.initials: HD
authors.lastname: Reines